PCOS and Infertility

Are PCOS and infertility associated with one another? Polycystic ovary syndrome, also known as PCOS, is a condition known to contribute to infertility. A male hormone, called androgen, is higher than normal in women with this condition even though Androgen is necessary for women to make estrogen. When our bodies produce a surplus of these male hormones, our periods become irregular and we can become infertile.

What Are the Symptoms of PCOS?

The symptoms of PCOS can vary greatly from patient to patient. Some women have very unstable periods with heavy vaginal bleeding for extended lengths of time. That is due to the inability to ovulate and produce progesterone. The lining of the uterus becomes thicker than usual and when it finally sheds, it is more painful and takes longer. Infertility is likely with this condition. The lack of ovulating on a consistent basis reduces your chance of conception. 

Many symptoms are more subtle. You may have always had more facial hair than your girlfriends had and thought nothing of it. There may be more body hair than unusual. The only place you won’t have more hair is where you want it - on the top of your head. Your hair will, however, become thinner at the crown area.

These are some common symptoms that are frequently ignored. Your skin is probably oilier and acne is more of a problem for you than others in your age. If you look closely, the areas around your neck and folds of your skin are darker in color than the rest of your body. Some women think they look unkempt, but it is a change in the pigment and has nothing to do with cleanliness.

Obesity and diabetes are two common symptoms of this syndrome. High levels of androgens contribute to both. Excess weight can be very difficult to manage on its own, but with elevated levels of androgens, it is even worse.

An ultrasound in PCOS patients who are undergoing treatment to stimulate ovulation may show multiple tiny little cyst formations on your ovaries. The cysts are not always visualized but they typically there.

What Causes PCOS?

The precise cause of PCOS is not known. There appears to be a hereditary factor involved as you often see several family members with the same diagnosis. We have already established that there is a hormone imbalance.  We, also, know that increased Androgen can result in obesity, unwanted hair and less frequent menses.

Insulin is also a hormone and a direct relationship between patients with PCOS and higher than normal levels of insulin in their system has been confirmed. This insulin elevation affects the production of estrogen and progesterone and the reproductive system is unbalanced.

It isn’t clear if your insulin levels are elevated because your sugar levels are higher or if you’re obese because your androgen levels are too high. Either way, obesity does compromise fertility. Below you will watch a video that offers more information on PCOS and infertility:

How to Treat Infertility Caused by PCOS

1. Lose Weight

The first suggestion your doctor is likely to make for treating PCOS Infertility is usually to lose weight. That is no simple task. Try--really, try if you want to have a baby. Eat healthier, exercise more and ask your doctor for help. You will feel better and your hormonal balance will improve greatly.

2. Fertility Drugs

  • Gonadotrophins

There are several different types of fertility drugs available, such as clomiphene. Each type stimulates ovulation but they are all more effective if the body weight is normal. Some are calledgonadotrophins. Gonadotrophins are extremely potent and sometimes overstimulate your ovaries increasing your chance of multiple births.

  • Metformin

Metformin is a medication developed for the treatment of diabetes. However, the addition of metformin to clomiphene has shown an increase in ovulation of better than twenty percent of the women taking it. Metformin alone has a documented increased ovulation in more than 50 percent of patients. At the same time, Metformin will decrease your insulin level--diminishing your appetite while releasing fat storage. In response, your androgen hormones will level out and hopefully you will conceive. It doesn’t always work.

3. Infertility Treatment

There are alternatives to explore. Once ovulation is confirmed by ultrasound but conception has not occurred, help may be required.

  • Intrauterine insemination is an option that is quite successful for many couples.
  • LOD or laparoscopic drilling of the ovaries is a surgical approach to infertility.  The ovaries are drilled to destroy androgen-producing tissues, thereby allowing hormone levels to normalize.
  • In vitro fertilization is only recommended under certain conditions.

Ask your physician if this is suitable for your situation.

The following video offers more information on PCOS and infertility:

What Should Be Expected from Fertility Treatments?

We can only offer statistics regarding success in treatment. Every woman’s body reacts differently.

  • Differences in weight and medical history and genetics are all points of consideration when taking medications.
  • You may not tolerate the side effects of certain drugs, such as Metformin. It causes nausea and vomiting in some women but not all.

Your fertility specialist will guide your through each option and suggest the best route for you. If he recommends in vitro fertilization, keep in mind that it is somewhat tedious.

  • You will normally get daily injections for about twelve days.
  • You will need blood tests and ultrasounds to monitor your body’s reaction.

Ultrasound will determine when your eggs are ready for retrieval and at that time, your partner needs to supply sperm. They are, then, combined and observed until they are ready for implantation into your uterus.

What Else Should You Know About PCOS and Infertility?

So you are pregnant, congratulations! Now, you have to take better care of yourself than you did before. Complications in PCOS pregnancies are considerably higher than non-PCOS.

  • The hormonal imbalance and the added weight gain affect the chance of miscarriage.
  • Gestational diabetes should be closely controlled to prevent difficulties. Diet and exercise are critical.
  • Preeclampsia and high blood presssure occurs only during pregnancy and the postpartum period. It affects the baby as well as the mother.The symptoms most noticed by patients are swelling and headaches or vision changes. It can be detected and treated relatively easily, but careful observation of the patient is mandatory.
  • You should also know that it doubles the chance of stroke in women of all ages. 

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