Unipolar ovarian cautery is a commonly used method, as it is readily available for every operating gynecologist. Atraumatic forceps have been designed to grasp the ovarian pedicle, to decrease the risk of hemorrhage. Bipolar diathermy is safer as the current only passes between the two jaws of the forceps, it is difficult to use for ovarian cautery. A relatively recent modification to ovarian cautery is the transvaginal hydro-laparoscopy (THL). THL has been used for ovarian drilling for polycystic ovary syndrome (PCOS). Transvaginal, ultrasound-guided ovarian interstitial laser treatment does not allow direct visualization of pelvic organs to assess the tubo-ovarian relationship, tubal patency, adhesions, and endometriosis. The cost of laparoscopic ovarian drilling when compared with the cost of ovulation induction using injectible follicle-stimulating hormone (FSH) highlighted that the cost of laparoscopic ovarian drilling using unipolar diathermy was 84% of the cost of one cycle of ovulation induction using FSH.