Diagnosis and Treatments

Laparoscopic ovarian drilling (ovarian diathermy) for PCOS

Surgery Overview

Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women with polycystic ovary syndrome (PCOS) who have not responded to weight loss and fertility medication. Electrocautery or laser is used to destroy a portion of the ovaries. Laparoscopy is usually done with general anesthesia. A small incision is made in the abdomen at the navel. A needle is used to inflate the abdomen with a small amount of carbon dioxide gas so the laparoscope can be inserted without damage to the abdominal 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.

Some of the risks of laparoscopy include:

  • 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 the gas inflation of the abdomen.
  • Problems caused by anesthesia.

If you have a laparoscopy procedure, you can usually go home the same day and resume normal activities within several days. Your return to normal activities will also depend on how quickly you recover from surgery, which may take a few days or as long as 2 weeks.

Partial ovarian destruction has been reported to help ovulatory cycles begin again spontaneously. Ovarian drilling is done for women with PCOS who have not responded to weight loss and fertility medication.

Case series studies, though not randomized, of about 1,000 women with PCOS have reported that ovarian drilling results in an 80% ovulation rate and a 50% pregnancy rate.