Results of bilateral ovarian wedge resection in 47 cases of sterility

A T FNE-YEAR intervals in the past two decades, we have reported our observations on patients in whom we diagnosed bilateral polycystic ovaries.l* 2l 3 We have described a syndrome characteristic of this lesion and adapted a surgical technique which has proved satisfactory. Since our first successful operation in 1929, we have operated upon seventy-five patients for this condition with increasingly encouraging results. In this report, we summarize the results of wedge resection of bot,h ovaries in those patients in the group who complained primarily of sterility. In the past, the prognosis in sterile matings has rested chiefly upon the results of tubal patency tests and the examination of the semen. Fundamental though these tests may be, it is our opinion that insufficient emphasis has been placed upon the reproductive role of the ovaries. More recently, tests for ovulation, such as endometrial biopsy, basal body temperatures, pregnandiol determinations, and daily vaginal smears have been carried out by some physicians to determine the occurrence and time of ovulation? We believe too little attention has been given to changes in the ovaries themselves, particularly in women who do not conform to the ovulatory pattern. One of the conditions encountered in patients complaining of sterility and amenorrhea, and one too frequently unrecognized, is bilateral polycystic ovaries. In this condition, ovulation occurs very rarely, at long intervals, or not at all, as shown by repeated endometrial biopsies and vaginal smears, basal temperature charts, and suggested by the history of sterility. The prognosis for fertility in these women grows progressively worse unless suitable positive measures are taken. The symptoms which prompt the patient to seek advice are, in the order of their frequency : 1, amenorrhea ; 2, sterility ; 3, hirsutism ; 4, pain (rarely) ; and 5, menometrorrhagia (occasionally). Underdeveloped breasts, acne, and/ or obesity are more often discovered by the physician than observed by the patient. Many of these women are psychically depressed. Bilateral polycystic ovaries are associated with a definite syndrome which we have described previously.3 In this condition, amenorrhea is usually secondary in character. After puberty, and for a period of a few years, there