Desperate to have a baby
Dear Dr Mitchell,
I was diagnosed with PCOS and placed on Metformin. I weigh 200 pounds and accept that this has contributed to my problems. I am, however, desperate to have a baby, and I’m wondering what are the next steps to reach my goal. What other medications will I have to take, and what are my chances of having a baby with PCOS?
The problem that you have with Polycystic Ovarian Syndrome is a fairly common problem that can be managed with a very good outcome. The syndrome usually includes irregular menstrual period, excessive weight gain, difficulty becoming pregnant, insulin resistance with a greater than usual tendency to developing diabetes mellitus, excessive hair growth on the face, chest and abdomen in a male pattern type, and acne. Other problems associated with the production of excessive male hormone (testosterone) include temporal baldness (losing hair in a male pattern type) and an enlarged clitoris.
The fact that you are now weighing 200 pounds is significant, and a big part of the management of women with polycystic ovaries is weight loss to try and achieve your ideal weight for height. This can be achieved by a regular exercise programme and a drastic reduction in the amount of calories that you consume. Weight loss can be difficult and requires a lot of discipline. It helps to get some guidance from a nutritionist who can help you with the correct food choices and your daily portions.
A supervised exercise programme also helps you with sticking to the daily routine.
The use of Metformin tablets is a mainstay in the management of women with polycystic ovaries. It helps in reversing some of the problems with insulin resistance and also ultimately improves your chances of becoming pregnant. The use of Clomiphene Citrate can also help to establish regular ovulation and improve your chances of becoming pregnant. It is usually given starting from day three to five counting from the first day of the menstrual cycle, and is taken for five days. A progesterone test should be done on day 21 to confirm that the Clomid is working. If the progesterone level is low then the dose can be increased in a step-wise manner by your doctor.
In some women who still do not become pregnant despite all the measures taken, then more powerful drugs are available to stimulate ovulation and these work quite well. Invitro fertiliation is done in some women especially those resistant to all the other methods employed to induce ovulation. This option for treatment is widely available but is a last resort.
Your spouse should also get a semen analysis done to ensure that he does not have any fertility issues of his own. Other causes of infertility such as blocked tubes should be investigated to ensure that your chances of becoming pregnant on the Metformin and Clomid is good. Daily folic acid supplementation is usually advised for all women who are trying to become pregnant. This will decrease your risk of having a baby with defects in the brain and spinal cord.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
