Laparoscopic ovarian drilling (ovarian diathermy) for PCOS
Surgery Overview
Laparoscopic ovarian drilling is a surgical treatment that can
trigger
ovulation in women with
polycystic ovary syndrome (PCOS). Electrocautery or a
laser is used to destroy parts of the ovaries.
This surgery is not commonly used. But it can be an option for
women who are still not ovulating after losing weight and trying fertility
medicines.
Ovarian drilling is usually done through a small incision (laparoscopy), with
general anesthesia. The surgeon makes a small cut
(incision) in the abdomen at the belly button. The surgeon then places a tube
to inflate the abdomen with a small amount of carbon dioxide gas so that he or
she can insert the viewing instrument (laparoscope) without damage to the
internal organs. The surgeon looks through the laparoscope at the internal
organs. Surgical instruments may be inserted through the same incision or other
small incisions in the pelvic area.
Because the incisions are so small, laparoscopy is often called
"Band-Aid surgery."
What To Expect After Surgery
If you have a laparoscopy procedure, you will likely go home the
same day and can do your normal activities within 24 hours. Your return to
normal activities will depend on how quickly you recover from surgery, which
may take a few days or as long as 2 to 4 weeks.
Why It Is Done
Ovarian drilling is sometimes used for women with PCOS who are
still not ovulating after trying weight loss and fertility medicine. Destroying
part of the ovaries has been reported to restore regular ovulation
cycles.1
How Well It Works
Studies of women with PCOS have shown that ovarian drilling
results in an 80% ovulation rate and a 50% pregnancy rate.1
Younger women and those with a
body mass index in the normal range are most likely to
benefit from laparoscopic ovarian drilling.2
Risks
Risks of laparoscopy include:
- Infection of the
incision.
- Bleeding from the incision.
- Internal
bleeding.
- Accidental injury to internal organs or major blood
vessels, from the laparoscope or surgical instruments.
- Pain after
the procedure, from inflating the abdomen with gas.
- Problems caused
by anesthesia.
- Adhesions or scarring inside the body.
What To Think About
No randomized controlled trials have been used to study this
treatment for starting ovulation:1
- Ovulation and pregnancy rates are based on
reports of about 1,000 women.
- Live birth rates, which are the true
measure of treatment success, are not available and are probably less than 50%.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- American College of Obstetricians and Gynecologists
(2002, reaffirmed 2008). Management of infertility caused by ovulatory
dysfunction. ACOG Practice Bulletin No. 34. Obstetrics and Gynecology, 99(2): 347–358.
- Stegmann BJ, et al. (2003). Characteristics predictive
of response to ovarian diathermy in women with polycystic ovarian syndrome.
American Journal of Obstetrics and Gynecology, 188(5):
1171–1173.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Kirtly Jones, MD, MD - Obstetrics and Gynecology |
|---|
| Last Revised | January 28, 2010 |
|---|
Last Revised:
January 28, 2010
American College of Obstetricians and Gynecologists
(2002, reaffirmed 2008). Management of infertility caused by ovulatory
dysfunction. ACOG Practice Bulletin No. 34. Obstetrics and Gynecology, 99(2): 347–358.
Stegmann BJ, et al. (2003). Characteristics predictive
of response to ovarian diathermy in women with polycystic ovarian syndrome.
American Journal of Obstetrics and Gynecology, 188(5):
1171–1173.
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