Improving Fertility in Women With PCOS
Polycystic ovary syndrome or PCOS affects as many as 5 million women in the United States and is one of the most common causes of infertility. PCOS is likely a number of different diseases that manifest in similar physical symptoms, such as acne, excess facial and body hair growth, insulin resistance, abnormal menstrual periods, infertility, and recurrent pregnancy loss. Over 60% of women with PCOS are overweight or obese. PCOS appears to have a genetic component that may be triggered or influenced by environmental factors. The symptoms of PCOS are at least in part due to excess androgens (male hormone secretion) that belong to the family of hormones to which testosterone belongs.
Improving fertility in women with PCOS has largely focused on medications such as clomiphene citrate (Clomid) which is the most commonly used oral agent for ovulation induction in women with PCOS. Studies suggest that only half of women who ovulate using clomiphene citrate end up having a baby. Metformin, a medication to lower insulin resistance and blood sugar has also been used to help induce ovulation and appears to work best in conjunction with either clomiphene citrate or lanother anti-estrogen, letrazole (Femara). Femara is an oral non-steroidal aromatase inhibitor that may result in more live births than can be achieved with clomiphene. For resistant cases, in vitro fertilization remains the most efficacious treatment of infertility in women with PCOS. Great care is needed when inducing ovulation in women with PCOS as the chance of developing ovarian hyperstimulation syndrome (OHSS) is increased. Vigilance and careful choice of gonadotropin dosing is imperative in the management of ovulation induction in women with PCOS and should only be done by a certified specialist where daily monitoring is avaialble.
If you have PCOS or have further questions on the best treatment path for you, contact us today!