A 32-year-old woman undergoes laparoscopic ovarian drilling for clomiphene-resistant PCOS. Which statement best describes the mechanism by which ovarian drilling restores ovulation?

• A Destruction of ovarian follicles releases androgens that stimulate new follicular recruitment
• B Induction of ovarian adhesions enhances local blood flow to remaining follicles
• C Reduction in ovarian androgen-producing tissue lowers local androgens, improving FSH sensitivity ✓
• D Thermal destruction of theca cells eliminates all ovarian steroidogenesis permanently

Explanation

Ovarian drilling destroys a portion of androgen-producing ovarian stroma (theca-interstitial cells), reducing intraovarian androgen concentration. This restores FSH sensitivity in granulosa cells, enabling monofollicular recruitment. It does not eliminate all steroidogenesis permanently, and adhesion formation is a complication, not the mechanism.

Reference: Bailey and Love's Short Practice of Surgery / Textbook of Gynaecology, Standard ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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