PCOS And Infertility

Polycystic ovarian syndrome, PCOS, is a condition in which the ovaries produce a high level of male hormones (androgens), particularly the hormone testosterone. Between six to ten percent of American women of childbearing age are affected with PCOS. This condition is the leading cause of infertility in women and if left untreated, it has the potential of increasing the risk of endometrial cancer.

Too Many Male Hormones Means Trouble

A known factor in polycystic ovarian syndrome is that the increased production of male hormones means that luteinizing hormone levels are very high while follicle stimulating hormones are very low, preventing follicles from producing a mature egg. With the absence of egg production, the follicles swell with fluid and form cysts. Every egg that is trapped in a follicle becomes another cyst and as a result, the ovary swells-sometimes to the size of a grapefruit. Progesterone is no longer produced since there is no ovulation; however, estrogen levels remain constant.

The Insulin Connection And Miscarriage

The high levels of androgens are the cause of obesity, facial hair, acne, and infertility. While the exact cause of PCOS is not fully understood, there is a definite link with insulin production and usage in the body. Many women with PCOS are also insulin resistant, which means there is a problem moving blood sugar out of the body and the pancreas is unable to supply the body with the insulin it needs. This insulin resistance has been linked to miscarriage in women with diabetes as well as those with PCOS. Women who are having difficulty with insulin balances are often prescribed diabetic medications such as metformin which impacts the way insulin regulates glucose. It also causes testosterone production to decrease which can help ovulation return.

Where There's A Will, There's A Way

For a woman who wants to conceive a pregnancy, PCOS has the potential to create a very challenging and sometimes disheartening situation. The best way to treat PCOS in order to allow for pregnancy is by treating the symptoms of infertility. Ovulation stimulating drugs such as Clomid have been shown to help four out of five women with PCOS to ovulate. This, of course, increases the chances of conception. If Clomid fails, then injectable drugs such as gonadotropins have been used with success.

There Is More Than One Way To Make A Baby

Another procedure used to help women with polycystic ovarian syndrome to conceive is known as ovarian drilling. This is done through a type of microsurgery in which a number of small holes are made in each ovary using a fine probe or laser. Ovarian drilling may encourage or restore responsiveness to ovulatory stimulating drugs. If a woman does not respond to this procedure, then in vitro fertilization becomes an option. Successful IVF has several determining factors including age and weight of the woman, length of infertility and the general state of health.

Even though PCOS is known to cause infertility, the proof is there that fertility treatments using ovulatory stimulating drugs can be effective in helping women with PCOS conceive and carry a pregnancy.


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