Laparoscopic treatment of polycystic ovaries: is its place diminishing?
OBJECTIVE
The purpose of this review is to provide a critical discussion on the place of laparoscopic ovarian drilling and medical treatment with metformin for polycystic ovary syndrome.


RESULTS
Laparoscopic ovarian drilling remains popular. It is associated with an ovulation rate of approximately 80% and a pregnancy rate of 50-60% within 1 year of the procedure. The technique results in a decrease in ovarian stromal blood flow. An increasing amount of data, however, suggests that treatment with metformin is equally as effective. The use of metformin in pregnancy appears to be safe; it decreases the miscarriage rate and possibly the incidence of gestational diabetes.


CONCLUSIONS
Laparoscopic ovarian drilling and metformin improve ovulatory dysfunction and pregnancy rate to a similar extent. The advantages of metformin continue beyond conception. It reduces the miscarriage rate and also decreases the likelihood of developing gestational diabetes. A randomized trial comparing the effects of metformin and laparoscopic ovarian drilling in women with polycystic ovary syndrome is recommended.
Al-Fadhli
Raedah
R
Department of Obstetrics and Gynecology, McGill University, Canada.
Tulandi
Togas
T
D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D010535:Laparoscopy / Q000379:methods*; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use; D010053:Ovary / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy / Q000601:surgery*; D011247:Pregnancy; D018873:Pregnancy Rate
D007004:Hypoglycemic Agents; D008687:Metformin