How can I increase my chances of becoming pregnant with PCOS?
DEAR DR MITCHELL,
I have PCOS. How can I increase my chances of becoming pregnant?
Polycystic Ovarian Syndrome (PCOS) is a condition that is associated with irregular menstrual periods, excessive weight gain, excessive production of the male hormone testosterone and an increased tendency to develop diabetes mellitus. The menstrual period may be missing for several months at a time, extending up to six to 12 months in some women. In some cases it may be excessively heavy and may last for several days when it comes. This is because women who have polycystic ovaries do not release an egg regularly and so the production of the hormone progesterone is low and this results in excessive thickening of the lining of the uterus. This can then result in excessive and prolonged vaginal bleeding.
The excessive production of the male hormone testosterone is associated with excessive growth of hair on the face, chest, and abdomen in a male pattern type. It also causes an increased tendency to develop acne. There is also associated excessive weight gain with the development of insulin resistance resulting in diabetes mellitus in some women.
Women who have polycystic ovaries should lose weight and try to achieve their ideal weight for height. This can be done by reducing calorie intake and reducing your intake of refined sugar and fatty foods. It is always useful to get some help from a dietician since this can sometimes be challenging. Weight loss can be achieved by becoming involved in a regular exercise routine. This coupled with the reduced calorie intake will definitely help to achieve your ideal weight for height, reduce your risk of diabetes mellitus, and improve your fertility. The use of Metformin is also helpful in establishing ovulatory cycles and improving your chance of becoming pregnant. In women who do not ovulate Clomiphene Citrate (Clomid) can be used to induce ovulation with a good outcome. Other drugs such as Letrozole can be used to lower your oestrogen level and help to induce ovulation.
If all the measures undertaken do not work, then invitro-fertilisation can be done with a good outcome.
Surgery can also be done to drain the cysts in the ovary (ovarian drilling), thus improving your chances of having regular ovulation and an increased chance of pregnancy. This can be done by open surgery (laparotomy) or using laparoscopic surgery.
Consult your doctor who will advise you further.
Best regards.
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.
