<s>[INST] Hallow Doctor, I am Mrs S. Banerjee, Age 30 wight 55 kg Height 5 ft, Hormon report = all are well , My ovary are affected with PCOS, I use metformin for last 3 year, and use letrozole 2.5 , After that i got pregnant , But unfortunetly i have a MC on feb 2011, After that i cannot ovulate , My endometrial echo is thick 15 mm , Should i go through ovarian drilling and is it safe and can i get pregnant after that? [/INST] Hi, sorry about the MC. Irregular menstural cycles & inability to  conceive are the common problems for women with PCOS. Improper ovulation & excess amount of androgen are the main reasons. Ovarian drilling (ovarian diathermy) is done in women with PCOS to improve the fertility rate. Destroying part of the ovarian tissue restores regular ovulatory cycles in around 80% of women. It is a surgical procedure that triggers ovulation. It is an option only when other measures like weight reduction & fertility drugs fail. It is a safe procedure in expert hands. The aim of this laproscopy procedure is to destroy testosterone producing tissue in the ovary. A combination of  Letrazole & Clomiphene Citrate has been found to be useful in improving ovulation. Your BMI is in normal range but the  endometrial thickness is high (normal 6.7mm). Since Letrazole has not helped you, you can undergo ovarian drilling. Good Luck. </s>