Polycystic ovarian syndrome (PCOS)

A post-coital test is carried out to see how well a woman's partner's sperm survives in her cervical mucus. She has to come to the clinic shortly after intercourse, and a sample of cervical mucus is examined under the microscope to check for the presence or absence of active sperm. It is unreliable and embarrassing and rapidly falling out of favour.

Gonadotropin treatment involves the woman taking a daily injection of FSH (follicle stimulating hormone-75-150 international units) and having regular ultrasound scans to monitor the development of the follicles (the little egg-containing sacs on the ovary).

When two or three follicles 16-20 mm in diameter are visible on ultrasound, ovulation should be triggered with an injection of hCG (human chorionic gonadotropin). The egg (or eggs) will be released about 35 hours later so the couple should have intercourse before then (or IUI - intra-uterine insemination - can be performed).

Laparoscopic ovarian diathermy
Laparoscopic ovarian diathermy (LOD) is a surgical treatment for PCOS, which is offered to women with clomiphene-resistant PCOS. It involves applying a short burst of diathermy (heat) or laser treatment to the surface of each ovary at multiple points. The hormone changes that this induces encourage the ovaries to ovulate spontaneously.

The laparoscopy is like a miniature telescope with a fibre optic system that is inserted through keyhole surgery into the abdomen, to examine the cavity, ovaries, outside of the tubes and the uterus.