Laparoscopic surgery is recommended should the medical treatment fail and for women who have experienced OHSS. This may be ovarian drilling or ovarian wedge resection. It is not clear why women with PCOS ovulate after ovarian drilling or wedge resection. According to Dr. R.K. Mishra, Director, World Laparoscopy Hospital, after surgery, ovulation occurs spontaneously in 70-90% of women, and the probability of pregnancy after one year is in the region of 40-60%. There is no increased risk of multiple pregnancies or OHSS. If ovulatory cycles fail to restore after the surgery, the doctor may restart ovulation induction. A recent study was done at World Laparoscopy Hospital up to 20 years after laparoscopic drilling has shown persistence of ovulation over many years. Compared with medical treatment, it need only be performed once and intensive monitoring is not required. The main problems associated with surgery include adhesion formation, the risk of destruction of the ovaries leading to ovarian failure. In addition, there are risks associated with surgery and anesthesia.