What is Ovarian Drilling?
Ovarian drilling is a minimally invasive surgical procedure used to treat women with polycystic ovary syndrome (PCOS) who do not ovulate with first-line fertility medicines like clomiphene citrate.
It involves using laparoscopy to make small punctures in the ovarian surface to restore regular ovulation. This procedure improves hormonal balance and increases the chances of natural conception.
It involves using laparoscopy to make small punctures in the ovarian surface to restore regular ovulation. This procedure improves hormonal balance and increases the chances of natural conception.
Ovarian drilling is a safe and effective option for women with PCOS who have not responded to clomiphene treatment. It restores ovulation, reduces androgen levels, and improves fertility outcomes naturally. Consult your fertility specialist to understand if ovarian drilling is suitable for your treatment plan.
Symptoms of Clomiphene-resistant PCOS
Women with clomiphene-resistant PCOS may experience:
- Irregular menstrual cycles or absence of periods (amenorrhea)
- Infertility due to lack of ovulation
- Excess hair growth (hirsutism) on face, chest, or abdomen
- Acne and oily skin
- Weight gain or difficulty losing weight
- Multiple small cysts seen in ovaries on ultrasound
Procedure / Treatment
- Preparation: Done under general anaesthesia as a day-care or short-stay procedure.
- Laparoscopy: A thin telescope (laparoscope) is inserted through a small cut near the navel to view pelvic organs.
- Drilling: Using electrocautery or laser, 4-10 small holes are made in each ovary. This reduces the production of male hormones (androgens) and helps restart ovulation.
- Recovery: Patients can go home the same day or the next day with minimal discomfort and resume normal activities within a few days.
- Follow-up: Doctors assess ovulation post-procedure through hormone tests and ultrasound monitoring.
Prevention
There is no direct prevention for clomiphene resistance in PCOS. However:
Maintaining a healthy weight
Eating a balanced, low-glycemic diet
Regular exercise to improve insulin sensitivity
can reduce PCOS severity and improve ovulation rates naturally, potentially reducing the need for surgical intervention.
Benefits of Ovarian Drilling
- Induces ovulation in women resistant to clomiphene
- Minimally invasive with quick recovery time
- Reduces male hormone levels, improving symptoms like acne and excessive hair growth
- Increases chances of natural conception without further fertility medication
- Long-term effect with fewer multiple pregnancy risks compared to gonadotropin injections
Types of Ovarian Drilling
Laparoscopic Ovarian Drilling with Electrocautery: Most common method using electric current to puncture ovarian surface.
Laparoscopic Ovarian Drilling with Laser: Uses laser energy instead of electric current, causing less thermal damage.
Unilateral vs Bilateral Drilling: Depending on the ovarian response and surgical decision, drilling can be done on one or both ovaries.