Understanding the Link Between PCOS and Infertility
Polycystic ovarian syndrome (PCOS) is a common hormone imbalance in women of reproductive age. The hallmark of the disease is irregular menstrual cycles due to lack of regular ovulation. To confirm the diagnosis, it is important to rule out other conditions like low thyroid hormone and an elevated level of a hormone called prolactin that can also lead to irregular ovulation. It is also important to confirm the ovaries have a good number of eggs, also known as “ovarian reserve”, as on rare occasions, irregular cycles can signal the onset of early ovarian failure.
Once a diagnosis of PCOS is established, it is fairly straightforward to control menstrual cycles with medications like birth control pills. However, if women with PCOS want to get pregnant, the lack of regular ovulation can make it difficult to conceive naturally. Thankfully there are readily available treatments to help induce egg maturation and ovulation. The most common medications used are clomid and letrozole. These simple-to-use, oral medications can help achieve regular ovulation most of the time. Both clomid and letrozole are safe to use with the only significant risk being an elevated risk for twins which roughly doubles compared to the background population. Metformin, a medication used for diabetes, can also be used, however, it generally takes longer and is less effective for ovulation induction.
For women who are unable to ovulate regularly on oral medications, injectable fertility drugs will be able to spur egg maturation. However, these medications carry a much higher rate of multiple gestation if used in isolation, so it is preferable to use them only in the context In Vitro Fertilization (IVF). IVF is a type of treatment that involves retrieving eggs, fertilizing them outside the body, and then transferring a single, fertilized embryos back into a uterus. Today, it is best practice to only transfer one embryo during a transfer which can yield very high success rates with extremely low risk for a multiple gestations that carry greater pregnancy risk. While there is a clear link between PCOS and infertility, fortunately, the condition is very treatable and many women with PCOS are able to achieve the family of their dreams.
If you are interested in meeting with a reproductive endocrinologist to discuss family-building with PCOS, you can reach out to info@rmany.com.