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, which directly affects a woman’s ability to conceive.

What are the symptoms of PCOS?

There are numerous symptoms that may be experienced by patients with PCOS and these symptoms can change. Below is a list of common PCOS symptoms:

  • 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
  • Infertility

What causes PCOS?

The exact cause of PCOS is unknown. It is a syndrome and has many possible causes and characteristics. However, some believed causes 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 there are several different factors that must be identified and doing so requires a combination of physical exam and history, ultrasound, and blood tests. Because of this, most reproductive centers use the “two out of three” guideline to more accurately diagnose PCOS.

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 normal weight or even somewhat underweight. Blood tests are typically suggested 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 medicine. Clomiphene citrate (Clomid) is an oral medication and 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 carefully 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 infertility issues get pregnant, if other treatment options have failed. Women who are overweight may increase their chances of improving ovulation patterns and fertility by achieving a healthier weight. To learn whether the cause of your symptoms might be due to PCOS, please contact Advanced Reproductive Center to schedule an appointment at our Rockford, IL office.

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