Polycystic Ovarian Syndrome and Fertility

Jun 24, 2015 - 12:24pm

Polycystic Ovarian Syndrome and Fertility

Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects about 10% of women of childbearing age. It is referred to as ‘syndrome’ because it has a wide range of symptoms and signs. It is one of the leading causes of impaired ovarian function and infertility.


What happens to ovaries in PCOS?

Normally, a number of follicles start to mature during each menstrual cycle and at least one follicle releases a mature egg at ovulation.

Normal Ovarian function

In a polycystic ovary more follicles are recruited and partially mature, but there is no release of  the egg. This means ovulation does not take place, as a result, a woman cannot get pregnant.

Polycystic ovarian function

What are the symptoms of PCOS?

These dense number of immature follicles in the polycystic ovaries not only cause irregular periods and absence of ovulation, but the whole hormonal system gets out of balance producing other symptoms of PCOS.

Ovaries, normally, produce a small amount of male sex hormones called androgens. In PCOS, ovaries produce more androgens, which may cause acne, development of facial hair and mood swings.

In addition, PCOS is linked to a metabolic problem called insulin resistance, where the body is not able to use insulin well. As a result, more insulin is produced to regulate blood glucose levels derived from foods. These high levels of insulin further stimulate androgen production from the ovaries. 

Glucose levels and insulin

What causes PCOS?

The exact cause of PCOS is unknown, but there is a genetic factor since it tends to run in families.

How is PCOS diagnosed?

PCOS can be difficult to diagnose since group of symptoms may vary from woman to woman. Firstly, the doctor needs to exclude all the other causes of your symptoms (ie. Thyroid problems).

Other investigations may include:

  • Menstrual cycle history.
  • Blood tests: hormone levels.
  • Vaginal Ultrasound: check of the shape of your ovaries.


What lifestyle and dietary measures I could try for PCOS?

PCOS cannot be cured but certain steps can be taken to improve its symptoms. The aim of treatments is to restore regular menstruation and achieve pregnancy if desired. Healthy diet and exercise are the pillars of PCOS management, particularly if you are overweight. Being within a healthy BMI (Body Mass Index) 18.5-24.9 can help to balance the hormone levels and improve your symptoms. These positive changes work by stabilising the blood glucose levels and improve the body’s ability to use insulin.

Even a 10% body weight loss can restore regular periods.


What further treatment options are available from my fertility specialist?

If you are trying to conceive you may be offered the following treatments:

  • Clomiphene – tablet form; stimulates ovulation.
  • Gonadotrophins – injection; stimulates ovulation.
  • Metformin – tablet form; increases your body’s sensitivity to insulin and helps to resume ovulation.
  • Laparoscopic Ovarian Drilling (LOD) – this surgical technique works by destroying small amount of ovarian tissue that is producing adrogens and may resume ovulation short-term.


Monitoring by the specialist

Every woman has an individual response to a treatment and your doctor will be doing regular monitoring to check your response. Some of these checks may include:

  • Ultrasound of the ovaries
  • Ultrasound of the uterus lining thickness
  • Hormone level blood tests

Final word …

Finding the best treatment suited to you can be a lengthy process.  If you are overweight, losing weight may assist your treatment outcome. 

Next time …

Stay tuned for my ebook coming up - Dietary strategies for PCOS symptoms and weight loss.

Image credit: bigstock.com

What PCOS symptoms do you suffer from? What measures have you found the most useful?

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