If a woman with PCOS is overweight or obese, lifestyle changes such as dietary modifications and improved physical activity can help with weight loss, which in some cases restores regular ovulation. If lifestyle changes are not sufficient, an ovulation-inducing treatment may be prescribed. The first-line medication is clomiphene citrate, which stimulates the ovaries to induce ovulation. In some cases, this treatment is combined with intrauterine insemination (IUI), particularly if there is a mild male factor contributing to infertility. When ovulation is successfully triggered with clomiphene citrate, the treatment is generally continued for six cycles.  

What Is Ovarian Drilling?  

Ovarian drilling is a surgical procedure used when a woman with PCOS does not respond to clomiphene citrate. Performed via laparoscopy under general anesthesia, this technique involves reducing the number of growing follicles, which are present in excess in PCOS and contribute to ovulation dysfunction. The procedure helps restore regular ovulation in about 50% of cases.  

Some doctors prefer to use ovarian stimulation with hormonal medications instead of ovarian drilling when clomiphene citrate fails. The choice of treatment depends on individual patient factors and the overall fertility plan.