10 things you need to know

"I have always had irregular menstruation, with very variable cycles and impossible to predict. After a series of examinations, my gynecologist diagnosed me with the polycystic ovarian syndrome. After the diagnosis, the first thing I asked was: if I have polycystic ovaries, can I get pregnant?" Question from one of our users on Beplus+

Yes, women with polycystic ovarian syndrome can get pregnant. It is possible that you get pregnant and have a baby, although it may be a little more complicated than if you have a regular cycle.

1. What is Polycystic Ovarian Syndrome (PCOS)?

PCOS also known as Stein-Leventhal Syndrome or Hyperandrogenic Chronic Anovulation affects approximately five to ten percent of women of childbearing age, which makes it the most common cause of infertility in women.

It is a metabolic-endocrine syndrome with symptoms that can produce symptoms from mild and almost asymptomatic to severe.

Polycystic ovary syndrome is associated with anovulation and amenorrhea (lack of menstruation or periods), obesity, elevated secretion of androgens or male hormones and identification on ultrasound of polycystic or multifollicular ovaries.

The most common symptom of PCOS is an irregular, abnormal, very slight or infrequent menstruation. When the ovaries make higher amounts of androgens than normal, this can interfere with the development and release of the ovum which leads to the formation of cysts in the ovary.

2.What causes PCOS?

Doctors are not sure precisely causes of PCOS. However, the most accepted explanation is a mixture of genetic and environmental factors. Also, overweight and obesity increase the risk of PCOS.

3.What is the relation between infertility and PCOS?

PCOS is a complex entity that encompasses endocrine and metabolic disorders and that usually occurs in women with irregular menstruations and alterations in ovulation, which reduces their fertility.

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4. What are the symptoms of PCOS?

The most common symptom is having irregular menstrual cycles, which can be intermittent and also variable in the amount of flow (very light or very abundant). Elevated androgen levels can lead to acne, excessive hair growth on the face and body, or male-type baldness on the scalp.

Also, one of each two women with PCOS develop type 2 diabetes before reaching forty years of age and have a higher tendency to obesity.

5. Polycystic ovaries or PCOS. What’s the difference?

It is important to emphasize that it is not the same to have cysts in the ovaries than PCOS. Polycystic ovaries are an ultrasound diagnosis that may or may not be accompanied by symptoms, while to consider PCOS at least two of the following symptoms must be present:

  • Anovulation or oligoanovulation.
  • Clinical or biochemical signs of hyperandrogenism, such as hirsutism, acne, high free testosterone.
  • Detection of more than twelve follicles in at least one of the ovaries.

In contrast, women with polycystic or multifollicular ovaries have many follicles in the ovaries but do not suffer from hormonal disorders associated with the first two points.

6. What is the treatment for PCOS?

If you want to get pregnant the treatment options are:

Lose weight: If you are overweight, losing weight can help you improve ovulation.

Medicines for fertility

Your doctor may consider some medications such as:

  • Clomiphene citrate. About 80 percent of women begin to ovulate in the first three months after starting clomiphene treatment. Of those women, 30 to 40 percent become pregnant for the third cycle of therapy.
  • Letrozole. It serves to promote ovulation as does clomiphene
  • Metformin. An insulin-sensitizing medication that also promotes ovulation. You can take it in combination with Clomiphene or Letrozole or alone.
  • Gonadotropins. It is an injectable medication that stimulates ovulation and the development of multiple ovules. It is an injectable medication that stimulates ovulation and the development of multiple ovules. Women with PCOS that do not respond to Clomiphene treatment may benefit from fertility drug treatment with gonadotropins.

If your body does not respond to treatments, or if you decide not to use them, another option is a surgery that can lower the level of male hormones and help with ovulation. If none of the above works, your doctor may suggest in vitro fertilization (IVF).

7. Is it possible to get pregnant with PCOS?

For women with PCOS, regular ovulation does not occur, so getting pregnant can be more difficult. The treatments for polycystic ovary syndrome depend on the symptoms, the intensity of these and whether they are aimed at treating hyperandrogenism, infertility or menstrual irregularity.

If pregnancy is sought, changes in lifestyle, pharmacological treatments or assisted reproductive technology be necessary.

8. What are ovarian stimulation and in vitro fertilization?

The technique of assisted reproduction to achieve pregnancy with PCOS that your doctor chooses depends on the couple's clinical history and the results of the fertility study.

Ovarian stimulation and ovulation induction consist of inducing multiple ovulation through hormonal medications, a process that is carried out to achieve assisted reproduction, either by artificial insemination or in vitro. The percentage of pregnancy ranges between 15% and 25% per treatment cycle and in approximately 15% of cases, women who follow this treatment have twins.

In vitro fertilization or IVF (IVF) is a fertility treatment through which the ovules and sperm are combined in a laboratory. About 1.5 percent of babies born in the United States are conceived through some technique of assisted reproduction.

IVF is the main treatment for infertility when other methods of assisted reproduction have not been successful, and the chances of success vary greatly depending on the age of the woman and the oocytes that are used.

9. How does PCOS affect a pregnancy?

According to a recent study by Swedish researchers at the Karolinska Institute in addition to having complications to become pregnant, women with PCOS may have more problems in pregnancy.

Women with PCOS are twice as likely as women without the condition of giving birth prematurely to their baby. They also have an increased risk of spontaneous abortion, high blood pressure, and gestational diabetes.

10. Can polycystic ovarian syndrome be prevented?

There's no way to prevent PCOS, but early diagnosis and treatment are the best ways to control the symptom.

It is essential to lead a healthy life, stop smoking and avoid alcohol, reserve 30 minutes of our day to exercise (go for a walk at a moderate pace is enough), try to eat a balanced diet and have a healthy weight.

Conclusion

Polycystic ovary syndrome is the most common hormonal disorder among women of reproductive age. Although it can make it harder to conceive, certain medications and changes in lifestyle can increase fertility and prevent complications.

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References

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  5. Bellver J, Rodríguez-Tabernero L, Robles A, Muñoz E, Martínez F, Landeras J, García-Velasco J, Fontes J, Álvarez M, Álvarez C, Acevedo B; Group of interest in Reproductive Endocrinology (GIER) of the Spanish Fertility Society (SEF). Polycystic ovary syndrome throughout a woman's life. J Assist Reprod Genet. 2018  Jan;35(1):25-39. doi: 10.1007/s10815-017-1047-7.
  6. Roos N, Kieler H, Sahlin L, Ekman-Ordeberg G, Falconer H, Stephansson O. Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. BMJ. 2011 Oct 13;343:d6309. doi: 10.1136/bmj.d6309.

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