Ovarian Drilling

Ovarian drilling is a procedure that may help induce ovulation. It has also been referred to as “surgical induction of ovulation”. This procedure is reserved for women with polycystic ovarian syndrome (PCOS) who have failed to ovulate with maximum doses of clomiphene (clomid). A laparoscopy is performed and tiny holes are “drilled” into both ovaries either with a laser or an electrosurgical needle. Laparoscopy is a surgical procedure that is performed under general anesthesia with you asleep. Patients are discharged home the same day. We do not completely understand why this procedure helps, but current evidence suggests that it may work by decreasing the amount of a male hormone (testosterone) that is produced by the ovaries. A decrease in ovarian testosterone production may facilitate ovulation.

Not all women who are resistant to clomiphene are candidates for ovarian drilling. Your doctor will determine whether or not you might benefit from this procedure. There are risks both from the laparoscopy and from the ovarian drilling that your doctor will discuss with you prior to the surgery. Approximately 80-85% of women will ovulate, either spontaneously or with clomiphene, after ovarian drilling. However, not all women who ovulate will get pregnant. The other alternative to ovarian drilling in clomiphene-resistant patients is the use of gonadotropin fertility drugs to stimulate ovulation. Current evidence suggests that ovarian drilling and gonadotropon therapy result in similar pregnancy rates, but ovarian drilling appears to have a lower risk of multiple births.