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DEAR DR. DONOHUE: I am writing in regard to the letter from the woman diagnosed with polycystic ovary syndrome.
I was diagnosed with Stein-Leventhal syndrome after many futile fertility treatments. My doctor performed an ovarian wedge surgery, and six months later I was pregnant. I conceived a second child 21 months after that.
I think polycystic ovary syndrome and Stein-Leventhal syndrome are the same. Why don't I ever read about the ovarian wedge surgery for infertile women with polycystic ovary syndrome?
— L.F.
Doctors Stein and Leventhal first described polycystic ovarian syndrome in 1937, and the name became Stein-Leventhal syndrome. Now it's most often called polycystic ovary syndrome. Those two doctors pointed out the salient features of the syndrome: enlarged ovaries studded with cysts, loss of menstrual periods, and obesity. Infertility was another common feature.
Doctors Stein and Leventhal also championed the surgical treatment of this syndrome — removal of a wedge of the ovary. The operation worked for some reason, but that reason wasn't appreciated until more recently. Removing the wedge decreased the production of male hormone, which is the basis of the syndrome.
Now that new information has shown that an overproduction of male hormone is the important cause of the syndrome, there are many medicines that can be used to treat it. The wedge removal isn't necessary. For one thing, it almost always caused only a transitory drop in male hormone production. For another, it was often associated with the formation of adhesions.
Taking medicines is much easier than having surgery and is a more reliable way to treat this illness, which now is known to have many features that were unrecognized in bygone years. One of those features is insensitivity to the action of insulin.
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