PCOS (Polycystic Ovarian Reserve Syndrome)

PCOS is present in up to 20% of infertile women.

PCOS is a hormone disorder that can be corrected using medication.

Overview

PCOS causes irregular or missed periods and affects 1 in 10 women of child bearing age.

Symptoms include:

  • Weight Gain/Obesity (although women without weight issues can also have PCOS)
  • Unwanted Hair Growth
  • Thinning Hair
  • Acne
  • Increased Fatigue/Low Energy
  • Mood Changes
  • Pelvic Pain
  • Headaches
  • Sleep Issues

Causes of PCOS

Exact causes of PCOS are not known. Most experts think several factors, including genetics, play a role. High levels of male hormones and high levels of insulin are known to cause PCOS symptoms.

Treatment Options

Medications

PCOS patients are sometimes treated with Clomid, however, Metformin is the “first line” treatment and is sometimes prescribed in combination with Clomid, FSH, or Letrozole. Metformin is an “insulin sensitizing drug” which lowers insulin levels by increasing the pancreatic cells sensitivity to insulin. This increased sensitivity leads to lower insulin levels, reducing male hormone production and allowing normal ovulation to resume. Fertility specialists will sometimes prescribe metformin for “long term” treatment of PCOS hoping to avoid the health consequences of the disease.

An infertility specialist, or an experienced gynecologist, should manage PCOS patients trying to become pregnant. FSH for ovulation induction should only be administered to PCOS patients by an infertility specialist as these patients can have an exaggerated, unpredictable response to this drug.

IUI Combined With Medications

If oral medications aren’t successful, IUI combined with Clomid/Letrozole and/or FSH is often the next step. Most patients become pregnant without needing IVF.

Surgery

Surgery was once a common treatment for PCOS where sections of the ovary were removed in an attempt to lower the production of male hormones (ovarian drilling) but is rarely performed today due to the effectiveness of medications.

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