Ovarian drilling is a surgical procedure used as a treatment for polycystic ovarian syndrome; its main effect is to reduce the amount of male hormone, testosterone, which is abnormally produced by the ovaries in a PCOS sufferer. The procedure is carried out using keyhole techniques so only a small incision is required. Once gas has been used to inflate the abdomen, it is possible to see the ovaries clearly using a magnifying laparoscope to enlarge the image on a TV screen. Now clearly visible, the ovaries can be punctured between four and 10 times using either a laser or an electrosurgical needle. This puncturing has the effect of reducing testosterone production for the dual purpose of alleviating the PCOS symptoms and encouraging ovulation.
The success of the operation will depend on a number of factors including whether the patient is a normal body weight. However, recent studies report that up to 80 per cent of women find they ovulate following the procedure. In addition, many patients who have been previously unresponsive to treatment with clomiphene or metformin find that the medication is more effective following the procedure.
As with all surgery, there are some risks involved, particularly the risk of adhesions forming on the ovaries and fallopian tubes – although a special dissolvable material can be used to limit scar formation. The risks are also kept to a minimum because keyhole surgery is generally much safer; most patients will find they can go home from hospital the same day and have a short recovery time.