What is PCOS and Why does it Cause Problems Getting Pregnant?

PCOS stands for Polycystic Ovary Syndrome. It is a leading cause of infertility and is very common; between one in every five to ten women probably has PCOS. About 70% of women with PCOS will not get pregnant easily. It is important to remember that many women with PCOS can get pregnant easily and must watch out for unwanted pregnancies.

what is PCOs

With PCOS the woman’s body produces abnormally high levels of the hormone messengers, androgen and insulin. This can cause an irregular menstrual cycle where periods come too close together, too far apart, or stop entirely. This happens when PCOS causes the woman to stop growing and releasing eggs in a regular way from the ovaries.

This failure of the normal process of growth and release of eggs may happen for nearly all the months of the year. As a result, women with this type of PCOS have much lower chances of becoming pregnant and face PCOS-related infertility.

Symptoms of PCOS include:

  • Ovaries that are large or have many cysts (fluid-filled sacs)
  • Excess face and body hair (chest, stomach, and back)
  • Weight gain, especially around the belly (abdomen)
  • Acne or oily skin
  • Male-pattern baldness or thinning hair
  • Dark or thick skin patches on the back of the neck, armpits, and under the breasts
  • Infertility

Doctors use pelvic ultrasound scans and blood tests to diagnose PCOS. PCOS can be over-diagnosed, so remember, to be diagnosed with PCOS you must have two or more of these things:

  • A Pelvic Ultrasound showing more than 20 mini (less than 10mm in diameter) cysts on one or both ovaries
  • A blood test showing raised androgen levels in a woman without any of the other medical causes for this condition
  • Irregular or absent periods
  • Infertility due to lack of egg release in a woman with good egg levels (AMH blood testing)
  • Signs of high androgen levels in the body, e.g. unwanted hair or significant acne

PCOS infertility can be improved with weight loss in women with a higher weight. Even relatively small amounts of weight loss, as little as 5% of total weight can help with pregnancy.

There are also effective fertility pills that can work well to encourage pregnancy in women with PCOS. Letrozole is the first line treatment for most doctors; other medications include Clomiphene citrate, Metformin and Gonadotrophin injections.

In the rare cases when egg growing fertility tablets and injections have not worked, surgery is a second-line treatment for PCOS-related infertility. This surgery is a relatively non-invasive “key-hole” procedure called laparoscopy. It involves gentle burning of the cystic areas in each ovary. While key-hole surgery has good pregnancy success rates, it is not suitable for women who already have low egg levels, and will in fact make the situation worse.

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