ABSTRACT
Although the classic procedure of bilateral wedge resection of the ovaries was abandoned long ago because of problems associated with postoperative adhesions, the operation was in fact remarkably efficacious in terms of inducing ovulation. The development of less traumatic procedures performed through the laparoscope has therefore been a welcome addition to our therapeutic repertoire. Although the very patients most resistant to endocrine methods of induction of ovulation-the obese-are those least likely to be selected for surgical treatment, an operative approach has certain theoretical advantages over endocrine therapy. This is particularly the case with regard to the intrinsic and most serious problems of ovarian stimulation therapy, namely multiple pregnancy and ovarian hyperstimulation syndrome (OHSS). Ovarian hyperstimulation is particularly common in women with polycystic ovary syndrome, whether they are undergoing treatment with fertility drugs or by in vitro fertilization. A serious condition which may threaten the patient’s life, OHSS pales in significance when compared with the problems of multiple
physical, psychological and social morbidity of multiple pregnancy can be appalling. Multiple pregnancy is not a feature of the outcome of treatment by ovarian diathermy. In my opinion that single observation should feature very highly in any evaluation of the procedure.
