PCOS: An infertility issue

PCOS is the most commonly occurring hormonal disorder in women and a leading cause of infertility. It is estimated that around 10% of the women in the reproductive age fall victims to this condition. Often women fail to realize PCOS as a reason for their infertility.

A woman with PCOS shows abnormal functioning in her hormonal pathway that controls egg production and preparation of uterus for pregnancy. High androgen levels and hyperinsulinemia (excess insulin) can adversely impact the menstrual cycle, hindering ovulation. When an egg is not released on a regular basis, this is called anovulation. Ovulation can either get ceased or occur abruptly.  This can cause additional hurdles in the way of a woman’s attempt in getting pregnant.

What are some of the problems that a woman with PCOS may face?

  • Lack of ovulation
  • Erratic and irregular menstrual cycle, the pattern that is unpredictable
  • Uterus that is not prepared to handle and sustain pregnancy

How can women with PCOS improve their chance of pregnancy?

Weight management

Lifestyle modifications in the form of weight reduction can have a positive impact on fertility, and it has been shown that even small weight reductions can facilitate improved pregnancy outcomes. Even a five to ten per cent loss of weight has been shown to greatly improve the chances of becoming pregnant.

Estimate your ovulation time and monitor ovulation

There are days in a woman’s menstrual cycle, around the middle of the cycle, when the women can conceive. This occurs soon after ovulation, creating a “fertile window” for the egg to get fertilized by the sperm. An ovulation calculator and an ovulation predictor kit can help estimate the precise time for ovulation.

Induction of Ovulation:

Ovulation is imperative and inevitable for pregnancy to occur and hence treatment options are aimed at getting the woman to ovulate and this is often termed as ‘Induction of Ovulation’.

Ovulation induction involves the use of medication to stimulate development of one or more mature follicles (where eggs develop) in those women who face difficulty in ovulation.

Depending on your overall diagnosis made by the doctor, your doctor may suggest oral anti-estrogen medications like Clomiphene or Metformin, an insulin sensitizer, to help induce ovulation. Alternatively, if these attempts fail, doctor may recommend another drug called letrozole, which can induce ovulation.

Talk to your doctor to get more information about these medications, and take these medications only on the advice and under the surveillance of your doctor!

PCOS and IVF Success

For women who have not been able to conceive naturally or by using medications or lifestyle treatment to improve their fertility, another option is assisted reproductive technology. This includes treatments such as IVF (In vitro fertilisation). To initiate these procedures, one has to be referred to a doctor -known as “IVF specialist”, who specializes in conducting such procedures. Assisted reproductive technology is best tried after other less intensive treatments have proved unsuccessful, as it is often costly and demanding. This technology is also more successful in women who have followed life-style modification techniques to control PCOS but failed on those.

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