A number of surgical techniques can be used for treating polycystic ovaries. The aim of these techniques is to improve the woman’s response to drugs to stimulate ovulation. Sometimes a woman will go on to ovulate naturally following on from one of these procedures, without needing any ovulation induction drugs. The umbrella term for the various techniques is surgical pre-treatment of the ovaries and the most poplar of these and the one that I practice is called laparoscopic ovarian drilling (LOD). The typical woman where I recommend LOD is a woman who fails to respond to Clomiphene. LOD is a successful operation but only with careful patient selection. Many women with PCO have a struggle with their weight and unfortunately the results of LOD for women who are seriously overweight (BMI 30+) carries a low chance for success.
The operation involves making a series of punctures in the surface of the ovary with a laparoscopic needle attached to monopolar diathermy. Typical I will make eight punctures in each ovary to a depth of about 5mm. As with all laparoscopic surgical procedures, great care is needed to avoid any damage to surrounding structures.