Ovarian drilling

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Ovarian drilling, also known as multiperforation or laparoscopic ovarian diathermy, is a surgical technique of puncturing the membranes surrounding the ovary with a laser beam or a surgical needle using minimally invasive laparoscopic procedures. It differs from ovarian wedge resection, which involves the cutting of tissue. Minimally invasive ovarian drilling procedures have replaced wedge resections. Ovarian drilling is favored over wedge resection because cutting into the ovary might result in adhesions, potentially complicating postoperative outcomes. Ovarian drilling and ovarian wedge resection are treatment options to reduce the amount of androgen producing tissue in women with polycystic ovarian syndrome (PCOS). PCOS is the primary cause of anovulation, which results in female infertility. The induction of mono-ovulatory cycles can restore fertility. The first-line medical treatment for infertility in women with PCOS is the oral drug letrozole to induce ovulation. Patients are considered resistant if the treatment fails for six months at the appropriate dosage. Women who are resistant to the medication are commonly treated with medications that induce ovulation such as gonadotrophins. Medications that induce ovulation can also be associated with multiple pregnancies and problems with the women's cycle and this therapy is very expensive due to the requirement for regular ultrasounds, laparoscopic ovarian drilling is sometimes considered by medical professionals for treating anovulation. Known side effects and risks include the need for anesthesia, the risk of infection, and a risk of adhesions forming. There may sometimes be a smaller risk of the person losing ovarian function. Ovarian drilling is a surgical alternative to CC treatment or recommended for women with WHO Group II ovulation disorders. Other non-surgical medical options in the treatment of PCOS include the oestrogen receptor modulator tamoxifen, aromatase inhibitors, insulin sensitising drugs, and hormonal ovarian stimulation. The effectiveness of the surgical procedure is similar to CC or gonadotropin...