PCOS and Infertility
Polycystic Ovarian Syndrome (PCOS) is one of the leading reasons for infertility in females. It causes anovulation or irregular menstruation wherein the female fails to release eggs regularly. It is also characterized by the appearance of many small cystic structures in the ovary. Five to ten percent of women of childbearing age have PCOS.
Normal ovaries vs polycystic ovaries
A woman develops several follicles in the ovaries during a normal menstrual cycle. One of the follicles containing an egg will mature and develop causing ovulation. On the other hand, polycystic ovaries also produce small follicles with eggs in them, but the follicles do not mature and develop properly hence no ovulation takes place. Some of the undeveloped follicles may turn into cysts and may appear on an ultra sound as a “string of pearls”.
Symptoms of PCOS
Some symptoms of PCOS include irregular menstrual cycle or sometimes total lack of period. Lack of ovulation causes infertility among women with PCOS. Other symptoms include increased hair growth on back, chest or face, thinning hair, obesity, high insulin levels or type two diabetes, acne or pelvic pain. Symptoms for PCOS vary with each woman. Some women only have an irregular period as a symptom. Most women are unaware that they have it. In fact, less than twenty-five percent of women with PCOS have been diagnosed.
Lose weight and ovulation
While some women can get pregnant despite PCOS, others will need to take steps to be able to conceive with PCOS. Some solution may be as easy as adjusting diet. Weight loss can sometimes improve hormones imbalances and resume spontaneous ovulation. If change of diet and weight loss fails to correct anovulation, other more serious treatment should be taken.
Treatment by medication
There are several drugs and medication which are recommended as treatment for anovulation. Clomid or other fertility drugs are often used in the treatment of infertility relating to PCOS. Clomid blocks estrogen receptors in the brain. With these receptors blocked, the brain thinks there are low estrogen levels. Low estrogen levels trigger the body to produce more follicle stimulating hormones (FSH) and LH which signal the body to ovulate. Even though Clomid is often successful at bringing about ovulation, only thirty to forty percent of the women who do ovulate from Clomid will actually become pregnant. Metformin is an oral anti-diabetic drug that can also be used to encourage pregnancy among women with PCOS. It improves the body’s ability to absorb insulin. It is considered safe to use on women who do not have diabetes because it affects insulin levels and does not actually lower blood sugar directly.
Fertility procedures as treatment
In vitro Maturation (IVM) or in vitro fertilization (IVF) are also options for women with PCOS. In vitro maturation is a procedure where immature eggs are harvested early in a woman’s cycle. The eggs are then matured in a laboratory and afterwards can be used for fertilization. In vitro fertilization, the eggs are harvested after they have already matured. The eggs are then fertilized and implanted in the woman’s uterus. IVF treatments also include medications that help the eggs develop. IVM is helpful for women who do not respond to drug therapy.
