Ovarian drilling - is it worth it?

[Omgdnswv]

TTC for over 2 years, PCOS, extremely long cycles, did 11 months on letrozole, 10 of which I ovulated but still nothing. Can't have IVF on the NHS for another year yet (and then it's probably just another waiting list before it starts)

Fertility nurse/doctor said the only other thing the NHS can offer me now is ovarian drilling, apparently it helps 50-70% of patients to ovulate on their own afterwards.
I'm absolutely terrified of being operated on, being this vulnerable when all the doctors and nurses and hospital staff are overworked, overtired, and accidents and scandals happen all over the country. I'm not from the UK and I'm shocked at how bad the health care sector is, but this isn't a small dentist appointment that I can just go home and pay out of pocket for, this is big and I'm scared something will go wrong.

Plus, I didn't get pregnant while ovulating on letrozole, so why would this be different?

Has anyone done it, did it work? And if it did work, did you get pregnant?

I'm really sorry to hear you are struggling. I also have PCOS and no natural cycles, although like you I did ovulate on Letrozole. I went privately for treatment due to the long NHS waiting lists, I can only speak from my experience but the private clinic I went to said straight off from my initial consultation (before we knew if the Letrozole would work) that they no longer recommended or performed ovarian drilling because it caries a risk of reducing the ovarian reserve /causing ovarian failiure which would obviously completely negate the point of having they surgery in the first place. That having been said, plenty of people do have it successfully.

I wonder though, if you have had a hycosy scan to check your tubes? Just because you are ovulating with the letrozole doesn't mean your tubes are open for fertilisation to happen. If you haven't already had that checked I'd request that before going for any kind of ovarian surgery.

@LavenderSweetPea thank you for your answer, I didn't know that about the ovarian reserve.

I've had my hycosy before I got letrozole, all clear and apart from the PCOS my uterus looks fine. I had a private ultrasound a couple of months ago to check lining and follicle size and they said that was all looking great too.

I had it done years ago. It made a world of difference. I suddenly had normal length cycles. It didn't help me get pregnant as I also had other issues but it really helped the pcos

Hello lovely, Have you had any prior tests before letrozole? To test patency of your tubes and semen analysis?

@MoonlightDreamer
My tubes are clear, DH's SA was first a bit bad, the repeat test was okay though so the fertility team said his side is fine (I did Google some of the values and according to the WHO his results make "pregnancy likely to occur". )
We've just done a re-test as the two seven tests were over a year old and this one recently came back with values below the minimum norm again. We need to wait for another retest that's booked for end of next month I think before the doctor will discuss with us.

It's good it sounds like they've done some of the tests to rule out other causes. If it were me, I'd think carefully about the ovarian drilling and maybe take a view based on your age. If your mid to late 30s maybe it's better to go for it because waiting a year or more for IVF could end up being problematic. If you've got more time maybe it's worth waiting. Your doctor should be able to advise how likely the adverse outcomes are (although I'm sure it depends on the skill of the person doing it)

I had it done 20 years ago. I have 3 children. One conceived post drilling and with the help of clomid. The other 2 were natural. So yeah it was worth it in my case. Good luck!

Also, assuming the procedure is successful and you ovulate properly yourself, I'd be asking what they think your chances of conceiving would be, given you have been ovulating on leteozole with no success. If there's any chance there's something else the matter (low egg quality, immune disorders etc) then I guess this won't help much, where IVF might. Your doctor will be able to advise based on your specific circumstance.

Could you request leteozole + IUI if it's possible sperm quality is at the route of your issues?

50-70 percent is good odds.

@LavenderSweetPea I asked about IUI before and was told the NHS doesn't offer it. I did some research about going private for it as its a lot more affordable than IVF (although also lower success rates) and read somewhere that its not done when there's sperm problem as its unlikely to work then (which seems counterintuitive because it saves the sperm lots of swimming and they wash it in something to leave only the best ones behind) anyway we waited for the NHS sperm test and then got side tracked with the results. Not sure how long I have to wait before I can do another go at letrozole or similar anyway.