The polycystic ovarian syndrome, which is abbreviated as PCOS, is one of the most common reproductive disorders we encounter at our Los Angeles based reproductive endocrinology and infertility (REI) practice. Each individual with PCOS may experience a different combination of symptoms related to the disorder, including increased body hair, acne, thinning scalp hair, elevated cholesterol, obesity, diabetes and more. PCOS’s primary symptoms, including irregular periods and infertility, are the most common presenting complaint.
For those patients with PCOS who desire to conceive, there are a variety of treatment paths from which to choose. The right path for any individual will depend on her unique medical, social, financial and emotional conditions. Some of the fertility treatments available to women with PCOS include:
1. Lifestyle modification: Close to half of all women with PCOS suffer from obesity, which is both a symptom and cause of PCOS. Breaking the cycle between PCOS and obesity by losing 10% or more of total body weight, is one successful way of treating the syndrome. Additionally, healthy body weight is important for a safe and healthy pregnancy. At our center, we often work with nutritionists and personal trainers throughout the San Fernando Valley and Los Angeles areas to help our patients achieve their weight loss goals.
2. Ovulation induction: Although many of the symptoms of PCOS contribute to infertility, the most important factor is anovulation. The vast majority of women with PCOS do not release an egg (ovulate) on a regular basis. Without this critical aspect of normal reproductive function, a woman cannot conceive. Fortunately, there are a variety of medications available which can induce ovulation. These medications come in oral forms, as well as injectable forms. It is common to combine ovulation induction with an intrauterine insemination to improve the chance for success.
3. In-vitro fertilization (IVF): During IVF, daily injectable medicine is used to induce multiple eggs to grow within a woman’s ovaries. These eggs are then retrieved (harvested) about 12 days later through an ultrasound guided procedure. The eggs are fertilized with chosen sperm in the laboratory and 3 to 5 days later, returned to the patient’s uterus as embryos. For women with PCOS, IVF represents a practical approach to becoming pregnant. IVF is advantageous because of its high success rates and lower chance for higher order multiple pregnancies.
4. Ovarian diathermy (drilling): Ovarian diathermy is a procedure where some of the ovarian tissue responsible for hormone production, is destroyed using an electrical current. For women with PCOS, this is therapeutic because, they often have excess hormone production from the ovary. Studies have shown that more than half of women who undergo this procedure begin to spontaneously ovulate within one year. The procedure requires a laparoscopy and has the risk of causing scarring within the abdomen.
Depending on a woman’s symptoms, PCOS can be treated in a variety of ways. If you have PCOS, or any other reproductive disorders, fell free to contact one of our reproductive specialists, we’d be happy to speak with you.