As a woman frustrated by months of trying in vain to become pregnant, you rely on your gynecologist for guidance, information and a solution for your infertility. During months of trying to be patient and calming your fears, you naturally wonder what could be wrong and more importantly, “Will I ever have a baby?” Happily, the answer in most cases is yes – with more patience and a more proactive approach to managing your medical conditions.

For about 8% to 10% of women between 15 and 45 years of age, the problem is polycystic ovary syndrome – PCOS – multiple cysts in the ovaries caused by hormone imbalances. The majority of PCOS affected women have the condition for many years but do not know they have it. The diagnostic tests for infertility discover PCOS, but only after many years of suffering with the symptoms.  

Diagnosis

When you were first examined for infertility, the gynecologist reviewed your medical history form and asked follow-up questions about various signs of infertility and specific PCOS related symptoms such as acne, weight gain, thinning hair or extra body hair and irregular periods. Those conditions can be caused by hormone imbalances which may be caused by PCOS or other problems. So if the doctor suspects PCOS, he will order another blood test for hormone levels and schedule a more definitive test – a pelvic ultrasound – to confirm the diagnosis and rule out other problems.

Ultrasound testing will look specifically for ovaries that are enlarged, typically two to three times normal size, resulting from failed ovulation. With PCOS the ovarian follicles, which would normally mature into eggs and be released for ovulation, instead become small cysts. Numerous cysts will be visible in the ultrasound images, sometimes encircling the ovaries like a “string of pearls,” confirming the diagnosis of PCOS.

Treatment

If you are overweight when diagnosed with PCOS and infertility, weight loss is the first recommendation of most doctors. The next step in treatment is usually clomiphene citrate medication. Clomiphene (brand name Clomid or Serophene) is a hormone that acts like estrogen to increase FSH and LH, both hormones that stimulate and support ovulation. Studies have shown 30% to 40% pregnancy rate for women who have taken up to three cycles of clomiphene treatment.

If treatment has not been successful after six cycles of clomiphene, it should be stopped because it is unlikely to be effective for you. The doctor may recommended ovulation induction with injectable gonadotropins or assisted reproductive technology procedures such as ovarian hyperstimulation with FSH injections or in vitro fertilization – IVF.

A newer and promising technique, in vitro maturation – IVM, is being used as an interim step before IVF as a more complete solution for some women with PCOS. In IVM, multiple follicles are extracted from the ovaries and allowed to mature into eggs in the lab. When mature, they are used in the IVF procedure, i.e. fertilized in the lab with sperm from the woman’s partner and then the fertilized egg is implanted a few days later into the womb.

PCOS is a very serious condition, but thousands of babies are born to PCOS afflicted women every year. With faith in your doctor, commitment to the treatments, and patience, you can be the next woman to beat this condition.

Technorati Tags: pcos and infertility, signs of infertility, symptoms of infertility