PCOS

Polycystic ovarian syndrome (PCOS) is the number one cause of irregular or absent ovulation (releasing an egg), a major cause of female infertility.

PCOS is an endocrine disorder that in addition to causing problems with ovulation, may also be associated with increased hair growth on the face, breasts and abdomen. This increased hair growth results from having a higher level of androgens, such as testosterone, that are produced by the ovaries.

PCOS is often related to being overweight or obese, but can also be found in women who are normal weight.

The name, PCOS, relates to the appearance of the ovaries on ultrasound. Instead of one large developing follicle and several smaller follicles, the ovaries have many small follicles without a developing larger follicle. The higher level of androgens in the ovary limits a follicle from fully developing and releasing an egg.

To diagnose PCOS, your doctor will need to take your history, do a physical examination, blood tests, and possibly an ultrasound of the ovaries.

There are a number of effective treatments for women with PCOS.

One of the most effective and least expensive treatments is lifestyle changes. For women who are overweight or obese, losing weight though diet and exercise may improve their PCOS condition, resulting in the resumption of ovulation and achieving a pregnancy.
There are also a number of medications that can help women with PCOS ovulate. These include oral medications Clomid and Letrozole. Sometimes these medications are combined with a medication, Metformin, that lowers insulin levels and makes the ovaries more responsive to Clomid and Letrozole.

For women that fail to ovulate with the oral medications, there are injectable medications (gonadotropins) that can be given to stimulate the ovaries to develop mature follicles. These medications are often combined with in vitro fertilization (IVF) treatment in order to control the number of embryos that are transferred back into the uterus and thereby decrease the risk of a multiple pregnancy.