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.[1] It differs from ovarian wedge resection, which involves the cutting of tissue. Minimally invasive ovarian drilling procedures have replaced wedge resections.[2] Ovarian drilling is favored over wedge resection because cutting into the ovary might result in adhesions, potentially complicating postoperative outcomes.[3] Ovarian drilling and ovarian wedge resection are treatment options to reduce the amount of androgen producing tissue in women with polycystic ovarian syndrome (PCOS).[4] PCOS is the primary cause of anovulation, which results in female infertility.[5] The induction of mono-ovulatory cycles can restore fertility.[6]
Laparoscopic ovarian drilling (LOD) may improve the effectiveness of other ovulation induction treatments and results in lower multiple pregnancy rates than other treatment options like gonadotropins.[7][needs update] The oral drug clomiphene citrate (CC) is the first-line treatment for PCOS-related infertility, yet one-fifth of women are resistant to the drug and fail to ovulate.[8] Patients are considered resistant if the treatment fails for six months at the appropriate dosage.[1] Ovarian drilling is a surgical alternative to CC treatment or recommended for women with WHO Group II ovulation disorders.[6] 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.[9] The effectiveness of the surgical procedure is similar to CC or gonadotropin treatment for induced ovulation for PCOS patients, but results in fewer multiple pregnancies per ongoing pregnancy regardless if the technique is unilaterally or bilaterally performed.[10]
If patients do not become pregnant six months after ovulation has been reestablished from ovarian drilling treatment, drug treatments may be reintroduced or in vitro fertilization (IVF) may be considered.[1]
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^Portuondo, J. A.; Melchor, J. C.; Neyro, J. L.; Alegre, A. (1984-07-01). "Periovarian adhesions following ovarian wedge resection or laparoscopic biopsy". Endoscopy. 16 (4): 143–145. doi:10.1055/s-2007-1018560. ISSN 0013-726X. PMID 6236073. S2CID 11796110.
^Ndefo, Uche Anadu; Eaton, Angie; Green, Monica Robinson (2013-06-01). "Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches". Pharmacy and Therapeutics. 38 (6): 336–355. ISSN 1052-1372. PMC 3737989. PMID 23946629.
^Hueb, Cristina Kallás; Dias Júnior, João Antônio; Abrão, Maurício Simões; Filho, Elias Kallás (2015-11-01). "Drilling: medical indications and surgical technique". Revista da Associação Médica Brasileira. 61 (6): 530–535. doi:10.1590/1806-9282.61.06.530. ISSN 1806-9282. PMID 26841163.
^ abLebbi, Issam; Ben Temime, Riadh; Fadhlaoui, Anis; Feki, Anis (2015-01-01). "Ovarian Drilling in PCOS: Is it Really Useful?". Frontiers in Surgery. 2: 30. doi:10.3389/fsurg.2015.00030. PMC 4505069. PMID 26236709.
^Farquhar, Cindy; Brown, Julie; Marjoribanks, Jane (2012-06-13). "Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome". The Cochrane Database of Systematic Reviews (6): CD001122. doi:10.1002/14651858.CD001122.pub4. hdl:2292/20354. ISSN 1469-493X. PMID 22696324.
^Moazami Goudarzi, Zahra; Fallahzadeh, Hossein; Aflatoonian, Abbas; Mirzaei, Masoud (2014-08-01). "Laparoscopic ovarian electrocautery versus gonadotropin therapy in infertile women with clomiphene citrate-resistant polycystic ovary syndrome: A systematic review and meta-analysis". Iranian Journal of Reproductive Medicine. 12 (8): 531–538. ISSN 1680-6433. PMC 4233311. PMID 25408702.
^Wang, Rui; Kim, Bobae V.; Wely, Madelon van; Johnson, Neil P.; Costello, Michael F.; Zhang, Hanwang; Ng, Ernest Hung Yu; Legro, Richard S.; Bhattacharya, Siladitya (2017-01-31). "Treatment strategies for women with WHO group II anovulation: systematic review and network meta-analysis". BMJ. 356: j138. doi:10.1136/bmj.j138. ISSN 0959-8138. PMC 5421445. PMID 28143834.
^Bosteels, J.; Weyers, S.; Mathieu, C.; Mol, B. W.; D'Hooghe, T. (2010-01-01). "The effectiveness of reproductive surgery in the treatment of female infertility: facts, views and vision". Facts, Views & Vision in ObGyn. 2 (4): 232–252. ISSN 2032-0418. PMC 4086009. PMID 25009712.
Ovariandrilling, also known as multiperforation or laparoscopic ovarian diathermy, is a surgical technique of puncturing the membranes surrounding the...
Polycystic ovary syndrome, or polycystic ovarian syndrome (PCOS), is the most common endocrine disorder in women of reproductive age. The syndrome is...
ovulation induction agents, insulin-sensitizing agents, gonadotrophins and ovariandrilling. In PCOS patients with overweight or obesity, weight loss is first...
There appeared to be no difference between letrozole and laparoscopic ovariandrilling. Gonadotrophins such as follicle-stimulating hormone (FSH) are, in...
Laparoscopic ovariandrilling: This 'update' of ovarian wedge resection employs a unipolar coagulating current or puncture of the ovarian surface with...
as well as those reporting on new applications such as ovariandrilling for Polycystic Ovarian Syndrome (PCOS) If, for the purposes of this discussion...
treat endometriosis. Excessive laparoscopic ovariandrilling has been reported to cause premature ovarian failure. (The primordial follicles are located...
of human cancers: glioblastoma multiforme, lung squamous carcinoma, and ovarian serous adenocarcinoma. In 2009, it expanded into phase II, which planned...
where Herman's aunt and uncle already lived. Herman joined the uncle's oil drilling business. Their son was born in Tulsa. Herman died in Tulsa on October...
Thomas, Peter; Md Saydur Rahman (2012). "Extensive Reproductive Disruption, Ovarian Masculinization and Aromatase Suppression in Atlantic Croaker in the Northern...
University professor who finds her values challenged when she is diagnosed with ovarian cancer. Thompson was instrumental in bringing Mike Nichols to direct the...
1992, before dying in 1995 in Hawaii following unsuccessful treatment for ovarian and uterine cancer. Of his years in Honolulu, Obama wrote: "The opportunity...
1952 The 42-year-old author of Goodnight Moon was hospitalized for an ovarian cyst. To prove how healthy she was after treatment, she kicked her foot...
occurs in a wide range of settings from composite material machining, drilling, hand-held grinding, and sanding of nanotube-containing composites, and...
married actress Cecilia Hart, with whom he had a son, Flynn. Hart died from ovarian cancer on October 16, 2016. In April 2016, Jones spoke publicly for the...
gas leb by Tory MP". Drill or Drop?. "House of Commons - Register Of All-Party Parliamentary Groups as at 28 September 2017: Ovarian Cancer". publications...
Studio City, California, on October 6, 2022, at the age of 72, from stage 4 ovarian cancer, with which she had been diagnosed in 2020. At the time of her death...
including its baby powder, contain asbestos and caused them to develop ovarian cancer. Six mineral types are defined by the EPA as "asbestos" including...
(3): 27–34. Lavretsky, Philip; Hernandez, Flor; Davis, Brian (2022). "Ovarian degeneration resulting in the phenotypic masculinisation of a wild female...
Deborah; Balcomb, Kenneth C.; Croft, Darren P. (27 August 2018). "Analyses of ovarian activity reveal repeated evolution of post-reproductive lifespans in toothed...
Augers to expand into the specialist drilling market with rock augers, core barrels, clean-out buckets and custom drilling solutions. In 2013 Digga constructed...
episode is dedicated to the memory of Nina Elias-Bamberger (the executive producer of Dragon Tales) who died of ovarian cancer on November 20, 2002....
used as a model for studying aging of the ovaries of primate females. Ovarian aging was found to be associated with increased DNA double strand breaks...
writing books, raising cattle, and caring for her husband. She died from ovarian cancer exactly 29 years after her premiere with Nureyev in Giselle. Margaret...
guidance during surgery. TAS3RS shows to be promising in being able to combat ovarian and peritoneal cancer as it allows early detection with high accuracy....
order to obtain a large group of oocytes, the patients undergo controlled ovarian stimulation (COH). COH is carried out either in an agonist protocol, using...
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