You're Having a Laparoscopy and There's Anovulation, Should You Have Drilling or Wedging?

Anovulation is the absence of ovulation during a menstrual cycle. An anovulatory cycle is a menstrual cycle in which the ovaries don’t release an oocyte. Ovulation can’t take place in such a cycle. Menstruation occurs as normal in such a cycle. Anovulation can cause infertility and should be treated if you wish to conceive.

Causes of Anovulation

  • Weight loss or weight gain
  • Excessive exercise
  • Stress
  • Medications such as steroidal oral contraceptives
  • Breastfeeding
  • Thyroid problems
  • Polycystic ovarian syndrome 
  • Pituitary problems

Diagnosis of Anovulation

The best way to detect anovulation is to perform a female hormone screen to measure changes in female hormones during a complete menstrual cycle.

Laparoscopy

If there are other ways to induce ovulation, drilling or wedging of the ovaries should not be considered because a large number of follicles are destroyed by this method and there is the danger of scar formation in addition to complications associated with anesthesia and surgery. However, if you are having a laparoscopy done for reasons such as pain in the pelvis, endometriosis, fibroids or lysis of adhesions and if anovulation is detected, then drilling or wedging of the ovaries should be considered despite the risk of reducing egg number. This is because there is the chance of a quick pregnancy after this procedure. Ovarian drilling at the time as laparoscopy involves the puncture of four to 10 follicles with electrocautery. This results in ovulation, either spontaneous or hormone assisted.

Ovarian drilling or wedge resection involves no increased risk of multiple pregnancy and helps resolve infertility caused by anovulation in as many as 60 percent of affected women.

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