الفهرس 
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Abstract
Polycystic ovary syndrome is a heterogeneous disorder that was first cribed by Stein and Leventhal in 1935. A clinical syndrome was identified that sisted of anovulation, hirustism, obesity and infeitility in association with aterally enlarged cystic ovaries.
It is extremely unlikely to find one single cause wheather genetic or ;ronmental of PCOD, so apolygenic background with involvement of both two ’tors can be involved in the pathogenesis of the disease as the ovary, the adrenal d and the hypothalamic pituitary axis.
The normal aberrations encountered in polycystic ovarian disease present as a ious circle of causes and events. The initiating and sustaining event is the biguity of the steroid signal influencing pituitary gonadotropin secretion. ppropriate feedback in the form of non-cyclic estrogen masks the usual datory recycling stimuli.
A growing body of evidence supports the view that PCOD is metabolic . rder that happens to have its principal manifestation as a reproductive ocrinopathy. The clinical spectrum is broad and extends from relatively normal nses to chronic oligomenorrhea or amenorrhea and from no hirustism to ’lization.
The diagnosis of polycystic ovarian disease depends on the clinical features, ratory investigations as gonadotropms, androgens and sex steroid levels in the ’e and plasma, also by ultrasonography MRl and laparoscopy.
By trans-vaginal ultrasonography, the ovary was considered as being . cystic if there were multiple small follicles (10 or more) 2-8 mm in diameter ther with increased echogenice stroma. These follicles are either peripherally d a hyperechogenic core of stroma described as ”Pearl necklace appearance ” follicles or scattered throughout it or both. The ovaries were usually but not ’ays enlarged. Endocrinological diagnosis of PCOD was based on elevated LH fu normal or decreased FSH: (reversed FSH: LH ratio more than 2.5. By ,~roscopy the typical features ofPCO (enlarged with thick white glistering capsule lost corrugations and stigmata of ovulation).
Different treatment modes have been tried to deal with defect. Among the erent medical therapies, clomiphene citrate appeared be the most successful and epted mode of treatment for these patients. Laparoscopic ovarian drilling by trocautery has been advocated as alternative treatment to exogenous therapy in anovulatory patients with PCOD failing to respond to dical induction of ovulation.
This study was conducted among Eighty patients, Preoperative hormonal file including FSH, LH, testosterone, androstenodione, free androgen index and m progesterone. Laparoscopical ovarian drilling ”LOD”: under general esthesia the pelvis was thoroughly inspected for any pathology &the ovaries were amined for the features of polycystic ovary, A diathermy needle was used to netrate the ovarian capsule at a number of points with the aid of a short burst of nopolar diathermy.
A standardized monopolar coagulation current set at 30W was applied for a ation of 5s per puncture giving a total thermal energy of 150j(30x5)per puncture.