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Laparoscopic Ovarian Drilling

Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women with polycystic ovary syndrome (PCOS). Electrocautery or a laser is used to destroy parts of the ovaries. This surgery is not commonly used. But it can be an option for women who are still not ovulating after losing weight and trying fertility medicines. 

Ovarian drilling is usually done laparoscopically under a general anaesthetic. The surgeon makes a small cut (incision) in the abdomen at the belly button. The surgeon then places a tube to inflate the abdomen with a small amount of carbon dioxide gas so that he or she can insert the viewing instrument (laparoscope) without damage to the internal organs. The surgeon looks through the laparoscope at the internal organs. Surgical instruments may be inserted through the same incision or other small incisions in the pelvic area. 

Ovarian drilling

Appearance of an ovary after ovarian diathermy

What to expect after surgery

If you have a laparoscopy procedure, you will likely go home the same day and can do your normal activities within 24 hours. Your return to normal activities will depend on how quickly you recover from surgery, which may take a few days or as long as 2 to 4 weeks.

Why it's done

Ovarian drilling is sometimes used for women with PCOS who are still not ovulating after trying weight loss and fertility medicine. Destroying part of the ovaries has been reported to restore regular ovulation cycles.

Success of ovarian drilling

Studies of women with PCOS have shown that ovarian drilling results in an 80% ovulation rate and a 50% pregnancy rate. Ovulation and pregnancy rates are based on reports of about 1000 women. Live birth rates, which are the true measure of treatment success, are not available and are probably less than 50%. Younger women and those with a body mass index (BMI) in the normal range are most likely to benefit from laparoscopic ovarian drilling.

Risks

  • Infection of the incision
  • Bleeding from the incision
  • Internal bleeding
  • Accidental injury to internal organs or major blood vessels, from the laparoscope or surgical instruments
  • Pain after the procedure, from inflating the abdomen with gas
  • Problems caused by anesthesia
  • Adhesions or scarring inside the body
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