Abstract: Polycystic ovarian syndrome is a common endocrine disorder, and the most common cause of anovulatory infertility. In women presenting with anovulation associated with PCOS, clomifene citrate is the standard first line treatment for induction of ovulation. With the development of operative laparoscopy, laparoscopic ovarian drilling (LOD) is wildly used in treatment of anovulation. Patient，who is CC-resistance, can be offered LOD as the preferred second line treatment for ovulation induction. It is important to note that the puncture needle is applied to the ovary at right angle. The ovary is then ample irrigated to minimize adhesion formation. Most of the patients who underwent LOD, the ovarian function, menstruation and endocrine is improved significantly. The study found that marked obesity, marked hyperandrogenism and long duration of infertility seemed to predict resistance to LOD. High preoperative luteinizing hormone concentration in women who ovulated after LOD predict higher probability of pregnancy. LOD appears to offer several advantages over gonadotrophin therapy, like avoiding multiple pregnancies and ovarian hyper-stimulation syndrome.

Key words: Polycystic ovary syndrome, Clomiphene, Laparoscopic ovarian drilling, Laparoscopy, Electrosurgery, Cautery