Polycystic Ovary Syndrome (PCOS)
What is PCOS and how can it affect infertility?
Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects between 5% to 10% of women of reproductive age worldwide. It is caused by hormonal imbalances that prevent or interrupt normal ovulation, directly affecting a woman’s ability to conceive.
What are the symptoms of PCOS?
Patients with PCOS may experience numerous symptoms. Common PCOS symptoms include:
- Non-existent or irregular menstrual periods
- Acne and dandruff
- Gaining weight, specifically around the waist
- Balding or thinning hair
- Skin tags, excess flaps of skin
- Depression and anxiety
- Sleep apnea
- Patches of thick brown or black skin
- Hirsutism, increased hair growth on women
What causes PCOS?
The exact cause of PCOS is unknown. It is a syndrome and has many possible causes and characteristics. Some believed causes of PCOS are insulin resistance, higher androgen hormones (male hormones), disruption of the development and release of eggs, and genetic predisposition.
How is PCOS diagnosed?
Diagnosing PCOS can be challenging as several different factors must be identified, and doing so requires a combination of physical exam and history, ultrasound, and blood tests. For this reason, most reproductive infertility centers use the “two-out-of-three” guideline to diagnose PCOS more accurately.
The American Society for Reproductive Medicine (ASRM) has determined that two out of three of the following conditions must be present for an individual to be diagnosed with PCOS:
- Irregular menstrual periods caused by anovulation or irregular ovulation
- Evidence of elevated androgen levels. The evidence can be based upon signs (excess hair growth, acne, or male-pattern balding) or blood tests (high androgen levels)
- Polycystic ovaries on pelvic ultrasound (ovaries that have multiple cysts)
Along with having two out of three of these symptoms, none of these symptoms can be caused by any other non-related PCOS reasons. A high BMI alone is not necessarily indicative of PCOS. In fact, at least half of women diagnosed with PCOS are of average weight or even somewhat underweight. We typically suggest blood tests to rule out any other conditions. Blood tests for testosterone might be recommended for women with acne or hirsutism. Blood tests for prolactin level, thyroid-stimulating hormone (TSH), and follicle-stimulating hormone (FSH) may also be recommended to rule out other conditions that may be causing similar symptoms.
What are the treatment options for PCOS and infertility?
One way to treat infertility linked to PCOS is to induce ovulation using medication. Clomiphene citrate (Clomid) is an oral medication that is often an early option. If Clomid fails, fertility medicines called gonadotropins can be injected to facilitate the growth of an egg. Women taking these medications must be observed during the process, as they can over-respond and be at an increased risk for multiple births. In vitro fertilization (IVF) may also help women who have PCOS and other infertility issues get pregnant when other treatment options have failed. Women who are overweight may increase their chances of improving ovulation patterns and fertility by losing weight. To learn whether the cause of your symptoms might be due to PCOS, please contact Advanced Reproductive Center to schedule an appointment today at 312.485.4847.