Effect of Laparoscopic Ovarian Drilling On Hormonal Profile of Patients With P.C.O.D

Abstract

Gross sclerocystic changes in the ovary were related by Stein and Leventhal, in 1935, to a clinical syndrome consisting of "menstrual irregularity featuring amenorhea, infertility, hirsutism, retru•ded breast development and obesity". During the past few years, the term "Stein and Leventhal syndrome" has fallen into disuse and "polycystic ovru•ian disease PCOD" has been adopted as the generic description for a broad spectrum of abnormalities in women with endocrine dysfunction, especially abnormal • androgen metabolism and production. Because the disease is not well defined, and the understanding of the functional aberration causing the disease is incomplete, the comparison of different modes of therapy is difficult. It is extremely unlikely that we shall t1nd one single cause, genetic or environmental of PCOD. So, we can expect a polygenic background with involvement of both genetic and environmental factors involved in the• pathogenesis of the disease. It was stated that the classic anatomic appearance of ovaries in PCOD consist of bilateral enlargement and a thickening of tuinca albuginea and the ovarian cortex was filled with subcapsular follicular cysts. Thecal hyperplasia occurs in the majority of the follicles in PCOD patients. Pathophysiology of PCOD including abnormal and excess androgen metabolism, hirsutism, menstrual irregularities, infertility, obesity and enlmged ovru•ies, with increase in hormonal levels of LH, El & Androgens with low FSH, E2 levels and rather normal prolactin and DHA levels. PCO has a histological feature of multiple microcysts with atretic and immature follicles, fibrosis, thickening and sclerosis of the ovarian capsule.