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PCOS and Fertility: Understanding and Increasing Your Chances of Conception


Question
hi, I'm a 26yr old who has three children already I've been trying for an other child with a new partner for almost 12months now and have had no luck with falling pregnant and have been told i have polysictic ovary syndrome how do i get around that and fall pregnant again???? please help...

Answer
Dear Chrissy,

Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance. About one in ten women of childbearing age has PCOS and is the most common cause of female infertility (not being able to get pregnant). With PCOS, women typically have:
- high levels of androgens (male hormones- although females also make them)
- missed or irregular periods
- many small cysts in their ovaries

The cause of PCOS is unknown. Most researchers think that more than one factor could play a role in developing PCOS. Genes are thought to be one factor. Women with PCOS tend to have a mother or sister with PCOS. Researchers also think insulin could be linked to PCOS. For many women with PCOS, their bodies have problems using insulin so that too much insulin is in the body. Excess insulin appears to increase production of androgen. This hormone is made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation.

PCOS symptoms often include:
- infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
- infertility (not able to get pregnant) because of not ovulating
- increased hair growth on the face, chest, stomach, back, thumbs, or toes - a condition called hirsutism
- ovarian cysts
- acne, oily skin, or dandruff
- weight gain or obesity, usually carrying extra weight around the waist
- insulin resistance or type 2 diabetes
- high cholesterol
- high blood pressure
- male-pattern baldness or thinning hair
- patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
- skin tags, or tiny excess flaps of skin in the armpits or neck area
- pelvic pain
- anxiety or depression due to appearance and/or infertility
- sleep apnea - excessive snoring and times when breathing stops while asleep

Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, whether or not you want to become pregnant, and lowering your chances of getting heart disease and diabetes. Many women will need a combination of treatments.
- For women who don't want to become pregnant, birth control pills can control menstrual cycles, reduce male hormone levels, and help to clear acne. However, the menstrual cycle will become abnormal again if the pill is stopped.
-  The medicine metformin (Glucophage) is used to treat type 2 diabetes. It also has been found to help with PCOS symptoms, although it is not FDA-approved for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production.
- Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. For most patients, clomiphene citrate (Clomid, Serophene) is the first choice therapy to stimulate ovulation. If this fails, metformin taken with clomiphene is usually tried. When metformin is taken along with fertility medications, it may help women with PCOS ovulate on lower doses of medication. Gonadotropins also can be used to stimulate ovulation. These are given as shots. But gonadotropins are more expensive and there are greater chances of multiple births compared to clomiphene. Another option is in vitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any one cycle and gives doctors better control over the chance of multiple births. But, IVF is very costly.
- "Ovarian drilling" is a surgery that brings on ovulation. It is sometimes used when a woman does not respond to fertility medicines.
- Keeping a healthy weight by eating healthy foods and exercising is another way women can help manage PCOS. Many women with PCOS are overweight or obese. Eat fewer processed foods and foods with added sugars and more whole-grain products, fruits, vegetables, and lean meats to help lower blood sugar (glucose) levels, improve the body's use of insulin, and normalize hormone levels in your body. Even a 10% loss in body weight can restore a normal period and make a woman's cycle more regular.

I hope this information has helped you and answered your question. I wish you well.

Brenda