Laparoscopic ovarian drilling is a surgical treatment that helps women who have PCOS ovulate without medications. Read on to learn how this works.

Polycystic ovarian syndrome (PCOS) affects 10% of all women and is defined as follows with two of the three criteria:

  • Signs or symptoms of anovulation or oliogoovulation
  • Hyperandrogenemia (clinical or serological)
  • Ovarian ultrasound of >12 follicles in an ovary
  • Rule out “other causes”

Women with PCOS have ovaries that produce more androgens (male hormones) than normal. This is due to elevated levels of insulin which leads to the increase in production of androgen within the ovary. These high levels of androgen can hinder the development and release of eggs during ovulation.

Polycystic ovary syndrome (PCOS) can cause the body to produce too much testosterone and is associated with insulin resistance, and can lead to decreased fertility. High levels of testosterone can cause irregular menstrual cycles, and prevent ovulation hindering pregnancy.

PCOS patients should first try weight loss management and/or take different medications to help with conception. However, if these treatments are unsuccessful, ovarian drilling (as known as ovarian diathermy) could be the answer.

How does ovarian drilling work?

Ovarian drilling is a surgical treatment used to help women who have PCOS ovulate without medications. While the name may sound forceful, ovarian drilling is relatively simple and minimally invasive.

This laparoscopic procedure is performed under general anesthesia, where one of our highly trained physicians will insert a thin, lighted telescope through a small incision below the belly button. This allows the doctor to visually examine the patient’s ovaries and other internal pelvic organs.

Electrocautery or laser is then used to create small holes in the ovaries, destroying the thick ovarian stroma that contribute to excess testosterone production. This process decreases the amount of testosterone production allowing many women to ovulate more regularly thus boosting fertility without medications.

Approximately 50% of women will conceive within the first year following ovarian drilling. Unlike fertility medications that are to be taken repeatedly, ovarian drilling is a one-time treatment. Also, the risk of multiples is not as likely with ovarian drilling as with fertility medications. Even in cases where ovarian drilling fails to regulate the menstrual cycle and restore ovulation, it can be effective in helping the women respond better to fertility medications.

The first step is to schedule a consultation with one of our physicians at Brown Fertility to determine if one is a good candidate for laparoscopic ovarian drilling.


American Society for Reproductive Medicine: Ovarian Drilling for Infertility
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Attain Fertility: PCOS and Ovarian Drilling
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