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Ovarian drilling for Poly Cystic Ovaries

What is Ovarian Drilling ?

Ovarian Drilling, also known as Laparoscopic Ovarian Drilling, is a surgery performed in the ovaries to stimulate ovulation in women suffering from Polycystic Ovary Syndrome (PCOS). This surgical procedure is usually performed using minimally invasive laparoscopic procedures where a laser beam or a surgical needle will puncture the membranes around the ovary.

The ability to conceive is related to the number of punctures done and around 5 – 10 punctures have been found to produce the desired conception. Ovarian drilling is performed laparoscopically and either transumbilical, using culdoscopy or transvaginal using fertiloscopy

Advantages

Some of the advantages that Ovarian Drilling provides over other treatment options are:

  • Faster time to pregnancy
  • Reduced need for ovulation-induction drugs
  • Takes into consideration the patient’s comfortability
  • Cost-effective
  • Possibility to be performed ambulatory.

When it is needed?

Ovarian Drilling is usually recommended for women suffering from PCOS who has problems in ovulating even after losing weight and being prescribed fertility medicine. This procedure is also known to provide a higher chance of pregnancy for patients who were not responding to medications like clomiphene earlier.


What Actually Happens ?

During the ovarian drilling procedure, the ovarian follicles and part of the ovarian stroma are destroyed. This leads to an increase in the production of the hormone FSH, which will in turn help restore the ovulation function.

Ovarian Drilling will also increase the blood flowing into the ovaries, thus allowing a high delivery of gonadotrophins and post-surgical local growth factors that will help increase the chances of getting pregnant.

Procedure

The procedure mainly involves the surgeon in first administering general anesthesia to the patient, which will render the patient unconscious throughout the surgery. The surgeon will then create tiny incisions in the abdomen near the belly button.

A tube is first inserted into the abdomen through one of these tiny incisions. Then, a small permissible amount of carbon dioxide is passed through this tube, which will push the other internal organs away from the ovaries allowing the surgeon a better viewing angle. This will not damage any of the other internal organs in any way.

Once the surgeon is able to get a good view of the operatable area, an electrical cautery dissector will be inserted through one of the other incisions and used to perform the electrocoagulation. The punctures done on the ovarian cortex are usually 4–10 mm deep and 3 mm wide. 

Ovarian drilling with laparoscopy is an outpatient procedure lasting 1-3 hours, plus 1-2 hours of recovery time. Patients can return to work or their normal activities within a week.


Risk Factors

In very rare cases, some patients have experienced some of the following risk factors:

  • Multiple Births
  • Pelvic adhesion formation
  • Hemorrhage
  • Gas embolism
  • Pneumothorax 
  • Premature ovarian failure
  • Long-term ovarian function
  • Developing hyper-stimulation syndrome

     

 

Authored By Dr. Sunil Eshwar Medical disclaimer: For information purposes only

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