Ovarian Drilling Procedure
Once the surgeon is able to see your ovaries, he will do the ovarian drilling—the goal is to destroy the testosterone producing tissue of the ovary.
There are generally small follicles which are visible on the surface of the ovary; this is where the electrical or laser energy will be directed, as this is presumed to be the spots where hormone production is at its maximum.
Your surgeon will make anywhere from 4-20 holes in each ovary, which are approximately 3 millimeters wide and 3 millimeters deep. While surgeons generally choose to perform the ovarian drilling on both ovaries, there have been reports of successful treatment of only one ovary.
Your surgeon will attempt to keep the areas of ovarian drilling as far away from your fallopian tubes as possible to limit the chances of tubal scarring.
Some surgeons will wrap your ovaries with a specific dissolvable material to inhibit scar formation, but despite best efforts, adhesions around the tubes and ovaries do occur after ovarian drilling.
Success Rates for Ovarian Drilling
It has been noticed that success rates for this procedure tend to be better in patients who were at or near their ideal body rate as opposed to the patients who remained obese at the time of the surgery.
Success rates for future ovulation range from 53% to 92%, with a slightly higher success rate when using electrical energy, which tends to destroy more tissue.
More specifically, approximately 80% of patients who underwent ovarian drilling resumed ovulation, while nearly 50% were able to become pregnant.
Patients who are not ovulating after an ovarian drilling procedure have been shown, in many cases, to be more responsive to clomiphene citrate, even if they were previously impervious to the drug.
After Ovarian Drilling
After you have had laparoscopic ovarian drilling, you will likely go home the same day, and can resume your regular activities within 24 hours.
Your risks from this procedure include infections from the incision, bleeding from the incision, pain after the procedure, problems caused by anesthesia, adhesions or scarring inside the body or internal bleeding, although serious complications are rare.
If you have explored many other options for PCOS, with little or no success, ovarian drilling may be a treatment for you, giving you a possible 50% increased chance of being able to get pregnant.