PCOS and Infertility - Facts You Should Know

From five to ten percent of childbearing-age women are affected by PCOS or "Polycystic Ovarian Syndrome," and is one of the more common infertility problems for women. Less than twenty-five percent of women with PCOS have been diagnosed, which is why most women are unaware that they have it. PCOS can result in a body resisting insulin, which can lead to diabetes. Some women's bodies produce high levels of androgens - which are male hormones - in response to their bodies' production of excess insulin.

The high levels of androgens means that there is a lower amount of female hormones, which can effect a woman's fertility as follows:

In a woman's normal menstrual cycle, the ovaries produce several follicles and each of these contains an egg. In the latter stages of the cycle, only one remaining follicle will produce the single egg needed for ovulation. For ovulation to take place, the matured egg will burst from the follicle as a result of a surge in Luteinizing Hormone or "LH." Women with PCOS, however, usually don't produce enough female hormones necessary for ovulation, so the follicles never mature into eggs.

Some follicles typically develop into cysts in the ovaries, and show up on ultrasounds as a 'string of pearls.' The lining of the uterus will begin to thicken, as an indirect result of ovulation not occurring.

The symptoms for PCOS vary from woman to woman. Some will have only an irregular period and others will have no period at all. Some lucky women will conceive anyway, during an irregular mestruation cycle. In any case, other symptoms can include the following: hair growth on chest, back or face, thinning hair, type 2 diabetes, high insulin levels, pelvic pain or acne. PCOS generally becomes worse with age.

Being unable to ovulate is the primary reason that Polycystic Ovarian Syndrome prevents a woman from conceiving. Thankfully, however, there are some things that can be done to fix this. Weight loss for some women is all they need to do to overcome PCOS. This is because hormonal imbalances are often improved at lower body weight. For overweight women with PCOS, Metformin is a drug that is effective for helping a woman's body absorb insulin. Since it doesn't directly lower blood sugar levels, it is considered safe and has proven very effective.

Certain fertiliy drugs have proven effective in helping women with PCOS by blocking estrogen receptors in the brain. The most common is Clomifene (or Clomiphene) and is marketed under the names "Clomid, Clomifert, or Serophene." By blocking these estrogen receptors, hormone glands in the brain sense the estrogen levels are low. This causes the female's body to ovulate by triggering her body to produce more Follicle Stimulating Hormone and Luteinizng Hormone. Nevertheless, only about thirty-five percent of women who ovulate from using these particular drugs will become pregnant.

One option for women with PCOS is IVM or In Vitro Maturation. In this procedure, immature eggs are taken from a woman and matured in a laboratory to be used later for fertilization with a sperm. After fertilization, the egg can be implanted into a woman's uterus in the hopes that an embryo will develop. In Vitro Maturation - although new and still somewhat experimental - is proving less expensive and is safer than IVF.

With IVF, however, only after a woman's eggs have matured are they harvested. The eggs (which were already mature when removed from the woman) can then be fertilized with sperm cells to be implanted in the uterus. In vitro fertilization often includes treatment to help the eggs develop. It's also useful for women who do not respond to drug therapy well.