Surgery for PCOS: When is it Necessary?

Surgery is not a first-line treatment for PCOS and is generally considered only when other treatments, such as lifestyle changes and medication, have not been successful, particularly for women struggling with infertility. The most common surgical procedure for PCOS is laparoscopic ovarian drilling.  

Laparoscopic Ovarian Drilling

• Procedure: This minimally invasive procedure involves making small incisions in the abdomen and inserting a laparoscope (a thin tube with a camera and light) to access the ovaries. The surgeon then uses a needle or laser to make small holes in the surface of the ovaries.  
• How it works: The procedure is thought to improve ovulation by reducing androgen production and altering the ovarian environment. This can help regulate menstrual cycles and increase the chances of conception.  
• Benefits: Ovarian drilling can be effective in restoring ovulation in some women with PCOS, particularly those who do not respond to fertility medications like clomiphene citrate. It is a minimally invasive procedure with a relatively short recovery time.  
• Risks: As with any surgical procedure, there are potential risks associated with ovarian drilling, including:
  • Infection.
  • Bleeding.
  • Scar tissue formation: This can potentially lead to pelvic pain or further fertility problems in rare cases.  
  • Ovarian damage.
  • Adhesion formation: This is the formation of scar tissue that can cause organs to stick together.  

When is Surgery Considered?

Surgery is typically considered for women with PCOS who:

• Are trying to conceive and have not been successful with other fertility treatments.
• Have not responded to ovulation induction medications.

Causes of PCOS

• Insulin resistance.  
• Hormonal imbalances.  
• Low-grade inflammation.  
• Genetics.

PCOS Symptoms

Physical Symptoms:

• Menstrual irregularities.  
• Hirsutism.  
• Acne.  
• Weight gain or difficulty losing weight.  
• Hair loss.  
• Skin problems.  
• Polycystic ovaries.
• Infertility.  

Emotional Symptoms:

• Mood swings.  
• Anxiety.  
• Depression.  
• Body image issues.  

When to See a Doctor

Consult a doctor if you experience:

• Irregular periods.  
• Signs of excess androgens.  
• Difficulty conceiving.  
• Symptoms of depression or anxiety.