Polycystic Ovary Syndrome and Fertility: Exploring the connection and impact | PCOS Awareness Month

PCOS, an acronym for Polycystic Ovary Syndrome, is a condition in which the ovaries produce excess androgens, i.e. male sex hormones that should be in small amounts in women. This syndrome refers to the ovaries' numerous small cysts. In recent years, PCOS has emerged as a very common hormonal disorder among women. This condition affects the ovaries but does not directly lead to infertility.

Exploring the connection between PCOS and Fertility

When a mature egg is released from an ovary, it results in ovulation. This process either leads to fertilization by male sperm or is excreted during menstruation.

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In some cases, a woman does not produce the required number of hormones for ovulation. In some, the growth of eggs can be impaired and their release during ovulation may not occur as required. When ovulation does not happen, the ovaries can develop into a number of small cysts. These cysts produce androgen hormones.

Therefore, women diagnosed with PCOS have elevated levels of androgens that exacerbate an individual's menstrual cycle. Moreover, factors such as the formation of thin, painless, fluid-filled sacs in the ovaries, thickening of the ovaries' outer shell, and high insulin levels in your blood are also some of the byproducts that cause disruption in the ovulation process. Period irregularities or missed periods are one of the initial, immediate signs of this disorder.

However, it is crucial to note that having PCOS does not mean that pregnancy is impossible and not all women with PCOS will experience infertility. PCOS manifests differently in individuals, and the severity of its impact on fertility can vary. Long-term effects of PCOS suggest concerns for increased risk of cardiovascular diseases, Endometrial disorders and severe emotional distress.

Symptoms

PCOS symptoms usually appear in late adolescence or early adulthood. They may include the following:

1. Excess hair growth on the face or other body parts
2. Hair loss on the scalp
3. Acne scarring or oily skin
4. Skin patches on the neck or armpits
5. Acanthosis nigricans (thickened, darkened skin patches), most commonly found on the neck, groin, or beneath the breasts.
6. Weight Gain or having difficulty losing weight

Diagnosis

At the first initial steps, your medical history and symptoms are evaluated. Based on the evaluation, a physical examination is advised. This would probably include a pelvic exam and an assessment of reproductive organs. Some of the symptoms of PCOS are often similar to other health issues. As a result, you may also be recommended tests such as:

Ultrasound: This test creates images of blood vessels, tissues, and organs using sound waves and a computer. The test is used to determine the size of the ovaries, whether they contain cysts and the thickness of the uterine lining (endometrium).

Blood tests: Blood tests are performed to assess the levels of androgens and other hormones. Your blood glucose levels may also be examined by your doctor. In addition, your cholesterol and triglyceride levels may also be checked.

Treatment

A variety of factors influence PCOS treatment. These could include one’s age, the severity of symptoms, and overall health. As there is currently no cure for PCOS, treatment and management are determined by the goal.

Lifestyle Changes: Lifestyle changes, such as regular exercise, a low-calorie diet and ensuring quality sleep every night are effective in reducing the impact of PCOS and prevent off-setting the chain of ovulation problems

Medications: A short course of tablets such as Clomiphene and Metformin can be taken at the start of each cycle for several cycles and can successfully treat the majority of women connected to PCOS.

Following are a few brief measures for effectively managing PCOS symptoms:

Clomiphene citrate (Clomid): Clomifene stimulates the ovaries' monthly release of an egg (ovulation).

Metformin: Metformin is commonly used to treat type 2 diabetes, but it also reduces insulin and blood sugar levels in PCOS women. Metformin has other long-term health benefits, such as lowering high cholesterol levels and lowering the risk of heart disease, in addition to stimulating ovulation, encouraging regular monthly periods, and lowering the risk of miscarriage.

Surgery: A minor surgical procedure known as laparoscopic ovarian drilling (LOD) may be a viable treatment option for PCOS-related fertility issues that do not respond to medication. Under general anaesthesia, your doctor will make a small incision in your lower tummy to insert a long, thin microscope called a laparoscope into your abdomen. The ovaries will then be surgically treated with heat or a laser to destroy the androgen-producing tissue (male hormones). LOD has been shown to lower testosterone levels and luteinizing hormone (LH) levels while increasing follicle-stimulating hormone (FSH). This balances your hormones and allows your ovaries to function normally again.

However, even with the implementation of these measures, if fertility issues persist, the preferred treatment process involving IVF is recommended. Every individual is different and hence it is important to consult a healthcare professional to choose a treatment plan that is optimal for your body.

(With inputs fromDr Parul Gupta Khanna, Fertility Specialist, Nova IVF Fertility, Gurugram)

Disclaimer: Please note that the information provided on this website is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition. The content provided on this website should not be used to diagnose or treat any health problem or disease. If you have or suspect that you have a medical problem, please contact your healthcare provider immediately. Never disregard professional medical advice or delay in seeking it because of something you have read on a website.

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