What is the exact definition of this term?

A laparoscopic procedure that makes small punctures in the ovary’s outer surface to help trigger ovulation in selected people with PCOS who have not ovulated on tablets (e.g., letrozole/clomiphene) and prefer to avoid or have not responded to gonadotropin injections.

Pros & Cons

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Potential benefits: spontaneous ovulation for months after the procedure; lower risk of multiple pregnancy compared with gonadotropins.

Risks/limitations: anesthesia and surgical risks, pelvic adhesions, and possible reduction in ovarian reserve; success rates vary and may be lower than with medication-based ovulation induction in some studies. Not a first-line option.

Who might consider it

Clomiphene/letrozole-resistant PCOS, high OHSS risk from injections, or when access to frequent monitoring is limited and surgery is acceptable.

Deep Dive

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Technique: a fine instrument delivers brief energy to 4–10 small spots on each ovary’s surface.

Expectations: cycles may regularize for months; we reassess ovulation and plan timed intercourse or IUI as appropriate.

Alternatives: low-dose gonadotropins with careful ultrasound monitoring or IVF when indicated.

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