Surgery to alleviate PCOS symptoms in women who are struggling to get pregnant is likely to be used only as a very last ditch resort. If a woman's ovulation cycle is irregular or if her periods have stopped completely, and she's thought to be suffering from PCOS, a variety of other methods will first be tried, to help her manage her condition.
These treatments include, for example, a weight loss and healthy eating regime designed to reduce high insulin levels in her body - if this is believed to be the root cause of her problems. Doctors may also use ovulation-inducing fertility drugs to help her ovulate regularly and increase her chances of becoming pregnant, or they may prescribe birth control pills - these will alleviate PCOS symptoms but are an obvious no-no if the patient is trying to pregnant.
Candidates For Surgery
Doctors will assess each individual PCOS case on its own merits, but generally speaking, you have to still be suffering from erratic or absent periods even after weight loss, fertility drugs and insulin-controlling medications have all been tried.
Some experts believe in offering surgery to PCOS patients who've already lost weight and used diabetes drugs to no avail. This is because these doctors think that surgery is preferable to ovulation-inducing drugs, in certain circumstances, because these drugs increase the chances of a multiple pregnancy (twins or triplets). The idea of having twins may seem like a problem solved to a PCOS patient struggling to conceive, but such pregnancies have inherent risks for both mother and babies.
The surgical procedure used to treat PCOS is called laparoscopic ovarian drilling, or LOD. The word "drilling" may sound a bit ominous, but this is a relatively non-invasive procedure that can almost always be performed on an outpatient basis.
Basically, after you've been given a general anesthetic, a surgeon makes several small cuts in your abdomen. He inserts a long thin tube with a tiny camera at the end through one hole - this allows him to watch what he's doing on a TV monitor. Through the other holes, he inserts surgical tools that allow him to burn away parts of the ovarian follicles using electrocautery (electrical energy) or a laser.
Risks and post-operative discomfort are minimal, and you will probably be allowed to go home that very same day.
Surgery Aims And Success Rates
The aim of the surgery is to destroy the parts of the ovaries that are producing too many male hormones (such as testosterone). This excess of testosterone can be a contributing factor to the development of the PCOS condition. The surgery also restores your hormonal balance by bringing down your levels of luteinizing hormone and increasing your production of follicle stimulating hormone. This should bring on normal ovulation and increase your chances of becoming pregnant.
Studies have found that LOD has a success rate of 80% in terms of restoring ovarian function, and that 50% of PCOS patients who have the surgery will become pregnant. Data for live births following the procedure is not available, but it's thought that the live birth rate may be less than 50%.