Primary Amenorrhea isa condition in which a young woman has not started her menstrual periods by the age of 16-18. The principal features of polycystic ovarian syndrome (PCOS) are anovulation, resulting in irregular menstruation, amenorrhea, and ovulation-related infertility.

From January 2007 to June 2013 we conducted 2215 laparoscopies, out of which 605(27.6%) were infertile patients with PCOS who underwent Laparoscopy procedure as day surgery in the standard method under general anesthesia; among these patients one case had primary amenorrhea and infertility.

A twenty-two years obese patient referred to us with acne and Hirsutism. PCO was diagnosed by ultrasound & confirmed by laparoscopy. Laparoscopic findings showed normal uterus & patent tubes. Ovarian drilling was done after 6 months of conservative management. 3 months after the drilling the patient was conceived, delivered a full term baby and was menstruating for the first time 6 weeks after her delivery. PCOS is one of the most common female endocrine disorders. The patient underwent laparoscopy and ovarian drilling followed by clomiphene plus metformin and finally she conceived and regained her first cycle after her delivery. The reason could be that the drilling decreases the level of androgen, metformin makes the cells more sensitive to insulin and clomiphene increases the chance of ovulation as well. Clinicians in Sudan must consider PCOS as an important cause of primary amenorrhea and a common cause of primary infertility.