Gynecologic Surgery


What is PCOS Drilling?

Role of polycystic ovarian drilling in the treatment of PCOS related infertility.
PCOS drilling cost

Medical Treatment

Management is based on treating anovulation and its effects, i.e. oligoamenorrhea, hirsutism, infertility and prevention of the long-term sequelae associated with insulin resistance.

Clomiphene citrate is the first drug of choice in ovulation induction. In case there is poor response, gonadotroipins will be the next drug of choice. Since gonadotropins are expensive and cause hyperstimulation, their use needs judicious monitoring. Surgical treatment could be the next step. 20% of PCOS conceive on their own, though many abort.

Surgical Treatment

Surgical treatment by laparoscopic pcos drilling is an excellent second line of management in many after failing medical management. Early resort to pcos drilling is indicated in women with altered FSH: LH ratios, poor response to ovulation induction drugs and to rule out other factors causing infertility during the laparoscopy.

How is PCOD drilling or PCOS drilling done?

PCOS drilling or PCOD drilling begins with a diagnostic laparoscopy. We usually do all our diagnostic laparoscopies by a mini laparoscope. Laparoscopy gives a complete idea about the woman’s pelvis. We can look for adhesions, endometriosis, pelvic infections and other similar diseases causing infertility. After this, the ovary is held with a laparoscopic instrument and the PCOS needle is introduced through the laparoscopic port. The needle used monopolar current to produce the PCOD drilling holes in the PCOS affected ovary. Usually 3 to 5 holes per ovary is done by this method. The PCOD drilling procedure is repeated on the other side ovary.

After this step, we can do a tubal patency test if opted by the patient. We test the patency of the fallopian tubes by methylene blue dye. Free spill of the dye from both fallopian tubes indicates open fallopian tubes. If no dye is seen coming from the fallopian tube end, blocked fallopian tubes are suspected.

Some patients may opt for a diagnostic hysteroscopy after the laparoscopy. This helps in completing the diagnosis of the infertility causes.

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