A normal tube and ovary as seen at laparoscopy.

Each month an egg develops inside the ovary in a fluid filled pocket called a follicle. This follicle is one inch in size and is about ready to ovulate.

After ovulation the follicle changes from producing mostly estrogen to producing mostly progesterone to support the early pregnancy. In this photo, you can see the ovarian stigma (spot where the egg escaped from the ovary).

Ovarian drilling can be performed at the time of laparoscopy. Either a fiber laser or an electrosurgical needle is used to puncture any visible ovarian follicle. Many women will ovulate for a few months after the treatment and a small number will conceive. Unfortunately by six months, usually the abnormal menstrual cycle and elevated male hormone pattern has returned. There is also a small risk of forming adhesions to the surface of the ovary after this surgery.