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PCOS and Infertility Treatments

Motherhood is a blessing. Most women long for it and many are gifted with it. But there are some who are deprived of this sublime experience. PCOS is one of the conditions that negatively affect a woman’s ability to have a child. Although difficult, with proper and timely treatment, even patients with poly-cystic ovary syndrome can enjoy a healthy pregnancy and motherhood.

Let’s find out how.

Women suffering from poly-cystic ovary syndrome have defective ovaries. They produce higher levels of male hormones (androgens) and so normal ovulation is hindered. Ovulation (the production of egg or ovum) is either strongly disturbed or almost absent. This is understandable enough that if there is no egg (or no right egg) there can be no conception. This absence or lack of ovulation manifests itself in absent or irregular menstruation. However, it should be noted that not all patients suffer from infertility. Also, not all patients who receive treatment can become pregnant. Infertility can be a result of another problem. So, it is important that required medical tests are done to rule out all other causes of infertility before starting the treatment for PCOS related infertility.

Even if patients can become pregnant, they have a high risk of developing gestational complications such as hypertension, diabetes, miscarriage, premature birth, etc. These factors must also be assessed and addressed when treating related infertility.

Many women become obese and have higher levels of insulin. These two conditions also contribute to infertility and gestational complications. Although there is a high percentage of obese women with PCOS who are pregnant with weight reduction and healthy lifestyle changes.

Weight reduction helps in controlling insulin levels. This in turn helps in restoring or regulating menstrual periods. Achieving a regular menstrual cycle is a big step towards restoring ovulation.

Commonly used drugs to treat poly-cystic ovarian syndrome related infertility are clomiphene, metformin and letrozole.

Clomiphene helps with maturation and release of eggs. However, women treated with clomiphene are likely to have multiple pregnancies, i.e. twins, triplets, etc.

Metformin is primarily used to treat insulin resistance or diabetes. But it helps in restoring ovulation and is therefore used in treating poly-cystic ovary syndrome related infertility. However, metformin does not help with pregnancy.

Letrozole helps treat infertility by restoring ovulation and controlling the production of androgens.

Gonadotropins shots can also be given to increase ovulation in PCOS patients. However, these shots have a high risk of causing multiple pregnancies and are expensive. So, the doctor should assess the condition carefully before taking this. These shots should only be tried if all other medications have failed.

When treatment with these drugs does not help a patient with poly-cystic ovary syndrome to conceive, the doctor can suggest other more complex and relatively expensive and risky treatments to achieve desired results.

1. Ovarian drilling (a laparoscopic surgery of the ovaries) can help to control the production of androgen, because part of the ovaries is removed in this surgery. Also, this procedure can help to increase ovulation. But there is a risk of ovarian scarring associated with this procedure.

2. IVF (in vitro fertilization) can be suggested for patients where all other treatments have failed. It is a process in which an egg is fertilized with a sperm outside the body and then implanted in the woman’s body. It may take many trials before a patient with polycystic ovary syndrome becomes pregnant with IVF and it is an expensive procedure. And there are cases where even IVF has failed.

It is up to your doctor to decide which treatment is best for you and it may take some trial and error, but with patience, perseverance and dedication, any PCOS patient can achieve good health and improve their chances of conceiving!

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