What can you tell me about diathermy, or ovarian drilling as they call it? The reason for the surgery is excess testosterone in my ovaries, and my doctor believes this can work. Do you know of this surgery working successfully? What sort of long-term problems could result from this surgery?

-- Fran

Ovarian drilling is best performed using an electrosurgery needle that is used to burn 10-12 small holes into each ovary during laparoscopy. The procedure often lowers male hormone levels and restores normal cycles for up to a year or more. This works best in nonsmokers. Ovarian drilling may be associated with the formation of ovarian adhesions, but these do not seem to interfere with conception; conception rates after the procedure can be as high as 50 percent. If performed by an inexperienced doctor, however, the procedure may be ineffective or result in ovarian failure.

I would recommend the procedure only after birth control pills or medications such as Glucophage or Rezulin have failed. These medications can be used to regulate male hormone levels and menses in women with polycystic ovaries. These medications are approved for type II diabetes, not PCOS, but many studies have shown them safe and relatively effective.