What Is It?
Laparoscopic Ovarian Drilling (LOD) is a minimally invasive surgical treatment used to help women with Polycystic Ovary Syndrome (PCOS) who are not ovulating (releasing eggs) regularly.
The procedure helps restore normal ovulation by reducing excess male hormones (androgens) in the ovaries. It can be especially helpful for women who have not responded to fertility medications like clomiphene (Clomid).
Who Needs It?
LOD may be recommended if you:
- Are not ovulating even after taking fertility tablets
- Have high levels of androgens (testosterone)/ LH
- Prefer a surgical option instead of long-term medications
- Concurrent Laparoscopy for Pelvic Evaluation
- Challenges with Gonadotropin Monitoring or Access
How Is It Performed?
Laparoscopic ovarian drilling is done under general anesthesia using keyhole surgery:
- Small cuts (usually 2–3) are made in your lower abdomen.
- A laparoscope (thin camera) is inserted to view your ovaries.
- A fine needle or laser is used to make tiny punctures (usually 4–10) on the surface of each ovary.
- These punctures reduce the production of male hormones and help the ovaries start ovulating normally.
Benefits of LOD
- Helps restore ovulation naturally
- May reduce the need for fertility medications
- Minimally invasive – small cuts and quick recovery
- One-time procedure with lasting effects (in many women)
- May improve menstrual regularity and hormonal balance
According to best practice suggestions :
- BMI < 25–30 kg/m²
- Elevated LH levels (e.g., LH > 10 IU/L)
- Ideally no prolonged infertility (shorter duration may be better)
Surgical Technique Highlights
- Typically involves 5–10 punctures (drillings) per ovary using monopolar energy, though techniques may vary.
- Aiming to reduce androgen production and restore ovulation by creating controlled thermal damage to the ovarian surface.
Recovery & Aftercare
- Hospital Stay: Usually same-day discharge
- Recovery Time: 3–5 days for most women
- Mild abdominal pain or bloating is common
- Most women can return to work or daily activities in about a week
Pregnancy After LOD
Many women begin to ovulate regularly within 4–6 weeks after the procedure. Pregnancy rates are good, especially in the first 6 months after the surgery.