Laparoscopic Ovarian Drilling (Ovarian Diathermy) for PCOS

Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women who have 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 through a small incision (Laparoscopy ), with general anesthesia. 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.

Because the incisions are so small,laparoscopy   is often called “Band-Aid surgery.”

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.

Is ovarian drilling safe?
There are some risks associated with ovarian drilling, as outlined below.

  • There is a minimal risk of bleeding, infection, and death, like with most surgeries.
  • Risks of anesthesia are also present.
  • Tools used during the procedure could damage your internal organs.
  • Your doctor could destroy too much of the ovary. This could cause your egg supply to diminish at a young age, sending you into early menopause.
  • Scar tissue can form between the ovaries and fallopian tubes. This can make conception even more difficult after the surgery.

Due to these factors, ovarian drilling is only advised for women whose fertility problems stem from PCOS. It is also only indicated for women with PCOS who have not had success with other fertility treatments.

Why It Is 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 may restore regular ovalution cycles.

How Well It Works

For women who do not respond to treatment with medicine, such as clomiphene, about 50% of them may be able to become pregnant after they have ovarian drilling surgery. Amer et al (2002) showed a significant reduction in miscarriage rates after laparoscopic ovarian drilling (from 54% to 17%).