Five Things You Should Know About PCOS and Fertility
Polycystic ovarian syndrome (PCOS) is a very common medical condition among women of reproductive age that often is caused by metabolic abnormalities and leads to irregular menses and infertility. Despite its name, PCOS is not primarily a problem in the ovaries but a lack of proper communication between the brain and the ovaries. Pre-diabetes and elevated insulin levels play a role in most cases of PCOS. Most women with PCOS have irregular menses, increased facial and abdominal hair growth, or acne. Although 80% of women with PCOS are overweight, 20% are thin or normal weight. Also, not all women with PCOS have obvious increased body hair. The following are five things you should know about PCOS and fertility:
1. Women with PCOS do not have large cysts on their ovaries.
The truth is polycystic ovarian syndrome is a terrible name for this syndrome; many follicle ovarian syndrome would have been a better name. The ovaries do not have large cysts, but many more follicles than the average woman. In a normal cycling woman, a few follicles will develop each month and eventually one will release an egg (ovulate), leaving the ovary with a few small follicles. In polycystic ovarian syndrome, the follicles start to develop but they never get proper stimulation from the brain so the many small follicles remain. Women with PCOS are not necessarily at higher risk for large ovarian cysts or surgery.
2. Women with PCOS have a normal number of healthy eggs.
Women with PCOS do not specifically have a problem with their ovaries or eggs, but have a problem with ovulation due to improper signaling between the ovaries and brain. Their fertility does not decline any faster than an average woman’s fertility. Also, women with PCOS have normal fertility when undergoing IVF and have many healthy follicles in their ovaries. In women with PCOS, the brain is often not signaling the ovaries properly; therefore, the follicles do not develop, and a woman does not ovulate.
3. Women do not need an ultrasound to confirm that they have polycystic ovarian syndrome.
PCOS is a syndrome and the diagnosis is made on clinical grounds. Simply having irregular menses with either increased hair growth, severe acne or elevated male hormones in blood tests is all that is needed to make the diagnosis. An ultrasound is not indicated or necessary in women with PCOS.
It may be helpful in borderline cases.
4. Women do not gain weight because they have PCOS.
Many women believe that it is because of their polycystic ovaries that they have gained weight. Many women with PCOS have pre-diabetes and elevated insulin levels. It is these metabolic abnormalities which can cause weight gain or difficulty losing weight. The same metabolic abnormalities prevent regular ovulation and create multiple follicles on the ovaries i.e. polycystic ovaries. It is not the polycystic ovaries that has caused the weight gain but the metabolic abnormalities lead to weight gain and polycystic ovaries.
5. Polycystic ovarian syndrome is common.
Polycystic Ovarian Syndrome is a common hormonal disorder and while there might not be a definitive cure for it, regular exercise and a healthy diet can help with the symptoms.
At Fertility Centers of New England, patients come to us because they are struggling with infertility and/or miscarriages. If you have more questions about the five things you should know about PCOS and fertility or are considering starting a family, please contact us for a free consultation.
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