subject: Women Health [print this page] PCOS and its relation to fertility and obesity Polycystic ovarian syndrome or PCOS is one of the major problems of infertility in females. A condition where your hormones are out of control causing the increased size of ovaries with small cysts on the outer surface of ovaries is known as PCOS. About 10% of women who are their childbearing age are victims of PCOS. Symptoms of PCOS are very confusing and they differ from woman to woman. You can get PCOS treated and get rid of the symptoms caused by it if you know the most common symptoms that are associated with it. Let us know what are the symptoms seen in PCOS. PCOS symptoms Symptoms that are seen in PCOS are obesity, infertility, irregular or heavy or no menstrual cycle, acne, and abnormal hair growth on the face and other body parts (upper chest, upper back), thinning of hair of loss of hair sometimes resulting in male-pattern baldness. There are other symptoms of PCOS that are rarely seen and they are like poor or disturbed sleep, mood changes, high blood pressure, pain in the pelvis, dry and itchy skin, fatigue, and headaches. In this article, we shall talk about the relation of PCOS with obesity and infertility. PCOS and infertility The first symptom of PCOS is the irregularity of the menstrual cycle. Sometimes, the menstrual periods might be completely absent for months to years while sometimes there may be bleeding for several weeks at a time. Only a few women with PCOS may get monthly periods. The underlying hormonal imbalance is the main reason for irregular menstruation. What happens in the general condition is there is a steady secretion of female sex hormones. But in the PCOS condition, the Leutinizing hormone or LH is secreted at higher levels. This high LH secretion in turn makes your ovaries secrete testosterone, a male hormone, at a higher rate. Too high levels of LH and testosterone hormones affect the normal levels of other sex hormones that work on controlling the menstrual cycle. This results in irregular periods and thereby affects the ovulatory process. Under normal conditions, the follicle from the ovaries gets mature and is released as an egg which will then get fertilized by the sperm resulting in pregnancy. But in PCOS, the follicles will never get mature completely and sometimes even fail to be released from ovaries. PCOS and obesity PCOS may cause a gradual or sudden weight gain with no other clear reasons. You may not be able to lose that excess weight that is gained for unknown reasons by doing exercises or by dieting. If women who are overweight try loosing at least 5% or more of their body weight, they can benefit by noticing an improvement in their PCOS symptoms. Higher levels of insulin are seen in PCOS women or the insulin that is produced may not function normally as it should. This improper functioning of insulin is one of the main reasons for an abnormal weight gain or the inability to lose excess weight. In some cases, PCOS follows with substantial weight gain. Due to these higher insulin levels, abnormal weight is added up in your central part of the body or the abdominal region. This excess weight is not easy to shed and also can increase the risk of getting metabolic conditions like type 2 diabetes, cardiovascular problems, and atherosclerosis. You should understand that there is a greater risk of developing PCOS if you are obese and PCOS itself can increase the risk of obesity. PCOS Management A simple lifestyle modification, having a healthy diet, doing regular exercises, taking medications like metformin, Clomid and Femara, gonadotropins, and undergoing surgical procedures like ovarian drilling can help in the PCOS condition. Due to the absence of ovulation getting pregnant is very difficult in the PCOS condition. With PCOS, if by any chance you get pregnant; there is a possibility of miscarriages due to imbalanced sex hormones and an increased level of insulin. There are few medical advanced techniques that can help to conceive even if you have PCOS. H3 Assisted Reproductive Techniques (ART) for PCOS IUI and IVF are said to be two ART procedures that can be considered to achieve pregnancy if all the above-listed treatments fail. Intrauterine Insemination (IUI) IUI is one of the fertility procedures that is done at the time of ovulation and works best in PCOS condition. Before the IUI process, your male partner is asked to collect the semen samples in a special container or even semen can be borrowed from a donor. The semen is then subjected to washing so that sperms are separated from other elements of semen and are then collected as a concentrated volume. This sperm is then placed in a thin, soft, and sanitized catheter and prepared to be inseminated into the uterus of the female. A surgical tool known as the speculum is used by the doctor to gently open your vagina and the cervical region is cleansed. The thin catheter with prepared sperm is inserted into the vagina and sperms are allowed to be released into the uterine cavity. You may have to stay in a lying position for a few minutes after sperms are inseminated. Invitro Fertilization (IVF) IVF is considered a costly procedure and is used by your doctor when all the other fertility treatment methods do not work for your PCOS. In the IVF procedure, you may have to take injectable fertility drugs that help to stimulate your ovaries to produce a good number of mature eggs. The eggs produced by ovaries are then collected and are combined with your partners’ or donors’ sperm in a petri dish in a lab. This mixing up of sperm and egg in a controlled specialized environment of the lab allows the sperm to fertilize the egg. The embryo thus formed due to fertilization is transferred into your uterus and it is known as embryo transfer. You will be scheduled a pregnancy test after 2 weeks of embryo transfer to see if the IVF cycle was successful. IUI success rate in women with PCOS and with no other fertility issues is said to be approximately 15% to 20% per cycle. In IVF, the success rate is 31.6% which is the same for those with PCOS and those who do not have PCOS. Factors that can influence IVF and IUI success rates are your age, type of ovarian stimulation, and semen parameters like motility of sperm and sperm count. Conclusion PCOS affects women in their childbearing age and is a very common hormonal disorder that can challenge the quality of life of those who suffer from it. It is however managed with proper treatment. The risk of long-term issues caused by PCOS like type 2 diabetes, heart diseases, and stroke can be reduced by early diagnosis and treatment.
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