Polycystic ovarian syndrome affects 6-12% of women in the reproductive age group*. Since it is a condition which affects the ovaries, it may cause infertility due to the inability to release an egg from the ovary. 60% of women who suffer from PCOS can suffer from infertility*.
However, the good news is that it is the most treatable cause of infertility. With minimal external aid, 90% women can conceive without major complications.
Let’s start with the basics.
What is Polycystic Ovarian Syndrome?
It is a metabolic disorder wherein numerous genetic variants and environmental factors interact, combine and contribute to the abnormal hormonal synthesis in the body. This hormonal imbalance leads to interference in the development of eggs. It can lead to accumulation of small immature eggs in the ovaries and delayed (or no) release of ma
ture eggs from the ovary. Increase in androgen or the male hormone makes the capsule of the ovary thick which further makes it difficult for the egg to release.
When the egg is not released for a prolonged period, the lining of the uterus does not get prepared for the pregnancy and can lead to difficulty in implantation of the pregnancy in the uterus. So even if the embryo is formed, it can’t stay in the uterus because it is partially prepared.
How does one overcome this?
The first line treatment is to relook at your lifestyle habits
- Exercise everyday for at least 45 minutes; any kind of exercise which increases heart rate and burns calories
- Improve your diet by including more proteins and, healthy fats, and eliminate carbohydrates or eat them in moderation
- Have a good sleeping schedule with proper timings so that the circadian rhythm is maintained
- Practise yoga or any hobbies which destress you
With these changes, sometimes including weight loss, 90% women start ovulating and their hormones get back to the normal range*. In such circumstances most women can even conceive on their own.
If after these changes, there is still no luck with pregnancy, then a fertility specialist might add few oral medications which aid in development of normal egg like:
- Clomiphene Citrate – It aids in normal egg development by blocking the action of oestrogen in the body which gives a signal to the brain. This increases FSH and LH synthesis from the brain, hence improving egg development.
- Metformin – Sometimes if the patient has insulin resistance then adding metformin which is an antidiabetic drug improves egg development and its release.
- Injectable FSH and LH – If the patient is resistant to the above treatment options, then the specialist might recommend direct FSH and LH hormones.
All these medications, along with timed intercouse or IUI (intrauterine insemination), usually increase the chances of pregnancy by 90%.
Note: Intrauterine insemination is a process in which the semen of the male is prepared and instilled into the uterus using a catheter.
Only 1% of the patients who don’t respond to all the above, and have associated other factors, might resort to IVF*.
There is a wide array of treatment options available for women with PCOS but all these treatments act only if you follow a healthy lifestyle. If PCOS is diagnosed at an early stage, chances of infertility are meagre.
Read more from #NuaExpert on Gynaecology Dr. Amodita Ahuja right here.
*Centre for Disease Control Prevention: PCOS (Polycystic Ovary Syndrome)