Polycystic ovary syndrome (PCOS) is a condition affecting women at reproductive age causing them to have irregular menstrual periods, acne (oily skin and pimples), excess hair growth (face, chest, and back). Those women might have problems trying to get pregnant (infertility) or keeping the pregnancy (repeated miscarriages). Also, it can be associated with problems with body metabolism like insulin resistance (or Diabetes Mellitus), obesity, sleep apnea, high cholesterol, depression, and anxiety.
The ovaries in women with PCOS are not functioning properly and causing hormonal imbalance by secreting too much testosterone (it’s a male hormone, normally produced by women in little amount). This hormonal imbalance has a negative impact on ovulation which results in absence of good quality ovulation, that why those women might skip menstrual periods and if they get pregnant some of them will have a miscarriage.
Even though the cause of polycystic ovary syndrome is not completely understood, there is evolving evidence supporting the fact that there is an inflammatory immune response in women with PCOS and a significantly high number of women with PCOS have antibodies against their ovaries.
How to get tested and what is the treatment if I have difficulty getting pregnant or keeping the pregnancy (repeated miscarriages)?
After thoroughly reviewing medical records, the patient will be examined and ultrasound will be performed. The blood tests will be obtained to investigate hormonal and metabolic status. Diagnosis of polycystic ovary syndrome can be challenging because many time patients don’t present or complaint of the same problems.
Treatment of PCOS will be individualized based on the work up performed, it includes:
– Weight loss (Low carb diet and regular exercise): can improve hormonal and metabolic status.
– Metformin: it’s a diabetic medication however its use nowadays has been extended beyond the treatment of diabetes and is considered a “wonder drug”. It helps women with PCOS to regulate the hormonal and metabolic problems and thus regulating the menstrual cycle and help women to get pregnant in addition to other medications.
– Clomiphene (Clomid) or Letrozole (Femara): those medications can help to stimulate the ovary to produce one or more eggs.
– Gonadotropins Injections: If clomiphene and Letrozole didn’t help, Gonadotropin injections (FSH, follicle stimulating hormone) might be recommended and ordered by REI specialists.
– Other medications will be prescribed as indicated by the immune testing.