Fist off…what is PCOS?
PCOS or Polycystic Ovary Syndrome is a complex hormonal, metabolic and reproductive disorder that affects up to 15% of women. As many as 1 in 10 women have it. That’s a lot! And 50% of women who have it are undiagnosed – so they don’t even know they have it.
This hormonal disorder causes enlarged ovaries with small cysts on the outer edges. It can be painful. The cause is not well understood but thought to be a combination of both genetic and environmental factors.
Symptoms include menstrual irregularity, excess hair growth, acne, and obesity. It may also include fatigue, depression, insulin resistance, high testosterone levels and an inability to lose weight. Women with PCOS face a greater risk for both Type II Diabetes and cardiovascular disease and even some types of cancer. It is important to note that one third of PCOS patients are normal weight or even underweight and can be harder to diagnose.
While there is no cure for PCOS, it can and should be treated. Treatments include birth control pills to regulate periods, a medication called metformin to prevent diabetes, statins to control high cholesterol, hormones to increase fertility, and procedures to remove excess hair. Because the symptoms vary from person to person, treatments need to be customized as well.
PCOS can affect fertility in a number of ways. First, if a woman is not ovulating, it can be difficult to get pregnant. A fertility clinic can prescribe medications to help ovulation and regulate monthly cycles. Sometimes that is all a PCOS patient needs to get pregnant and have a healthy baby. Even if ovulation occurs, an imbalance in hormones may prevent the lining of the uterus from developing properly to allow for implantation of the mature egg. A fertility clinic can prescribe hormones to help implantation too.
Treatment for PCOS symptoms may include:
- Birth control pills to help correct hormonal imbalances.
- Insulin-sensitizing drugs to improve the body’s use of insulin and testosterone production.
- In the case of diabetes, medication to control blood sugar levels.
- Exercise and healthy eating to help boost overall well being and control weight.
Maintaining a healthy weight can help reduce insulin and testosterone levels and improve symptoms. An adjustment to diet and exercise in conjunction with medication may be all that’s needed to become pregnant and have a healthy baby.
Fertility Treatments for PCOS Patients
Every patient is unique, but traditionally here at Overlake Reproductive Health, after a full evaluation and work up we give patients ovulation induction medications with timed intercourse or intrauterine insemination (IUI) scheduled at the time of ovulation. Before that, we may perform an HSG to check if the Fallopian Tubes are open and also do a semen analysis of the partner to check if sperm counts are normal. The typical success rates with IUI are about 15 to 25 percent per cycle. That number can go down with age.
If ovulation induction with timed intercourse or IUI fail to achieve a pregnancy after three attempts, or if the patient also has other infertility factors such as blocked Fallopian tubes, her physician may recommend in vitro fertilization (IVF).
Most fertility patients with PCOS will go on to have a healthy baby once treated. The sooner you come into a fertility clinic, the sooner you can be diagnosed and on your way to parenthood. Over our thirty years in business, we’ve helped thousands of PCOS patients become parents.