One of the common causes of infertility is Polycystic Ovarian Syndrome (PCOS). Do you have questions about PCOS? We’ve answered several of the most common here:
What is Polycystic Ovarian Syndrome (PCOS)?
Polycystic Ovarian Syndrome (PCOS) is a condition where many cysts – small, fluid-filled sacs – form on a woman’s ovaries. Women with PCOS produce more male sex hormones, called androgens. The overproduction of androgens interferes with the body’s signals to develop and release eggs from the ovaries. Many women with PCOS may be at risk of developing other metabolic disorders, including insulin resistance, type 2 diabetes, high blood pressure, high cholesterol, and sleep apnea.
What causes PCOS?
PCOS is fairly common. Between 5 and 15 percent of women of childbearing age have PCOS, and many women with PCOS aren’t even aware they have it until they experience infertility.
We’re not sure what causes PCOS, but underlying factors may be genetic. PCOS tends to run in families, and can be passed down from either the mother’s or father’s side. A woman’s weight, diet, and exercise habits can also play a role.
How can I tell if I have PCOS?
Because their bodies are producing more male hormones, women with PCOS tend to have irregular menstrual cycles, or even stop menstruating altogether. They also tend to grow more facial and body hair in patterns and places similar to male hair growth, and may also have ongoing issues with acne. At the same time, women with PCOS may experience thinning hair on their scalp, similar to male pattern baldness.
Weight gain also appears to be a factor in PCOS. Women with PCOS may find it difficult to manage their weight.
The presence of these factors help doctors determine whether or not a woman has PCOS. While no single medical test exists to diagnose PCOS, a doctor can confirm the diagnosis with a physical exam, ultrasound, and/or blood testing.
During the physical exam, the doctor will look for acne, abnormal patterns of hair growth, or other visible signals of a hormonal imbalance. Blood testing can confirm high levels of androgens and screen for other associated metabolic conditions. An ultrasound will help observe whether or not ovaries have a high number of cysts.
Is it still possible to become pregnant with PCOS?
The good news is that PCOS is treatable. The first step for some women may be to make lifestyle changes to address insulin resistance, weight management, and any other relevant metabolic disorders. Diabetes medications, such as metformin, might be prescribed. For some women, losing weight and managing insulin may be enough to restore normal ovulation patterns without further intervention.
Another option is to stimulate ovulation using an oral medication such as clomiphene citrate (Clomid) or Femara (Letrozole).
If oral medications are not successful, hormones knowns as gonadotropins can be injected. Gonadotropins are usually effective at stimulating ovulation in women with PCOS, but may increase the risk of multiple pregnancy.
If medication regimens prove ineffective, doctors may consider a procedure known as ovarian drilling. During this procedure, a surgeon uses a laser or fine electrical needle to penetrate the surface of the ovary and reduce the number of cells that produce androgens, improving the chances of future ovulation.
For many women, in vitro fertilization (IVF) may be an additional option to consider, as IVF pregnancy rates tend to be very high for women with PCOS, and rates of multiple pregnancy can be kept to a minimum.
Will insurance cover PCOS treatment?
Coverage varies from plan to plan, and we’ll be glad to support you as you discuss options with your insurance carrier.
Sources:
https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
https://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/infertility.aspx
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