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PCOS Treatment: Laparoscopic Ovarian Drilling

A keyhole procedure that can restart regular ovulation in women with PCOS who want to conceive and haven't responded to ovulation tablets.

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PCOS Treatment: Laparoscopic Ovarian Drilling at Prakash Hospital, Gynecology & Obstetrics
Surgery duration
30 to 60 minutes
Anaesthesia
General
Hospital stay
Same day or one night
Results
Ovulation often returns in 6 to 8 weeks
On this page

Overview

With PCOS, months can go by without a period, and when you're trying for a baby every one of those months counts. Many women ovulate with letrozole or clomiphene tablets and some weight loss. For those who don't, ovarian drilling is one of the next options.

Laparoscopic ovarian drilling is done through small keyhole cuts. The surgeon uses a fine needle carrying electrical energy (diathermy) to make a few tiny punctures on the surface of each ovary, usually about four. This destroys a small amount of the tissue that makes excess male hormones (androgens). As androgen levels fall, the hormone signals between the brain and ovaries rebalance, and in many women the ovaries start releasing an egg on their own.

About half or more of women start ovulating after drilling, and many conceive within 6 to 12 months. Those who don't often respond better to ovulation tablets afterwards. Because it usually leads to one egg a cycle, it doesn't raise the chance of twins the way fertility injections can. It doesn't cure PCOS, though, and the effect can wear off.

PCOS care in our gynaecology department runs from diagnosis to fertility support, including hormonal treatment, diet and lifestyle advice, and laparoscopic surgery. Before drilling, we check your tubes and your partner's semen report, so the operation is offered only when lack of ovulation is the real problem.

Why it's done

Ovarian drilling is a fertility treatment for women with PCOS who aren't ovulating. It's usually a second-line option, after tablets.

  • No ovulation after several cycles of letrozole or clomiphene at proper doses
  • Wanting to avoid the twin risk and frequent monitoring scans that come with fertility injections (gonadotrophins)
  • A laparoscopy that's needed anyway, for example to check the tubes or treat endometriosis, so drilling can be done in the same sitting
  • High LH (luteinising hormone) levels, which tend to respond well to drilling
  • Living far from the hospital, where coming in for scans every few days during injection cycles is hard

Is it right for you?

Usually a good fit

  • PCOS with absent or irregular ovulation, and you want to conceive
  • No response to ovulation tablets
  • Open tubes and a normal semen analysis for your partner
  • A BMI under about 30, or weight coming down, as results tend to be better

May not be suitable

  • PCOS when you're not trying to get pregnant. Drilling doesn't treat acne, excess hair or weight
  • Low egg reserve (a low AMH), since drilling removes some ovarian tissue
  • Blocked tubes or a severe sperm problem, where IVF is usually the more direct route
  • A very high BMI, where weight loss comes first and anaesthesia carries more risk

Types and techniques

Drilling with diathermy

The standard method. A fine insulated needle delivers a short, measured burst of electrical energy at each point, so that as little tissue as possible is affected.

One ovary or both

Both ovaries are usually treated. Some surgeons treat only one to protect egg reserve, and studies suggest results can be similar.

Other checks in the same sitting

A dye test (chromopertubation) is often done during the same laparoscopy to confirm the tubes are open, and a hysteroscopy may be added to check the inside of the uterus.

Preparing for surgery

  • Your partner's semen analysis and a check that your tubes are open, if these haven't been done
  • Blood tests for AMH, thyroid and prolactin, plus fasting sugar and HbA1c, because PCOS raises the risk of diabetes
  • If you're overweight, losing even 5 to 10% of your weight can restart ovulation by itself. Our PCOS diet chart is a practical start
  • Metformin is usually skipped on the morning of surgery. Your doctor will confirm
  • Folic acid tablets every day from now, since you may conceive soon after
  • A pregnancy test before surgery, which is ideally planned in the first half of your cycle
  • About 6 hours without food before the operation
  • Track your cycles afterwards. Our ovulation calculator helps you find your fertile days

The procedure, step by step

  1. 01

    Anaesthesia

    You're asleep under general anaesthesia for the 30 to 60 minutes the operation takes.

  2. 02

    Keyhole access

    A small cut at the navel takes the camera, and one or two more take the instruments. The surgeon inspects the pelvis. PCOS ovaries typically look enlarged, smooth and pearly white.

  3. 03

    Drilling the ovaries

    Each ovary is held steady and the needle is applied at a few points, usually about four, for a few seconds each. The ovary is cooled with sterile fluid to protect the surrounding tissue.

  4. 04

    Checking the tubes

    If planned, a blue dye is passed through the cervix to show that the tubes are open.

  5. 05

    Finishing

    The pelvis is rinsed with fluid to reduce the chance of adhesions, the gas is let out and the cuts are closed.

Benefits and risks

Benefits

  • Ovulation returns for about half or more of women
  • Usually one egg a cycle, so no added risk of twins or ovarian hyperstimulation
  • One procedure instead of repeated injection cycles with frequent scans
  • Ovulation tablets often work better afterwards if ovulation doesn't return on its own
  • The tubes and pelvis can be checked in the same operation

Possible risks

  • Adhesions (scar tissue) around the ovaries and tubes, which can themselves affect fertility
  • Lower egg reserve if too much tissue is treated, and rarely early ovarian failure
  • The effect wearing off, often after months to a few years
  • General surgical risks such as bleeding, infection or injury to nearby organs, all rare
  • No response in some women, who then move on to injections or IVF

Recovery timeline

  1. 01

    Day 0 to 1

    Mild tummy cramps and shoulder-tip pain from the gas are common. Most women go home the same day or the next morning.

  2. 02

    Days 2 to 7

    Rest and walk. Most women return to work within a week. You can start trying for a baby once you feel comfortable.

  3. 03

    Weeks 6 to 12

    Your gynaecologist tracks your cycles, often with ultrasound or a progesterone blood test, to see whether you're ovulating. Many women have a period within about 6 weeks.

  4. 04

    Months 3 to 12

    If you're ovulating but not yet pregnant, keep trying. If ovulation hasn't returned by about 3 months, tablets are usually restarted. If there's still no pregnancy after 6 to 12 months, the plan moves on to injections or IVF.

When to call your doctor

  • Fever or chills
  • Tummy pain or bloating that builds instead of settling
  • Redness or discharge from the cuts
  • Vomiting, or being unable to pass wind
  • A positive pregnancy test with one-sided pain or bleeding. Ask for an early scan to confirm the pregnancy is in the uterus

Call us on +91-8826000033 or come straight to our 24/7 emergency department.

Alternatives to surgery

Lifestyle changes and tablets

For most women with PCOS, weight loss, regular exercise and ovulation tablets come first. Letrozole is now generally preferred to clomiphene. Our PCOD page covers how the condition is managed day to day.

Gonadotrophin injections

Daily hormone injections with ultrasound monitoring bring on ovulation in most women, but carry a higher risk of twins and of ovarian hyperstimulation.

IVF

If other treatments fail, or there's also a tube or sperm problem, IVF is the next step. We offer counselling on assisted reproduction and can guide you on where to go next.

Talk to our Gynecology & Obstetrics team

Ask about your options, the cost and your insurance before you decide. See the insurance and TPA panels we work with.

Book an Appointment+91-8826000033

This page explains PCOS Treatment: Laparoscopic Ovarian Drilling in general terms. Your own plan depends on your health, your test results and your doctor's advice. Please read our medical disclaimer.

Your care team

PCOS Treatment: Laparoscopic Ovarian Drilling is led by our Gynecology & Obstetrics team, with other departments stepping in at each stage of your care.

Gynecology Department
Leads your treatment

Gynecology Department

At Prakash Hospital, our Obstetrics and Gynecology Department provides expert care for women at every life stage — from prenatal care and childbirth to gynecological health and menopause management.

What the department treats

High-Risk Pregnancy Care

Laparoscopic Surgery

PCOS Management

Infertility Treatment

Prenatal and Postnatal Care

Menopause Management

Visit the Gynecology & Obstetrics department

Other departments involved

Diagnostic

Runs your hormone, AMH and sugar tests before surgery and the blood tests that confirm ovulation afterwards.

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Skin and Hair

Treats the acne, excess facial hair and hair thinning linked to PCOS, which drilling doesn't fix.

Visit department

General Medicine

Manages insulin resistance, diabetes and thyroid problems that often come with PCOS.

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Meet the specialists

Related procedures

Procedures often considered alongside PCOS Treatment: Laparoscopic Ovarian Drilling, or that treat related conditions.

Laparoscopic Ovarian Cystectomy

Keyhole removal of an ovarian cyst that keeps the healthy ovary, usually with a stay of one night or less.

Hysteroscopy

A camera through the cervix to see inside the uterus and remove polyps, small fibroids or scar tissue, with no cuts.

Dermatology & Cosmetic Surgery

Laser Hair Removal

Laser light damages hair roots to reduce unwanted hair over 6 to 8 sessions, with settings matched to your skin.

Fibroid Removal (Myomectomy)

Removes uterine fibroids and repairs the womb, easing heavy bleeding and pressure while keeping pregnancy possible.

More in Gynecology & Obstetrics

Other procedures our Gynecology & Obstetrics team performs.

View the department

Laparoscopic Hysterectomy

Removes the uterus through keyhole cuts, for fibroids, heavy periods or adenomyosis that other treatment hasn't fixed.

Normal Delivery (VBAC)

Care through labour and vaginal birth, including VBAC for suitable women who have had one caesarean before.

C-Section Delivery

Delivers the baby through a low cut in the abdomen and uterus, planned or in labour, usually under spinal anaesthesia.

Colposcopy

A magnified check of the cervix after an abnormal Pap or HPV test, with a small biopsy if needed.

Endometrial Ablation

Treats the uterine lining to make heavy periods lighter or stop them, with no cuts, for women who want no more children.

Tubal Ligation

Blocks or removes the fallopian tubes for permanent contraception, usually as day-care keyhole surgery.

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Health Calculators

Free tools to check your weight, plan a pregnancy, track calories and more.

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Pregnancy & fertility5 calculatorsOvulation CalculatorPregnancy Due Date CalculatorConception CalculatorPeriod Due Date CalculatorPregnancy Weight Gain CalculatorWeight & body composition5 calculatorsBMI CalculatorIdeal Body Weight CalculatorBody Fat CalculatorLean Body Mass CalculatorBody Type CalculatorNutrition4 calculatorsProtein CalculatorMacro CalculatorCarbohydrate CalculatorWater Intake CalculatorHeart, kidney & fitness3 calculatorsHeart Rate CalculatorGFR CalculatorCalories Burned CalculatorCalories & diet5 calculatorsCalorie Intake CalculatorBMR CalculatorTDEE CalculatorWeight Loss CalculatorWeight Gain Calculator

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Frequently Asked Questions

Answers to common questions about PCOS Treatment: Laparoscopic Ovarian Drilling at Prakash Hospital, Noida.

Will ovarian drilling cure my PCOS?

No. PCOS is a long-term hormonal and metabolic condition. Drilling opens a window, often lasting months to a few years, in which ovulation returns and you have a real chance to conceive. Diet, exercise and weight still matter afterwards.

Does it help with weight gain or facial hair?

It lowers testosterone for a while, but it isn't done for excess hair (hirsutism), acne or weight. It's a fertility treatment. Those symptoms are treated with diet and exercise, medicines and skin treatments.

How soon could I get pregnant after drilling?

Women who respond usually ovulate within 6 to 8 weeks, and most pregnancies happen in the first 6 to 12 months. If you haven't conceived by then, your gynaecologist will move to the next step rather than waiting longer.

Is PCOD the same as PCOS?

In India the two terms are often used for the same thing. Both involve ovaries with many small follicles and irregular ovulation, and drilling helps either when the problem is lack of ovulation.

I have insulin resistance or diabetes. Is surgery safe for me?

Yes, if your sugar is controlled. We check your HbA1c beforehand, and metformin is usually restarted as soon as you're eating. Good sugar control also improves your chance of ovulating and lowers risks in pregnancy.

Is ovarian drilling covered by insurance?

Many health policies exclude infertility treatment, though some cover a laparoscopy done to diagnose or treat a condition. Read your policy's terms and ask your insurer before booking. Our insurance partners are listed on the site.

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