Laparoscopic Ovarian Drilling to Treat PCOS and Infertility

A polycystic ovary syndrome (PCOS) diagnosis may mean that your body has been producing too much testosterone and insulin, leading you to have problems with fertility. High insulin and testosterone levels can lead to an irregular menstrual cycle due to ovulation issues, hindering your pregnancy efforts. PCOS treatments such as ovarian drilling regulate hormone levels and improve ovulation and menstrual cycles, increasing your chances of getting pregnant.

How It Works

Ovarian drilling is one of several surgical methods that healthcare providers have used to treat PCOS. However, it is the only surgical option for PCOS-caused infertility. It is a second-line treatment option for infertility, after medication options.

In women with PCOS, the ovaries may develop a thick outer surface that can affect ovulation. Ovarian drilling breaks through a thick outer layer and boosts fertility. Many women ovulate more regularly after ovarian drilling since testosterone production is directly affected. Contrary to the scary name, Ovarian Drilling is actually a relatively simple and minimally invasive procedure, here is how it works:

• Performed under general anesthesia
• Typically done on an outpatient basis with minimal recovery time, so you will go home the same day.
• Surgeon makes a small incision below the belly button.
• A tube is inserted into the abdomen, filling it with carbon dioxide and inflating the abdomen to prevent damage to the internal organs and let the surgeon better visualize the abdominal organs.
• A thin telescopic camera is inserted into the abdomen, allowing the surgeon to view the internal organs and ovaries on a connected monitor.
• Another incision allows the surgeon to place special instruments in the abdominal cavity to perform the actual procedure.
• Using the camera as a guide, special tools are inserted into the abdomen where an electric current or laser is used to make very small holes on the ovaries to destroy a small portion of thickened tissue.

The theory is similar to that of Ovarian Wedge Resection; by destroying ovarian tissue and reducing androgen production (male hormones), you can better manage PCOS symptoms.

Risks

Ovarian drilling is not frequently used due to the risk of ovarian scarring, so make sure to get a second opinion and exhaust all other treatment options (like weight loss and medications) before proceeding with the procedure. Other risks associated with this procedure include:

• Bleeding and pain
• Development of adhesions or scar tissue on your pelvic organs
• As with any surgery, there is minimal risk of infection and death
• Some anesthesia-related risks
• Too much of the ovary could be destroyed cause egg supplies to diminish at a young age, starting the onset of early menopause.
• Scar tissue can form between the ovaries and fallopian tubes, making conception even more difficult.

Success Rates

Pregnancy success rates from ovarian drilling range at around 61%. A few studies have shown that success rates are higher in women within the normal range for body mass index (BMI). In most cases, the risks of ovarian damage and other complications do not outweigh the benefits of the surgery. Make sure to discuss the procedure and the associated risks and benefits with your healthcare provider before having any type of surgery.