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Ovarian Drilling
What is Ovarian Drilling?
Ovarian drilling, done during laparoscopy, is a procedure in which a laser fibre or electrosurgical needle punctures the ovary 4 to 10 times. This treatment results in a dramatic lowering of male hormones within days and is often performed in women who have polycystic ovary syndrome (PCOS). Studies have shown that up to 80 percent of patients will benefit from such treatment. Many women who fail to ovulate with clomiphene or Metformin therapy will respond when these medications are reintroduced to the system after ovarian drilling. Side effects are rare, but may result in adhesion formation or ovarian failure if there are complications during the procedure.
Ovarian drilling is a surgical technique dedicated to the treatment of Polycystic Ovary Syndrome. It consists of performing micro-perforations in ovaries in order to induce ovulation. Polycyctic Ovary Syndrome (PCOS) is characterized by ovulation disorders and represents the most common cause of infertility in women of reproductive age.
Ovarian drilling, which was commonly performed by laparoscopy, is now currently performed by fertiloscopy, benefiting in turn from its mini-invasiveness and physiological approach.
Procedure
This procedure is done under short general anesthesia. Patient can leave the hospital on the same day of surgery. Ovarian drilling is usually done through a laparoscope (small incision). 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. The ovaries are identified and several small holes made in each ovary, either with a fine hot diathermy probe or laser.
The procedure is usually done on an outpatient basis, so you will go home the same day. The surgeon will make a small incision in your lower abdomen and insert a small camera which is linked with a monitor. Sometimes gas is used to inflate the abdomen so that the surgeon can better visualize the abdominal organs. Another incision allows the surgeon to place special instruments in the abdominal cavity to perform the actual procedure. Then the surgeon will destroy a small portion of the ovary using either a laser or cautery.
Risks of this procedure include bleeding, development of adhesions or scar tissue on your pelvic organs, pain and infection. Pregnancy rates range from 30% to 85%. A few studies have shown that success rates are higher in women within the normal range for BMI or Body Mass Index. In most cases, the risks of ovarian damage and other complications do not outweigh the benefits of the surgery. Make sure to discuss the procedure and the associated risks and benefits with your doctor before having surgery.
Polycystic Ovarian Syndrome
The condition, polycystic ovarian syndrome, known as PCOS, is the commonest cause of ovulation disorders in women of reproductive age and is a familial condition. Polycystic ovarian syndrome (PCOS), is a primary ovarian condition and is characterized by the presence of many minute cysts in the ovaries and excess production of androgens. Polycystic ovarian syndrome can be found in apparently normal women and the full expression of the disease so-called "Stein-leventhal syndrome" is very uncommon. Polycystic ovarian syndrome is frequently associated with weight gain, excessive hair growth in the face and body, irregular and infrequent periods or absent periods, infrequent or absent ovulation, miscarriage and infertility. The cause of PCOS is not fully understood. There are long-term risks of developing type 2 diabetes, cardiovascular disease and cancer of the womb. Women diagnosed as having PCOS before pregnancy have an increased risk of developing gestational diabetes. Incidence of Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) accounts for 90% of women with oligomenorrhoea (infrequent periods) and 30% of women with amenorrhoea (absent of periods) and over 70% of women with anovulation.
Diagnosis of Polycystic Ovarian Syndrome : -
Laparoscopy : - Laparoscopy allows direct inspection of the ovaries; the ovaries are enlarged and polycystic. However, polycystic ovaries may appear normal at laparoscopy.
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