Laparoscopic ovarian drilling

Abstract

Laparoscopic ovarian drilling has been widely accepted as the second line of choice for induction of ovulation in CC-resistant PCOS women in preference to gonadotrophin therapy. In addition to its proven efficacy, LOD offers several advantages over gonadotrophins such as avoiding multiple pregnancies and OHSS. Using a monopolar needle applied at right angle to the antimesentric surface of the ovary with penetration of the ovary to a depth of 7-8 mm at four points with a power setting of 30 W for 5 s per puncture seems to be an optimum approach that maximises effectiveness and safety. PCOS women could expect 50-60 % pregnancy rates during 12 months following LOD. The role of LOD before ART remains to be adequately investigated. In addition to the short term benefits of LOD, about one third women undergoing this surgery will continue to benefit for several years.