Recognition of abnormal ovarian structure occurred well before any understanding of ovarian function. Polycystic ovaries (polycystic ovary syndrome, PCOS) were described as early as the nineteenth century. Gross sclerocystic changes in the ovary were described by Chereau in 1845. An association of ovarian morphology and menstrual function emerged and with it, proposals for treatment. Surgical management with ovarian resection became a standard of care in the late 1890s in Europe by Gusserow and Sweifel. In the American literature, Finley described a “cystic degeneration of the ovary” in 1904.1 Though the etiology of this degeneration was unclear, he proposed that partial wedge resection was appropriate management for restoration of menses. The general thinking at the turn of the century was that the polycystic appearance of the ovaries and its impact on menstruation, ovulation, and reproduction was anatomic in origin and required surgical management.