3rd September 2015
Polycystic ovarian syndrome (PCOS) is a hormonal condition that sometimes leads to infertility in women. PCOS is quite common, with millions of young women in the UK being affected.
However, the good news is that women with PCOS typically have a very good chance of conceiving when aided by fertility treatments.
What is PCOS?
When a woman has PCOS, she does not ovulate regularly and has ovaries with many small cystic structures. Additionally, her body produces a surplus of androgens, also known as ‘male hormones.’ In men, these hormones are responsible for muscle mass and hair growth. In women, androgens are required to make oestrogen. However, with PCOS, women have too many male hormones, making both excessive hair growth and acne a problem.
Additionally, the overabundance of androgens often leads to irregular ovulation or no ovulation at all, which results in irregular or no menstrual periods. Obviously, this could lead to difficulty in becoming pregnant. Women with PCOS also have a high resistance to insulin, which makes it hard for their bodies to regulate blood sugar levels. This increases the risk of heart disease and diabetes.
Causes and symptoms of PCOS
There is no known cause of PCOS, but research has shown that it is probably an inherited condition. This means that it cannot be prevented, but thanks to modern medicine, it can be controlled through a combination of healthy diet, exercise, and medication.
Women with PCOS may exhibit a wide range of symptoms, which can include:
- Irregular or no menstrual periods
- Heavy vaginal bleeding
- Oily skin and acne
- Darkening and thickening of the skin of the neck, armpits, and groin
- Excessive hair growth on face, chest, stomach, and thighs
- Thinning hair on the head
- Type 2 diabetes
- High cholesterol
Getting pregnant with PCOS
The majority of women with PCOS will be able to have a baby by undergoing fertility treatment. In most women age 35 and younger, it isn’t so much about whether or not treatment will work – it is more about which treatment is best for the individual.
When fertility treatments are used in women with PCOS, treatment is typically aimed at establishing regular ovulation and usually begins with oral tablets or injections that achieve this goal. Medications for this purpose include Clomid, Metformin, and injectable gonadotropins. If inducing ovulation through these medications is unsuccessful, the next step is generally IVF – in vitro fertilisation.
It is important to understand that if a woman has PCOS, it may not be the only reason she is unable to conceive. At the beginning of treatment, other reasons for infertility – in both male and female partners – will need to be ruled out before fertility medications for ovulation stimulation are used.