Polycystic Ovarian Syndrome and Infertility - FAQs
A Multidimensional Approach to Infertility Management
Q. What is Polycystic Ovary Syndrome?
A. Polycystic ovary syndrome (PCOS) is a condition characterized by multiple cysts (fluid-filled sacs) in the ovary and is caused because of an imbalance in a woman's hormone levels, usually resulting in higher levels of androgens (male hormones) in her system. In this, a woman menstruates or ovulates (releases egg) infrequently or not at all. About 5-10% of adolescent girls and women have PCOS.
Q. What are the Problems Associated with PCOS?
A. The features of PCOS are different from woman to woman, but may include any or all of the following:
- Less frequent or no menstrual periods and/or irregular bleeding
- Acne (pimples) and oily skin
- Excess growth of hair (hirsutism) on the face, chest, abdomen, back or pubic area
- Thinning of hair on the head
- Weight gain
- Patches of thickened brown skin or skin tags on the neck, groin, underarms, or skin folds
- Difficulty in becoming pregnant
Many are first noticed during the teenage years, soon after a woman begins getting her periods.
Long Term Risks or Complications Related to PCOS Are:
- Infertility (inability to get pregnant)
- Abnormal lipid levels, such as high total cholesterol and low HDL ("good") cholesterol
- High blood pressure (above 140/90 mmHg)
- Endometrial cancer
- Heart problems
Q. What Causes PCOS?
A. The exact underlying cause of PCOS remains largely unexplained. An excess of ovarian androgen production remains central in the development of PCOS. It is also said to be hereditary.
Q. How is PCOS Diagnosed?
A. The doctor will take a detailed medical history, especially about the woman's menstrual cycle and reproductive events and examine for increased acne, hair growth or any other features of PCOS. The doctor may recommend an ultrasonography (USG), blood tests for any abnormal hormone levels, blood pressure and blood sugar.
Q. What is the Relation Between PCOS and Infertility?
A. Many women with PCOS don't ovulate and thus cannot become pregnant. These women are unable to produce and release an egg due to a complex web of multiple hormone imbalances (e.g. insulin, androgens, oestrogens, progesterone, thyroid hormones, prolactin, etc). In a woman suffering from PCOS these hormones influence each other in some way resulting in lesser chances of releasing egg and thus in turn decreasing the chances of the woman to get pregnant. PCOS is the most common cause of anovulatory (no egg released) infertility accounting for about 75% of cases.
Q. How is PCOS Treated?
A. As each woman is different, so are her problems, their severity and treatment. The different options are:
- Medical - hormonal pills for making menstruation more regular, for women having difficulty becoming pregnant
- Creams and ointments to treat acne
- Bleaching, waxing, electrolysis, shaving and medicines for removal of hair
- Lifestyle and dietary modifications (PTO)
Q. How is Infertility Related to PCOS Treated?
A. For anovulatory infertility in women with PCOS, several methods have been widely used to restore ovulation (release the egg) and thereby increase the chances of pregnancy.
Lifestyle measures including a proper diet, increased physical activity with weight reduction, should be the first-line treatment of obesity in PCOS.
Some medicines like clomiphene citrate, metformin, gonadotropin therapy may be prescribed by the doctor to stimulate ovulation and rarely surgery may be required.
For more information, contact your doctor.