Success in IVF with Polycystic Ovary Syndrome (PCOS)
Dr Madhurima Rajkhowa FRCOG explains how CARE can optimise your chances of success in IVF if you have Polycystic Ovary Syndrome (PCOS).
Around 25% of couples who attend a fertility clinic will be told that their struggles to conceive lie with their absent or irregular ovulation. Of these, 85% will be diagnosed with PCOS.
There are some simple ways to increase your chances of a pregnancy, such as taking specific fertility tablets, or surgery called ovarian drilling in suitable patients. But if you still find you are having trouble becoming pregnant, here at CARE, there are several things we can do to help.
What is Polycystic Ovary Syndrome?
PCOS is one of the most common hormone conditions. It can causes absent or irregular ovulation and can affect 1 in 5 women of a childbearing age. It is a leading cause of female subfertility and is responsible for a number of symptoms that can have an impact on you, both physically and emotionally.
Causes of polycystic ovary syndrome
The exact cause of polycystic ovary syndrome is unknown, but it is thought to be a hormonal problem.
Many women with PCOS are found to have an imbalance in certain hormones, including:
- raised levels of luteinising hormone (LH)
- lack of progesterone
- high levels of testosterone (male hormone), though never in the male range
- low levels of sex hormone-binding globulin (SHBG)
The exact reason why these hormonal changes occur isn't known. It's been suggested that the problem may start in the ovary itself, in other glands that produce these hormones, or in the part of the brain that controls their production. The changes may also be caused by the resistance to insulin.
Polycystic Ovary Syndrome is strongly linked with insulin resistance (which means ineffective action of insulin on target tissue, including the ovary), with resultant compensatory high insulin levels. These high levels of insulin cause the ovaries to produce too much testosterone, which interferes with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation.
Insulin resistance can also lead to weight gain, which can make PCOS symptoms worse, because having excess fat causes the body to produce even more insulin.
There may be a genetic link to PCOS, although specific genes associated with the condition haven't yet been identified.
What are the symptoms of Polycystic Ovary Syndrome?
The symptoms can vary significantly between women and despite the name, many women do not have cysts on their ovaries. PCOS is however one of the main causes of female infertility
- Menstrual problems such as, irregular or absent periods
- Heavy bleeding or bleeding inbetween periods
- Increased facial or body hair
- Thinning of the scalp hair
- Irregular or absent ovulation
- Increased body weight
Polycystic Ovary Syndrome and Supplements
Many women with PCOS also have low Vitamin D levels, we recommend that you make sure that your diet is rich in Vitamin D, sources include:
- Oily fish
- Red meat
- Egg yolks
- Fortified foods such as most fat spreads and some breakfast cereals
Women with PCOS have been found to have low levels of myo-inositol which is linked to insulin resistance. Taking a supplement of Myo-inositol (2 sachets daily) may lower insulin resistance resulting in weight loss and improved ovulation.
How CARE can help
In order to optimise your chances of a pregnancy with PCOS, CARE will help you to reduce particular risks that are related to IVF and PCOS. To do this we can:
- Help you to optimise your weight
- Prescribe specific medication that can help reduce the risk of over response
- Reduce your chances of over stimulation
Your safety is the most important aspect of any treatment which is why we will always offer you individualised treatment plans and help you every step of the way. To ensure your safety we will:
- Provide individualised stimulation
- Plan a treatment to suit your needs
- Closely monitor you at every stage of your treatment
If you would like to learn more about your treatment options, please feel free to contact your nearest CARE clinic. Our teams are always more than happy to help.
Dr Madhurima Rajkhowa FRCOG is the Medical Director at CARE Fertility Birmingham.