As many as almost 30% of women of childbearing age have Polycystic Ovarian Syndrome ( PCOS ). However, most of them are unaware of it until they begin trying to conceive. PCOS is one of the leading causes of female infertility and until a few decades ago, there was not much one can do to change that. Women that had it just went with the odds. Luckily, with the advancements in reproductive technology and medicine, every couple can get a taste of parenthood, no matter their fertility issue.
What is PCOS ?
PCOS is a common endocrine system disorder in women in which a woman’s hormones, specifically her sex hormones namely estrogen and progesterone, are out of balance. Also, in most cases, the male hormone is elevated.
The disorder involves the presence of multiple small follicles in a woman’s ovaries, many of which produce differing levels of hormones. An ultrasound scan also reveals that the dominant follicle cannot develop as easily as it is supposed to. This means that an ultrasound scan will probably show enlarged ovaries that contain follicles (small collections of fluid) in women with PCOS.
In short, progesterone needs to work with sufficient amounts of estrogen to promote menstruation. In women with PCOS, their ovary stops the increased production of those two hormones, or it may only produce the hormone estrogen but not progesterone.
What are the Symptoms of PCOS ?
One of the most typical symptoms is a total absence of or irregular periods. Some women experience infrequent yet very heavy periods alongside tenderness, bloating, and pain. And, since the male hormone (testosterone) is usually at higher levels, the woman with PCOS may have increased (and darker and thicker) hair growth hair and acne. Many women also have issues with her weight (obesity) and, of course, difficulty getting pregnant.
It has also been evidenced that hormonal imbalances can be related to problems with the metabolism of sugar in the body, which leads to an increased risk of gestational diabetes, should the woman does get pregnant, as well as weight gain.
PCOS & Fertility
It is important to note that the presence of PCOS is not an untreatable condition that delivers nothing but bad news. Many women in their early 20s have severe side-effects from the syndrome that subside as they age and their follicle number drops. So, it’s not a surprise to find out that their hormonal imbalance linked to the syndrome corrects itself as you get older.
Also, the symptoms of PCOS together with the heightened risk of miscarriage that’s documented mean that the chance to get pregnant is low and that medical support should be sought. The physician that will handle your case will perform an ultrasound scan to indicate the presence of small follicles, and ask for blood tests that will reveal any changes to testosterone and LH levels, as well as insulin and blood glucose levels.
That said, research has shown that women with PCOS have a pretty good chance at conception as long as they are patient and dedicated and allow an adequate amount of time for changes to their lifestyle (see below) to enhance their fertility naturally.
1. Lifestyle Modifications
One of the first things your physician might tell you is to lose weight through a change of diet and exercise, which could be more difficult due to the increased testosterone levels but is impressively effective in restoring regular periods and balancing hormones in obese women.
Other approaches include the intake of insulin sensitisers that help lose weight and reduce the impact of insulin resistance. Taking ovulation-inducing drugs is also a course of action and the same applies to the use of injectable drugs (FSH) if the body does not respond well to the other treatments. However, the medications are a good option that increases the likelihood of a pregnancy by up to 25% only if the fallopian tubes are open, and the male partner’s sperm counts are normal.
During treatment, women with PCOS will undergo a drug-induced ovarian stimulation process that ranges from 7 to 14 days, and most of them will require 4-6 visits for monitoring their ovaries’ stimulation prior they get their HCG trigger shot that will help complete egg maturation and is taken only once per cycle.
Of course, injectable gonadotropins that are used to treat PCOS do not come without serious concerns, given that they increase the risk for high-order multiple pregnancy (higher than triplets), which is simply unacceptable for some couples.
3. In-Vitro Fertilisation (IVF)
If everything else has failed, IVF steps in and gives solutions to even the most severe situations, such as when the patient with PCOS also has blocked fallopian tubes or other underlying conditions that prevent her from conceiving.
Recent advances in IVF technologies also allow us to control multiple pregnancy risk and still maintain high pregnancy rates. A variant of an IVF treatment that helps us achieve that is blastocyst embryo transfer, where Team Miracle select the best quality embryos for transfer.
But, the key to success lies in the IVF clinic’s culture environment and whether their medical staff is proficient at blastocyst culture and day 5 blastocyst transfers. If their lab quality control and culture system are inconsistent, and the culture environment is suboptimal, the hatching embryos get stressed excessively, and their development is jeopardised. For that reason, the Cyprus IVF Clinic is equipped with a stellar lab and cutting edge technologies that help our specialised medical personnel and experts to reach their maximum potential and deliver excellent results each and every time.
PCOS & IVF Success Rates
In general, cases of infertility caused by PCOS have excellent success rates with IVF. However, patients should be aware that not all fertility clinics are the same and each has a different success rate per case.
Team Miracle, though, at the Cyprus IVF Clinic has skyrocketed live birth rates per egg retrieval and prides the best success rates on the island and three times more chances for a woman with PCOS to conceive than in the UK or anywhere else abroad. No wonder we have become the elite destination for couples seeking esteemed medical experts, worldwide known specialists in reproductive medicine, and the latest equipment and technology in the field under the same roof.
So, if you have been trying to get pregnant for at least 6 months (for women older than 35 years of age) or 12 months if you are younger than 35 and suspect PCOS might be behind this issue, please book an appointment with Dr. Firdevs, a leading fertility specialist and OB/GYN, to discuss your options.
PCOS is one of the most treatable causes of female infertility so why miss out on your chance to get pregnant with the help of those that have given more than 6,000 couples the widest smile ever!