Polycystic Ovarian Syndrome (PCOS) is a leading cause of infertility and impacts 5 to 10 million women and girls in the United States.
In fact, it’s the most common cause of irregular cycles and abnormal ovulation in women with infertility.
PCOS is a lifelong health condition that generally becomes an issue in a woman’s teenage years or early 20s. The condition is characterized by an irregular menstrual cycle and may or may not be associated with acne, obesity, or excess facial or body hair.
PCOS even has its own support network, PCOS Challenge, because it helps for you and other women to share your experiences and offer support to one another.
PCOS symptoms and signs
Women who have PCOS will generally become aware of it within a few years of reaching puberty.
Symptoms and signs may vary from woman to woman, but following is how we diagnose the condition:
Evaluate your menstrual cycle. How predictable are your cycles? Were there any changes in your cycles during your teenage years and early adulthood? Have you had any problems with your menstrual cycle, ranging from amenorrhea (lack of any periods) to frequent heavy menstrual periods?
Assess your physical appearance. Do you have acne? Excess facial or body hair? Do you show signs of “male pattern” balding? Have you gained weight?
Measure your egg count. Women with PCOS have a high egg count. At your initial in-person visit, we’ll perform an ultrasound to measure your ovaries and count your “potential eggs,” also called antral follicles. Additionally, we will do a blood test called AMH, anti-mullerian hormone, which is another way to assess your “egg count.”
Besides affecting fertility, PCOS puts you at an increased risk for several other health conditions, including:
Diabetes
Endometrial cancer (cancer of the lining of the uterus)
Sleep apnea
Gestational (pregnancy-related) diabetes and high blood pressure
Metabolic syndrome, a cluster of conditions including high blood pressure, increased waist measurement, increased glucose levels, low “good cholesterol” levels and high triglyceride levels that together increase your risk of heart disease, stroke and type 2 diabetes
Read more about PCOS signs and symptoms in our blog post, Common PCOS Symptoms.
PCOS treatment options
PCOS treatment focuses on both managing your overall health and working on specific fertility issues.
By first making small improvements to your overall health through lifestyle changes and medication, you’re likely to have even greater success when you start infertility treatment.
Lifestyle changes. Multiple studies have demonstrated weight loss benefits for PCOS patients who are overweight or obese. Losing as little as 5% of the initial weight has been associated with improved pregnancy rates. You can achieve this beneficial weight loss by starting to follow a PCOS diet and by increasing your level of exercise.
Medication. When added to lifestyle changes like improved diet and increased exercise, birth control pills may decrease the risk for diabetes and endometrial cancer that are so commonly associated with PCOS.
Once you’ve begun to improve your overall health, you’ll be ready for one of these treatments targeted specifically for infertility:
Oral medications to induce ovulation. Clomid is the most common initial treatment, with most pregnancies occurring on lower dosages and within the first four ovulatory cycles. Other estrogen blockers, such as letrozole / Femara®, can be used with similar effect. Clomid and other estrogen blockers may negatively impact on a woman’s cervical mucus production. This negative side effect can be overcome with intrauterine insemination (IUI).
In vitro fertilization (IVF). Women with PCOS are typically excellent candidates for IVF. The combination of fertility drugs with IVF works by increasing the number of eggs available for fertilization. Success rates are typically good for women with PCOS and frequently they have extra embryos to be used for future pregnancies.
effortless IVF®. Patients with PCOS are typically also candidates for effortless IVF®, a more natural and affordable form of IVF with comparable success rates to traditional IVF. To learn more about effortless IVF®, visit effortlessivf.com.
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