Do I need surgery for polycystic ovaries?

For patients with polycystic ovary, they will not get pregnant even if they do not take contraceptive measures when they have sex, but this disease can make women infertile, so most people will cooperate with doctors for treatment after being diagnosed with polycystic ovary. This disease has no effect no matter whether it is medication or surgery, and can only be treated with traditional Chinese medicine. So, does polycystic ovary require surgery?

Does Polycystic Ovarian Disease Require Surgery?

The first step in treating polycystic ovary is to check the severity of the polycystic ovary, just like treating other female gynecological diseases. Generally speaking, doctors will only recommend polycystic ovary surgery when the condition is moderate to severe.

What tests should be done for polycystic ovary?

1. Endocrine examination

Blood endocrine examination is performed in the early follicular phase (2-4 days of the menstrual cycle) (vaginal ultrasound examination of amenorrhea patients without dominant follicles can be performed at any time), showing:

(1) Hyperandrogenism: Hyperandrogenism is the basic endocrine characteristic of testosterone (T), and testosterone (T) is usually moderately elevated. However, 20% to 30% of patients with PCOS do not have elevated androgen levels.

(2) Hyperprolactinemia: About 12% of PCOS patients have moderate elevation of prolactin (<50 μg).

2. Ultrasound examination

Ultrasound polycystic ovary syndrome is a clinical sign, which is not equal to polycystic ovary syndrome. However, in actual work, ultrasound diagnosis of polycystic ovary syndrome has become a very important position. It is recommended that experienced doctors perform vaginal ultrasound examination (unmarried women without sexual activity can undergo transrectal ultrasound examination) to detect ovarian morphology. The new ultrasound diagnostic criteria for polycystic ovary are that one or both ovaries have more than 12 follicles with a diameter of 2-9 mm and/or an ovarian volume greater than 10 ml. The diagnosis can be made if the follicles in one ovary meet this standard.

3. Diagnostic curettage

Endometrial biopsy performed a few days before menstruation or within 24 hours of menstruation showed that the endometrium was in the proliferative phase or hyperplasia without secretory changes. It is recommended that patients >35 years old should undergo routine curettage to detect atypical endometrial hyperplasia or endometrial cancer at an early stage.

4. Laparoscopy

It can be seen that both ovaries are multicystic and enlarged, the capsule is thickened and grayish white, and there are no signs of ovulation (ovulation orifice, corpus luteum or bloody body). The diagnosis can be confirmed by taking ovarian tissue under laparoscopy and sending it for pathological examination. Due to the widespread use of vaginal ultrasound, laparoscopy is not used as a diagnostic method for polycystic ovary syndrome, but as a treatment method.

5. Other examinations

Basal body temperature measurement: For those with irregular menstruation or continuous spotting, basal body temperature measurement is required, which is mostly manifested as single-phase urine 17-hydroxy, 17-ketosteroid measurement; it can be slightly higher or normal. If it is significantly elevated, it indicates hyperadrenal function, oral glucose tolerance test (OGTT) and insulin release test; usually 75g of glucose is taken orally, blood is drawn on an empty stomach in the morning, and blood is drawn again 1 hour and 2 hours after taking the glucose to measure the levels of glucose and insulin in the blood.

Polycystic ovary surgery

Laparoscopic ovarian drilling (LOD): including ovarian electrocautery drilling, cutting, laser treatment, ultrasonic scalpel ovarian drilling and transvaginal water injection laparoscopic ovarian drilling. After LOD surgery, endocrine abnormalities in infertile patients with PCOS were significantly improved, serum T and LH levels were reduced, and the LH/FSH ratio decreased. The ovulation rate and pregnancy rate were significantly improved after surgery. LOD has the advantages of less trauma, low incidence of pelvic adhesions, and high pregnancy rate after treatment.