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Ovarian drilling with laparoscopy is a technique which may help women who have Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovaries (PCO) to ovulate normally, thus increasing their chances of pregnancy. Ovarian drilling is typically considered after several attempts at ovulation induction using clomid, or an insulin-sensitizing medication, such as metformin. Polycystic ovaries are generally smooth and pearl colored, and have many small immature follicles along the outside lining of the ovary. Women with either condition may have higher levels of testosterone in their bodies, which inhibits ovulation.
Ovarian drilling cauterizes the stromal theca cells in the ovary. The reduction of this testosterone-producing tissue leads to reduced testosterone levels in the body. Studies have reported that approximately 80% of women who underwent this surgery began ovulating regularly. Post surgery, women who did not regain ovulation, and were previously resistant to clomid citrate, were then more receptive to medical protocols. Pregnancy rates after ovarian drilling are reported as around 50%.
Ovarian drilling with laparoscopy is an out-patient surgery. Anesthesia is administered to the patient, and three small incisions are placed in the abdomen. The abdomen is inflated with gas to allow the physician to view the ovaries using a laparoscope. The drilling is done by cauterizing different parts of the ovary, and removing the unwanted tissue. The physician is able to explore the reproductive system during the laparoscopy, to determine if any additional issues may be present. When the procedure is done, a super glue-like adhesive is administered to the incisions, and the patient is able to go home to heal, after recovering from anesthesia.