To mark PCOS awareness month, this September I have written a series of short blogs to break down the symptons, the causes and the treatment options. In this my final blog, I want to examine the options to help you conceive when suffering with PCOS.
PCOS is one of the primary causes of a woman’s infertility. It affects somewhere between 5-10% of women aged between 20 and 40. This makes it the most widespread reproductive syndrome for this age group of women. But there is good news, it is treatable and many women who have suffered go on to achieve a successful pregnancy!
What fertility treatments are available for PCOS?
Nealy one-third of all infertility diagnoses in women, can be attributed to PCOS, it is the most common ovulatory disorder in women of reproductive age.
For women with PCOS who are actively trying to conceive, it is advised to consult with a fertility specialist, since more than 95% of women with PCOS do not ovulate regularly, or have regular menstrual cycles and therfore experience difficulty when trying to conceive.
In anovulatory cycles, ovarian follicles fail to mature fully and release eggs. Treatment to promote the recruitment and release of the egg is required (ovulation induction).
For the optimal management of PCOS, we must also look at any coexisting causes of infertility and assess tubal function and semen analysis. We then manage ovulation induction through close monitoring and a time line.
Oral fertility medications like clomiphene (Clomid or Serophene) or letrozole (Femara), which have been available for many decades, continue to be widely used to produce an ovarian follicle containing an egg.
In additional metformin may be prescribed. Metformin helps to decrease glucose production and makes the body more sensitive to insulin, thus leading to more regular ovulation.
It is only recommended to stay on a medication-only protocol for three to four cycles, after which, chances of this protocol resulting in a pregnancy decrease.
Depending on the initial testing, your fertility specialist may recommend timed intercourse or intrauterine insemination (IUI) with medications to induce ovulation and monitoring the development of the follicles. Provided that the Fallopian tubes are open and the sperm counts are normal, this treatment option can result in a successful pregnancy.
The typical success rate with IUI are about 15-25% per cycle; a woman’s individual success rate with IUI is largely impacted by her age.
If after a few attempts with IUI, or if the patient is presenting other factors, such as blocked Fallopian tubes, in vitro fertilization (IVF) may be recommended.
There is hope!
With the proper treatment, PCOS can be managed long-term and patients can live relatively symptom free.
While myths persist that women with PCOS cannot get pregnant, the reality is that PCOS is highly treatable and nearly every women with PCOS should be able to get pregnant unless other causes coexist.
In fact, many women will experience increases in fertility through simple lifestyle changes and weight loss. Others will find success with basic infertility treatments and medications. And for those that need additional help conceiving, in vitro fertilization (IVF) is a highly effective form of treatment for women with PCOS.
Thank you for taking the time to read this blog series on PCOS, you can show your support and raise awareness by sharing this blog on your social media.
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