PCOS and Fertility

Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a health condition caused by an imbalance of reproductive hormones that affects 1 in 10 women of childbearing age. 

Most women learn they have PCOS in their 20s and 30s, when they have problems getting pregnant. It’s the leading cause of infertility in women.

Women with PCOS have missed, infrequent, or prolonged menstrual periods, or they have higher than normal androgen (male hormone) levels. 

The ovaries may develop numerous small cysts (fluid-filled sacs, or follicles), which affect the ovaries’ ability to produce an egg or release it during ovulation.

At the OB/GYN office of Dr. Hany H Ahmed in Houston, Texas, we offer a number of innovative treatments for women struggling with PCOS and infertility. Because you may not be familiar with the syndrome or its potential treatments, we’ve put together this guide to bring you up to speed.

Causes and symptoms of PCOS

The precise cause of PCOS isn’t yet known, but it’s believed that several factors play a role:

1. Genetics

Your risk for developing PCOS may be higher if your mother, sister, or aunt has the condition.

2. High androgen levels

All women make small quantities of androgen, but these hormones primarily control male traits.

If the body produces an abnormally high level of androgens, in addition to preventing the ovaries from releasing an egg during the menstrual cycle, the androgens can cause facial hair growth, male pattern baldness, and acne, all telltale signs of PCOS.

3. High insulin levels

Insulin is a hormone that helps process food into energy that your body can use. When you develop insulin resistance, as in Type 2 diabetes, your blood levels of the hormone rise, and you can’t process what you eat. 

Many women with PCOS develop insulin resistance, particularly those who are overweight or obese, don’t have a healthy diet, and don’t get enough physical exercise.

Additional symptoms include weight gain or difficulty losing weight; a propensity toward Type 2 diabetes; skin darkening, especially in the neck, groin, and underneath the breasts; and skin tags, excess skin flaps in the armpits or on the neck.

Complications from PCOS

Left untreated, PCOS may lead to complications that include:

PCOS may also lead to metabolic syndrome, conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that increase risk of heart disease.

Treatments for PCOS that increase fertility

PCOS isn’t curable, but you do have options if you want to get pregnant. These include:

Medications

If your doctor has ruled out other causes of infertility in both you and your partner, he might prescribe a drug such as clomiphene (Clomid) that helps you ovulate.

Intrauterine insemination (IU) or in vitro fertilization (IVF)

IU or IVF may be options if medication doesn’t work. Your egg is fertilized with your partner's sperm within your uterus, or in a tube or dish, respectively. In the latter, the doctor then places the fertilized egg in your uterus to implant and develop.

Losing weight

If you’re overweight or obese, and especially if you have prediabetes along with that, losing weight by eating a healthier diet and getting regular exercise can go a long way toward making your menstrual cycle more regular, thus increasing your fertility.

Surgery

Surgery is the option of last resort, when all the other options fail to work. One option is ovarian drilling. The outer shell (cortex) of ovaries is thickened in women with PCOS, and may be partly responsible for preventing spontaneous ovulation.

With ovarian drilling, the doctor drills through the shell to make holes in the surface of your ovary. The surgery usually restores ovulation, but only for 6-8 months.

In 85% to 90% of cases, PCOS-caused infertility is successfully treated with conventional medical therapies.

If you’re struggling to get pregnant, it’s time to make an appointment to see Dr. Ahmed so he can determine if you’re suffering from PCOS and devise an appropriate treatment plan. You can call the office or schedule your consultation online.

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