PCOS is a significant cause of infertility. In fact, polycystic ovarian syndrome is the number one cause of infertility in women in the United States.
PCOS increases androgen levels in the ovary, which causes a lack of ovulation, or irregular ovulation. The unnatural level of androgen interferes with the normal growth of follicles, which are cysts carrying eggs (ova) in the ovary. You are born with millions of ova which develop into follicles during normal cycles. One of these follicles eventually releases the egg (ovulation) creating fertility. PCOS reduces your odds of becoming pregnant by reducing the number of ovulation cycles per year. The syndrome can also cause minor ovulation defects; even cycles that appear ovulatory could be less than ideal for fertility if you are not under treatment.
REASONS FOR HOPE
If you want to become pregnant, options are available. Your treatment plan should be customized to your individual situation. The recent explosion of research in PCOS and its connection with insulin resistance has added more and better treatment options for patients. Here is a summary:1. Clomiphene citrate (trade names, "Clomid" or "Serophene" which is usually prescribed with Metformin (an insulin sensitizer). Ovulation rates are up to 90 percent and average pregnancy rates of 50 percent have been seen.
2. Taking Metformin alone. While this is an option, testing shows that using Metformin alone for fertility treatments is not as effective as combining it with Clomiphene.
3. Injectable gonadotropins. Generally used in cases of failure to ovulate with Clomiphene. These medications include the hormones FSH (trade names Follistim, Bravelle, Gonal-F) or a combination of FSH and LH (trade name Menopur or Repronex). Ovulation rates for injectable gonadotropins are over 90 percent and pregnancy rates are approximately 50 percent.
4. Ovarian drilling. Many women who undergo this procedure will eventually return to having irregular periods.
5. Diet modification and exercise. An example would be a reduced carbohydrate diet, and regular, structured exercise. Of course, you should consider looking at other reasons for infertility before committing to fertility treatments for PCOS.
6. A semen analysis (sperm count) is recommended to see if the problem is with the male. For women, a common procedure is to have the fallopian tubes checked with a rapid x-ray screening test called an HSG hysterosalpingogram), in which dye is injected into the uterus and seen to flow out of the tubes on a monitor screen. Also, a laparoscopy can be performed, in which a small incision is made in the umbilicus and a scope with a video connection is inserted to further evaluate the inside of the pelvis. This is normally a short, sameday surgical procedure performed under general anesthesia.
USEFUL WEBSITES
American Society for Reproductive Medicine website explores infertility and other topics- http://www.asrm.org
The InterNational Council on Infertility Information Dissemination, Inc.- http://www.inciid.org
The National Infertility Association- http://www.resolve.org
The Society of Reproductive Endocrinology and Infertility- http://www.socrei.org
Vitaline’ PCOS website- http://www.vitaline-slimming.com/pcos
Postings, blogs and other information regarding infertility- http://www.fertilethoughts.net/ft/infertilityAn article on various means to treat infertility- http://www.drexelfertility.medem.com (go to the heading, "Information Resources" in the middle part of the page and click on the link, "Infertility."
