Many women suffer from a very common condition called Polycystic Ovarian Syndrome, also referred to as PCOS. This condition is a common cause of anovulation (absence of ovulation), and female infertility. PCOS can be very frustrating for women and couples when they are trying to conceive.
Polycystic Ovarian Syndrome is a disorder in which a woman does not release an egg regularly, or in other words does not ovulate. The ovaries contain small cystic structures, which are tiny fluid-filled sacs. The eggs grow but are never released from these fluid-filled sacs, resulting in anovulation. The difference between a normal ovary and a polycystic ovary is that in a polycystic ovary, unlike a normal ovary, there are many small follicles with eggs in them, but they do not mature properly which leads to a lack of ovulation.
Many women who may not pay attention to their cycles or are not concerned about getting pregnant may not even realize they have this condition until they begin focusing on their cycle and try to become pregnant. Some basic, common symptoms of a woman with PCOS are: irregular menstrual cycles or no period at all, acne, darkened skin patches, depression, sleep apnea, anxiety, and/or excess amount of facial and body hair growth. Women may also have an excess amount of testosterone hormone within their system, which leads to the extra amount of facial and body hair growth.
When women notice that their menstrual cycle is not normal, they should reach out to their healthcare provider. Their healthcare provider will then help diagnose the cause, or refer them to an infertility specialist who will help diagnose the cause. PCOS can be diagnosed with an ultrasound. When an ultrasound is done, a woman who has PCOS will be able to see several cystic structures on their ovary. PCOS can also be diagnosed with blood tests that measure a woman’s hormone levels.
There is no cure for PCOS. This may be frustrating and scary for a young woman and couple to discover after trying to conceive, however it is possible for women to become pregnant with PCOS. With some lifestyle changes, certain drugs, and guidance from a knowledgeable infertility doctor, you can become pregnant.
Some infertility doctors may start with looking at the cause of PCOS. While there is no definite answer as to why a woman may have PCOS, there are a few common conditions linked to PCOS including genetics, excess insulin, and being overweight or obese.
If a woman’s insulin levels are not within normal range, their doctor may recommend and guide them into normalizing their insulin levels. Normalizing their insulin levels helps to regulate their hormones, which will increase their chances of regulating a menstrual cycle. Also, their doctor may advise them to lose weight if their BMI is not within normal range. Women with excess insulin may have ovaries that make more androgen hormones such as testosterone. There are a couple things a woman can do to regulate insulin which include:
- Metformin is one drug that may be recommended. Metformin is a diabetes medication that regulates the amount of insulin in your blood.
- Cinnamon: who knew a common cooking spice would help with PCOS? Researchers have discovered ingesting a small amount of cinnamon daily (1 teaspoon) could help regulate insulin levels. It does not hurt to try this while possibly utilizing other treatments as well.
- Changing eating habits such as eating fewer starches and sugars. A woman will want to choose foods that are high in fiber and low in refined carbohydrates.
If normalizing insulin levels do not work, or if a woman’s insulin levels are already within normal range, it is possible to induce ovulation. There are a few treatments and each treatment varies on success depending on each woman.
- Clomiphene citrate is a common medication used for women with PCOS and has a high success rate, although it does come with side effects such as mood changes, vomiting, hot flashes, and high multiple pregnancy rates.
- Gonadotropin is a hormone shot and has an increased risk of multiple births due to over-stimulating the ovaries.
- Letrozole is the most common and successful drug used for PCOS. Letrozole blocks estrogen production and increases the production of the follicle-stimulating hormones (FSH).
- Ovarian drilling may be suggested after medications have been tried. Ovarian drilling is when a surgeon inserts a small needle within a woman’s abdomen and destroys a small part of the ovaries.
The first step with any woman who may be suffering from PCOS is to take a look at their eating and exercise habits. Changing what they eat and their activity level may help tremendously with becoming pregnant, even though they have PCOS. Even if they begin taking infertility treatments to help increase ovulation, they will want to continue a healthy lifestyle.
When a woman with PCOS does become pregnant, it is important to know that their risk of miscarriage is three times higher than women who do not have PCOS. They also have an increased chance of having gestational diabetes, high blood pressure, preeclampsia, and possibly a C-section. It is important they work carefully with their healthcare provider when they become pregnant to prepare a safe plan for mom and baby.