Laparoscopic Ovarian Drilling for PCOS

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Laparoscopic ovarian drilling is a surgical option for selected women with polycystic ovary syndrome who do not ovulate and have not responded appropriately to medical ovulation treatment. Small controlled points are made on the ovarian surface using heat or another surgical energy method.

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When May It Be Discussed?

- Confirmed PCOS with persistent anovulation
- Inadequate response or unsuitable response to ovulation medicines
- A need for laparoscopy for another pelvic indication
- An individual treatment plan in which the expected benefit outweighs surgical risks

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Why Is It Not a Routine First-Line Treatment?

Ovulation medicines are generally considered before surgery. Ovarian drilling may create pelvic adhesions and can potentially affect ovarian tissue, so the number and extent of punctures must be carefully controlled.

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Procedure and Follow-Up

1. Preoperative fertility and general-health assessment
2. Laparoscopy under anaesthesia
3. Inspection of the pelvis and ovaries
4. Controlled treatment of the ovarian surface
5. Recovery and postoperative review
6. Cycle monitoring to assess whether ovulation resumes

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Possible Risks
- Bleeding or infection
- Anaesthesia-related complications
- Injury to pelvic structures
- Adhesion formation
- Reduction in ovarian reserve if excessive tissue is affected
- No improvement in ovulation