Surgical and Non-Surgical Treatment Options in Polycystic Ovary Syndrome Cases: A Meta-Analysis

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder with significant reproductive and metabolic consequences. This meta-analysis assessed surgical and non-surgical interventions by synthesizing findings from randomized controlled trials and comparative studies published between 2013 and 2023. The analysis focused on lifestyle modification, pharmacological therapy, and surgical approaches such as laparoscopic ovarian drilling (LOD). Lifestyle strategies, including dietary change and structured exercise, demonstrated consistent improvements in insulin sensitivity, weight management, hormonal balance, and psychological well-being, although evidence on live birth rates was less consistent. Pharmacological agents, particularly letrozole, showed higher effectiveness than clomiphene citrate in achieving ovulation, pregnancy, and live birth rates, while also lowering the risk of multiple pregnancies. Surgical interventions were effective in clomiphene-resistant cases but carried risks such as adhesion formation, limiting their role to selected patients. The evidence indicates that lifestyle modification and pharmacological therapy should be prioritized as first-line treatments, with surgical procedures reserved for women who do not respond to medical approaches. These findings provide guidance for patient-centered clinical decision-making in PCOS management