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Birla Fertility & IVF

What is PCOS (Polycystic Ovary Syndrome)?

  • Published on July 16, 2021
What is PCOS (Polycystic Ovary Syndrome)?

PCOS, polycystic ovarian syndrome, is a complicated hormonal disease that occurs in women. It is one of the most prevalent endocrine disorders that impact women’s quality of life. In the reproductive years, it affects 4% to 20% of women globally. According to information from the World Health Organization (WHO), PCOS affects about 116 million women worldwide. Currently, PCOS is diagnosed in 1 in 10 women.

What is PCOS (Polycystic Ovarian Syndrome)?

The term “polycystic” literally means “many cysts,” and cysts are tiny fluid-filled sacs that typically form on the border of the ovary. These cysts, also known as follicles, are filled with immature eggs. A person with PCOs may not have regular periods, or their periods may continue longer than usual. Additionally, a person’s body may contain extremely high levels of the hormone androgen. The name is a misnomer since not everyone with PCOS has ovarian cysts, and not every ovarian cyst is a sure marker of PCOS. Instead, PCOS is an endocrine and metabolic illness that affects the body in ways other than the ovaries. There are three main characteristics of PCOS:

  • High level of male hormones
  • Cysts in the ovaries (in rare cases, cysts don’t form in the ovaries)
  • Irregular periods

Symptoms of PCOS

Some women start seeing symptoms around the time of their first period. Others only discover they have PCOS after they’ve gained a lot of weight in short span of time or they’ve had trouble getting pregnant.
The most common PCOS symptoms are :

  1. Irregular periods – A lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year.
  2. Heavy bleeding – The uterine lining builds up for a longer period of time, so the periods you get can be heavier than normal.
  3. Unusual Hair growth – More than 70 per cent of women with this condition grow hair on their face and body — including on their back, belly, and chest . Excess hair growth is called hirsutism.
  4. Acne – Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back.
  5. Weight gain – Up to 80 percent of women with PCOS are overweight or obese.
  6. Male-pattern baldness – Hair on the scalp gets thinner and falls out.
  7. Darkening of the skin – Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
  8. Infertility – If the woman is suffering from severe PCOS, there is a possibility she will face difficulty in getting pregnant.

Causes of PCOS

Doctors and researchers do not exactly know the causes this disorder. Therefore, it’s advisable to get checked early on when you think you’re beginning to show signs of PCOS. It is said that insulin resistance, genes, and inflammation have all been linked as primary causes of this disease.

Insulin Resistance : More than 70% of women suffering from PCOS have displayed insulin resistance. This implies that the body’s cells aren’t able to process insulin properly. When the body is unable to get enough insulin, it demands more insulin leading to the pancreas generating more than necessary. This excess insulin triggers ovaries to produce androgens.

Genes : Due to the clustering of the disease among families, scientists believe that it’s highly associated with one’s genetic composition. If your immediate family members have had PCOS in their lifetime, there is a chance that you might have it as well. We don’t yet know which specific gene is the reason, it could very well be a cluster of genes.

Inflammation : Higher levels of inflammation in the body is also commonly seen among women with PCOS.

How to Diagnose PCOS?

There are a couple of different criteria and methods to diagnose PCOS.

Rotterdam criteria : Under this criteria, PCOS is diagnosed based on the presence of irregular ovulation, high androgens (male sex hormones), and/or polycystic ovaries.

Androgen Excess and PCOS Society (AE-PCOS) : PCOS cannot be diagnosed unless both high androgens and ovulation dysfunction are present. The AE-PCOS criteria do not permit diagnosis based only on irregular ovulation and polycystic ovaries.

Treatment for PCOS

Diet and lifestyle: Treatment usually begins with a carefully chosen diet, healthy lifestyle choices, and exercise. Losing 5 to 10 percent of your body weight can help regulate menstrual cycles and improve symptoms.

Studies comparing diets for PCOS have found that low-carbohydrate diets are effective for both weight loss and lowering insulin levels. A low glycemic index (low-GI) diet that gets most carbohydrates from fruits, vegetables, and whole grains helps regulate the menstrual cycle better than a regular weight loss diet.

Diet combined with moderate exercise helps immensely in lowering body weight and regulating one’s metabolism.

To help you ovulate, your doctor might recommend :

Clomiphene (Clomid) : This oral anti-estrogen medication is taken during the first part of your menstrual cycle.

Letrozole : Now commonly used as the first-line treatment.

Metformin (Glucophage, Fortamet, others) : This oral medication for type 2 diabetes improves insulin resistance and lowers insulin levels. If you don’t become pregnant using clomiphene, your doctor might recommend adding metformin. If you have prediabetes, metformin can also slow the progression to type 2 diabetes and help with weight loss.

Gonadotropins : These hormone medications are given by injection.
Doctors might also recommend other medicines to reduce excessive hair growth.

How to get pregnant with PCOS?

Since PCOS causes irregular periods and interrupts normal menstrual cycles, it makes it harder to get pregnant. Most women with the disease have fertility issues and it decreases the chances of conceiving. However, the chances of getting pregnant with PCOS can be enhanced with the right treatment. IVF is considered a good option for patients suffering from infertility caused by PCOS.

Some of the necessary steps that doctor usually suggests on How to Get Pregnant with PCOS are :

Clomiphene Citrate (CC) : It is the standard medicine suggested for ovulation induction in women with PCOS. After the medicine is given, ovulation is successfully achieved in women with PCOS problems, and thus helps them with timely menstruation, and improved conception chances. Non-obese women or those obese women who do not ovulate even after lifestyle changes are suggested for ovulation induction therapy with Clomiphene Citrate (CC). This increases the chances of conception with PCOS.

Metformin with Clomiphene Citrate (CC) : For Insulin Resistant women, the combination of metformin and clomiphene citrate have been used and proven to improve the metabolic abnormalities in PCOS patients. It is also known to improve ovulation rates and help conceive pregnancy in women with PCOS.

Gonadotropin Therapy : Ovulation induction with gonadotropin therapy is recommended for many patients with PCOS. These help follicles to mature and eggs to ovulate.

Laparoscopic Ovarian Drilling (LOD) : It is a surgical treatment of PCOS that can trigger ovulation in women. Although not commonly used, it is recommended to patients who fail to ovulate even after losing weight or trying medications. It is usually done with a small laparoscopic incision with general anaesthesia. This helps improve pregnancy chances in women.

IVF (In-Vitro Fertilization) Treatment : IVF is a procedure in which the fertilisation takes place outside the body. The eggs are extracted outside the body by giving stimulation medications and then fertilised in an IVF lab. The Embryo formed is transferred back to the uterus to implant. This increases the chances of pregnancy for women with PCOS.

What are the complications of PCOS?

PCOS can lead to complications, some of which may include:

  • Recurrent miscarriages
  • Increased chances of premature birth
  • High risk of infertility
  • Heavy bleeding during menstruation
  • Irregular periods

Tips to Manage PCOS and Improve Fertility

A few dietary and lifestyle changes can help you boost fertility along with managing symptoms of PCOS are:

  • Add zinc-rich foods such as nuts, dairy items, meat, potatoes, and grains.
  • Include folic acid-rich foods like broccoli, Brussels sprouts, kidney beans, chickpeas, kale, cabbage, and spinach.
  • Include iron-rich foods such as red meat, shellfish, pumpkin seeds, spinach, wheat bread, and cereals.
  • Incorporate healthy fats into your diet, such as walnuts, corn, chia seeds, flaxseed oil, and olive oil.
  • Eat timely while maintaining the portions of the meal
  • Don’t skip your meal during the day
  • Avoid unhealthy, junk, and oily food

Bottom Line

PCOS is a very common condition found in women nowadays. It can be a result of a sedentary lifestyle and unhealthy diet intake. The above article gives you a complete idea about PCOS from what it is to the treatment options for the same. If you are  diagnosed with PCOS and planning a pregnancy but facing difficulty, consult our fertility expert today for free by calling in the given number or filling in the required details in the ‘Book Your Appointment’ form for a call back from us.

Frequently Asked Questions (FAQs)

  • How can I stop the signs of PCOS?

PCOS symptoms cannot be prevented from appearing. The best course of action, however, is to consult a specialist and look for suitable instructions to manage them effectively. They may guide you through lifestyle modification and other necessary medications as a course of action to improve your quality of life.

  • Does the fact that I have irregular periods suggest that I have PCOS?

No, a bad diet, a change in lifestyle, or other factors are common reasons for irregular periods. However, PCOS might occasionally be one of the causes of irregular periods. Therefore, it is best to consult with your gynecologist to identify the precise underlying cause and receive the appropriate care.

  • Can PCOS affect my ability to conceive?

Yes. Your fertility may be impacted by your PCOS condition due to hormonal abnormalities. Additionally, it may make it more difficult for you to conceive naturally. But you can always get connected to a fertility specialist in order to receive expert advise and the possibility of stating a family.

Written by:
Dr Prachi Benara

Dr Prachi Benara

Consultant
Dr Prachi Benara is a skilled infertility specialist with more than a decade of experience. Trained from some of the most premier institutes in the field in India which include Maulana Azad Medical College, BJ Medical College (Ahmedabad), PG Diploma in Reproductive and Sexual Health. She further trained in the United Kingdom to pursue her interest in Reproductive medicine and IVF. Her focus areas include advanced laparoscopic and hysteroscopic surgery, IVF, IUI, Frozen embryo transfer and correction of uterine anomalies including uterine septum to improve chances of pregnancy.

Over 11 years of experience

Gurgaon, Haryana

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