Die operative Behandlung des polyzystischen Ovarsyndroms ist als laparoskopische ovarielle Thermokoagulation (Drilling, LOD) ein weit verbreitetes Verfahren. Der Stellenwert ist noch unklar. Langzeiterfolge mit ovulatorischen Zyklen über einen Nachbeobachtungszeitraum von bis zu 9 Jahren sind beschrieben. Schwangerschaftsraten sind unter LOD vergleichbar einer niedrig dosierten Gonadotropinstimulation über 3–6 Zyklen. Nachteile des LOD sind die Notwendigkeit eines operativen Eingriffs und postoperative Adhäsionsbildung. Bei Patientinnen mit schlechter Ansprechrate kann LOD die ovarielle Stimulierbarkeit verbessern.

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