Is it Hard to Get Pregnant With PCOS?

Polycystic Ovary Syndrome, also known as PCOS, is the leading cause of female factor infertility in the United States. It affects approximately one in 10 women. The causes of PCOS are not well understood and treatment is limited to addressing the symptoms as there is currently no cure. The imbalance of hormones causes excess male hormone levels, missing or lengthy menstrual cycles during which ovulation may not occur, and insulin resistance. All of these factors combined cause issues which may make it difficult for a woman with polycystic ovary syndrome to become pregnant.

Symptoms

• The symptoms of polycystic ovary syndrome vary from woman to woman. They may include absent or long menstrual cycles, lack of ovulation, insulin resistance, male pattern baldness, weight gain, acne and oily skin. These symptoms are caused by the imbalance of hormones associated with PCOS. Symptoms can range from mild to severe. Many women do not know that they have PCOS until they attempt to conceive. Polycystic ovary syndrome cannot be cured, so treatment consists of treating individual symptoms rather than the condition as a whole.

Diagnosis

• Being diagnosed with polycystic ovary syndrome is generally done by an endocrinologist. This medical professional will order bloodwork to show the balance of hormones present in the body. A woman with PCOS may show elevated androgen--male hormone--levels as well as possibly exhibiting insulin resistance. Testing for PCOS may need to be done at certain points in the menstrual cycle. If no cycle is present, one may be induced for the testing.

Treatment

• Treating polycystic ovary syndrome is treating the symptoms. Commonly used treatments for women who are looking to conceive include the use of clomiphene citrate (Clomid) to induce ovulation. This is often done in conjunction with the use of metformin (Glucophage) to combat insulin resistance and increase egg quality to increase the chances of a natural conception. Injectible drugs such as Gonal-F and Follistim also can be used to stimulate ovulation, with HCG triggers given to know the exact date of ovulation so conception may be targeted.

Fertility

• In many cases, natural conception may not occur. This can be due to many factors, such as the woman not responding to treatment with drugs alone. In these cases, intra uterine insemination (IUI) and in-vitro ferilization (IVF) may increase the chances of conception. With IUI, ovulation is timed and in some cases induced, and the sperm is inserted via catheter into the uterus directly. Since many fertility medications can decrease the presence of fertile cervical mucus for the sperm to live in, this treatment can circumvent this issue. Another path to conception is IVF, in which eggs are harvested and embryos cultivated, then re-implanted to a carefully monitored uterine lining. These options can be quite costly but have good success rates for women with PCOS.

Warning

• Polycystic ovary syndrome presents some risks to both mother and baby once conception has been achieved. There is a higher risk of gestational diabetes, miscarriage and high blood pressure. In many cases, treatment with metformin is continued throughout pregnancy. Metformin is a class B drug believed not to cause any harmful fetal side effects. Women with PCOS are carefully monitored during their pregnancy to catch potential problems quickly, and should consult with their physician often.