Normal menstrual cycle of a female
The reproductive system of humans is regulated by a complex set of hormones. These hormones are secreted at intervals to regulate the cycle. They are responsible for the preparation of the uterus to house a foetus, releasing of the ovum (ovulation), maintenance of the pregnancy and menstruation.
What is PCOS?
Polycystic ovarian syndrome, or PCOS, has become a common condition amongst reproductive age females. It is caused by irregular levels of hormones that influence the reproductive system. Moreover, there is also an excess of male hormones (known as androgens) present in the female.
Features of PCOS
The symptoms and signs of PCOS are related to hormonal imbalances and the menstrual cycle which they control.
- Irregular periods, where their duration is longer or shorter. These changes also have no proper pattern to them.
- Periods are absent altogether.
- Periods are accompanied by heavy bleeding and abdominal pain.
- Increased weight gain due to hormonal imbalances.
- Facial hair growth and acne due to excessive male hormones.
- Difficulty in getting pregnant.
Confirming the PCOS diagnosis
Following a clinical interview, physical and pelvic examination, the gynaecologist arrives at a tentative diagnosis of PCOS. Next up, the blood is tested for hormone levels to confirm the diagnosis. In addition, ultrasound scans are performed and the characteristic cystic appearances of the ovaries, which are confirmative of PCOS, are identified.
How is PCOS treated?
Treatment of PCOS is twofold. It involves medical therapy using drugs and lifestyle modifications such as a PCOS diet.
Medical therapy – Oral contraceptive pills regularize the hormonal cycles as they contain hormone levels compatible with each stage of the menstrual cycle.
Lifestyle modifications – Patients are encouraged to go on a PCOS diet. It consists of a low-calorie high-fiber diet that helps with weight loss. Plenty of leafy vegetables and fruits are also included in the diet. Most importantly, fast foods and foods rich in starch must be avoided completely.
What is the relationship between PCOS and infertility?
When the hormonal cycle becomes unbalanced, the regulation of the menstrual cycle is disturbed. Ovulation occurs at irregular intervals or during some months, doesn’t occur at all. Because of this, the fertilization of an ovum becomes exceedingly difficult.
Polycystic ovary syndrome and pregnancy
Reduction of weight and drug therapy helps improve and regularize periods in women suffering from PCOS. With regularization of periods, a reliable and definitive fertile window can be identified. Subsequently, timed intercourse or techniques such as IUI can lead to a successful pregnancy.
Fertility treatment for PCOS
Fertility can be successfully achieved in PCOS thanks to the wide variety of fertility therapies available. Some of these include,
Ovulation induction – The drug clomiphene citrate is used to trigger ovulation. Ovulation is observed through ultrasound scanning and is then combined either with timed intercourse or IUI.
IUI – Intra uterine insemination involves medically inducing the female partner to ovulate after which the concentrated male sperm is introduced into her uterine cavity using special equipment in the hope that it fertilizes the released ovum.
IVF – In vitro fertilization is where harvested eggs from the female are fertilized outside the uterus with the male sperm before being reintroduced into the uterine cavity for implantation.
Laparoscopic ovarian drilling – A surgical procedure where ovaries are drilled using an incision in the abdomen through which a laparoscope is inserted. Subsequently, this is combined with timed intercourse or IUI to increase the chances of achieving pregnancy successfully.