Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome is a health problem that can affect a woman’s period, hormones, fertility, heart, blood vessels and appearance. It is the most common cause of infertility among women. A woman with PCOS would have many small cysts in her ovaries, abnormal hormone levels, and suffer from the following symptoms:

• Irregular periods or no periods at all
• Difficulty becoming pregnant (reduced fertility)
• Having more facial or body hair than usual
• Loss of hair on the head
• Patches of skin that are thick and dark brown
• Skin tags (excess flaps of skin around the neck and in the armpits)
• Being overweight, rapid increase in weight, difficulty losing weight
• Oily skin, acne
• Depression and mood swings
• Pelvic pain
• Sleep apnea (when breathing stops for a short period of time while asleep)

What causes Polycystic Ovarian Syndrome?
The cause of PCOS is not yet fully known. PCOS sometimes runs in families. So it may have a genetic basis. If any of your relatives (mother, aunts, sisters) are affected with PCOS, your own risk of developing PCOS may be higher .

How can PCOS affect fertility?
Though a lot of PCOS women will get pregnant on their own surprisingly due to erratic ovulation, most could face some problems related to the ovulation (release of the egg during each period cycle).

Since the immature follicles do not mature regularly in each cycle, getting pregnant may become very difficult.

The other issue in PCOS patients may be the excessive weight gain (obesity) which further increases the chances of not ovulating. Obesity can also make patients more resistant to simple ovulation inducing drugs.

Some women may also have temporary cessation of periods which needs medicines to be resumed.

Can I conceive with PCOS?
The good news is that the chance of getting pregnant with PCOS using fertility treatments is very good. It is one of the most easily responding and treatable problems. A great majority of women with PCOS will be able to have a baby with simple fertility treatment. Various treatments are available for conception. Most treatments involve induction of ovulation with commonly known drugs like clomiphene, letrozole and metformin. They would successfully induce ovulation in 80% to 90% of patients and 60% to 70% would get pregnant.

For the rest, the second step could be treatment with some injectable drugs to induce ovulation called gonadotropins.

In some patients, laparoscopy and ovarian drilling is preferred to other treatments because it can help resume ovulation in the ovaries. It also gives advantage of directly checking the pelvis for other factors that may contribute to infertility.

If this doesn’t work, in vitro fertilization (IVF) is recommended as it can successfully produce a pregnancy in almost all women with PCOS.

What can I do to increase my chances of conception if I have PCOS?
To improve your chances of getting pregnant if you have PCOS and to reduce the long term risks of the problem, lifestyle changes play a major role.

• Eat a healthy balanced diet. This should include fruits , vegetables and whole foods (such as wholemeal bread, whole grain cereals, brown rice, wholewheat pasta), lean meat, fish and chicken. You should decrease sugar, salt, caffeine and alcohol
• Eat meals regularly especially including breakfast
• Exercise regularly (30 minutes at least three times a week)
• Keep your weight to a level which is normal

Do not hesitate to discuss the condition fully with your gynecologist or health practitioner and its implications for you as an individual. Assess your chances of pregnancy with PCOS and follow the doctor’s advice.