Polycystic Ovary Syndrome (PCOS) is an ovulatory disorder that impacts egg development, ovulation and very often fertility. PCOS presents differently in everyone and is the most common endocrine problem in women.
Up to 15% of women of childbearing age are affected by PCOS. Women with PCOS do not ovulate regularly, if at all. PCOS can also lead to long-term health issues such as diabetes and heart disease. Therefore, a proper diagnosis is the first step to improved chances of fertility and better overall health.
What Is an Ovulatory Disorder?
Ovulatory disorders are one of the main causes of infertility in women. An ovulatory disorder is a group of disorders in which ovulation does not occur (anovulation) or occurs on an infrequent or irregular basis (oligo-ovulation). For women who are not ovulating regularly, the cause is usually that the ovary is not receiving the appropriately timed signals to mature and release an egg. The pituitary gland, at the base of the brain, produces the hormones that control the ovaries – FSH (follicle stimulating hormone) and LH (luteinizing hormone). If ovulation is not occurring in a regular, timed fashion, it is likely that the hormones are not being produced properly.
What Is PCOS?
PCOS is an ovulatory disorder in which women often have higher than normal levels of androgens, or “male hormones” and high levels of LH. This hormone imbalance causes several follicles to start developing, none of which fully mature or reach the point of ovulation. The result is the development of many small cysts in the ovaries, giving the ovary a “polycystic” appearance. Due to the lack of ovulation, progesterone is not made in the female body, and the menstrual cycle becomes irregular or completely absent, thereby resulting in infertility.
What Are The Symptoms of PCOS?
PCOS is characterized by a range of symptoms that tend to be mild at first. The primary symptom of PCOS is irregular menstrual cycles or no menstrual cycles at all. Other symptoms of PCOS may include:
- weight gain
- excess facial hair
- excess body hair
- small cysts in the ovaries
- trouble losing weight
- thinning hair on scalp
- trouble getting pregnant
How Is PCOS Diagnosed?
PCOS is often diagnosed in a woman’s teens but can impact women throughout their reproductive years. There is no specific test for PCOS, yet a fertility expert can review your medical history and perform basic fertility testing, including blood work to check hormone and sugar levels as well as an ultrasound to evaluate the appearance of the ovaries and uterine lining.
What Are The Treatment Options for PCOS?
Usually PCOS is easily treated. PCOS treatment focuses on normalizing hormone levels and regulating the menstrual cycle. This is achieved through a range of lifestyle changes and medications. The treatment will be determined based on individual goals, whether you want to become pregnant, the severity of symptoms, and how at risk you are for other medical conditions. A combination of lifestyle changes, such as a diet and exercise, and fertility medication is often advised for women with PCOS trying to conceive.
How Can You Get Pregnant If You Have PCOS?
For pregnancy to occur, an egg(s) needs to mature, ovulation needs to occur, and sperm needs to fertilize an egg. Therefore, many women will start with low-tech treatment options such as clomiphene citrate or letrazole, medications that stimulate an egg or eggs to mature and ovulate. This medication is usually paired with either timed intercourse or intrauterine insemination (IUI).
If the only cause of a woman’s infertility is PCOS, then treatment with ovulation induction medications is very effective; over several cycles, 70-80% of women will ovulate and 40-50% will go on to achieve pregnancy. In more serious cases of PCOS or when other factors may be affecting the ability to conceive, in vitro fertilization (IVF) may be recommended.
What Are Your Chances of Success?
PCOS patients usually begin with either timed intercourse or Intrauterine Insemination (IUI) as a first course of treatment. With IUI treatment the goal is to bring patients back to the natural conception rates found in the fertile population for their age. In Vitro Fertilization (IVF) treatment, however, can more than double the success rates found in low tech treatment options.
When Should You See A Fertility Specialist?
If you have been trying unsuccessfully to get pregnant with the help of your Ob/Gyn using clomiphene or letrazole to stimulate egg production and ovulation for a couple of cycles, there is likely another reason contributing to the cause of infertility. This is the time to schedule an appointment with a fertility specialist known as a Reproductive Endocrinologist.
Most patients with ovulatory disorders have successful pregnancies, yet this does not mean everyone has success right away.
For more information or to schedule an appointment with one of our fertility physicians, please call 800.858.4832.