Feb 22, 2023

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Feb 22, 2023

PCOS and Infertility

Polycystic ovary syndrome(PCOS) is a quite common disorder found 1 in 15 women worldwide. It is a heterogeneous endocrine disorder due to excessive secretion of or abnormal insulin activity. It is considered the most common cause of infertility in women at an early age of reproductive period. Many women are unaware of this condition, inviting complications such as diabetes mellitus, adverse pregnancy outcome, metabolic syndrome, and some cancers. Obesity is a predisposing factor for polycystic ovary syndrome and infertility as a consequence of it.

Symptoms:

  •         Irregular menstruation

  •         Heavy bleeding

  •         Missed periods.

  •         Excessive growth of facial hair

  •         Acne

  •         Alopecia

Majority of women dealing with the issue of infertility are not aware of polycystic ovary syndrome. The excessive production of male hormones interferes with maturation and release of eggs. In simple words, due to absence of ovulation, no pregnancy. Let us understand the science behind it.

Normal Life cycle of egg:

Female reproductive system consists of two ovaries (right and left), fallopian tube, uterus, and vagina. Ovaries store eggs for a lifetime. These eggs are immature and surrounded in a fluid filled follicle.

Pituitary gland located at the base of the brain produces hormones, responsible for functioning of ovaries. Pituitary glands secrete follicle stimulating hormone or FSH and luteinising hormone or LH into the bloodstream. After these hormones reach the ovaries, immature eggs start to mature expanding the size of the follicle. As the eggs mature the follicle secrete estrogen, which is the main female sex hormone. Once the amount of estrogen in the blood reaches a certain level the pituitary sends a surge of luteinising hormone to the ovaries causing the most mature follicle to open and release its egg. This process is called “ovulation”. Then the egg travels through the fallopian tube where it awaits fertilization eventually the remaining immature follicle and eggs dissolve. If the egg is not fertilised the egg and the lining of the uterus are shed during the next menstrual period.

 What happens to egg in polycystic ovary syndrome?

Pituitary glands release abnormally high amounts of luteinising hormone into the bloodstream disrupting menstruation cycle. As eggs do not mature and ovulation does not occur which can lead to infertility. Follicles do not dissolve and remain as fluid filled sacs or cysts. Along with\ this, high levels of insulin hormones are found in blood. Increased insulin combined with high levels of luteinising hormone can lead to excess production of a male hormone called testosterone. In ovaries abnormally high levels of testosterone prevent ovulation which can lead to infertility. It also causes physical features associated with polycystic ovary syndrome such as acne and abnormal hair growth on the face.

Polycystic ovary syndrome increases risk for type 2 diabetes, heart disease, high blood pressure cholesterol abnormalities in the blood and endometrial cancer.

 What is the treatment of PCOS?

There is no cure for polycystic ovary syndrome. Some medications help to treat your symptoms such as hormonal birth control which while preventing pregnancy also regulates your menstrual cycle.

Anti – androgen medications reduce testosterone production in your ovaries which further reduce abnormal hair growth and acne.

Diabetes medications such as metformin which lowers your insulin levels and regulates your menstrual cycle. Fertility medications which can stimulate ovulation to help you get pregnant. If fertility medications are ineffective, Best Gynecologist in Gurgaon recommends laparoscopic ovarian drilling. During surgery, the surgeon will insert a small needle into the ovary and use an electric current to destroy small areas of ovarian tissue where testosterone is produced. Overtime testosterone production diminishes, and ovulation may occur.

In childbearing age, infertility issues change a woman’s life upside down. Women have to go through constant criticism, which creates negativity in mind. It leads to depression, anxiety, lack of confidence, lack of social engagement, marital issues, mood swings etc. To control these psychological problems antidepressant therapy and counselling is required for a long time. Strong family support will help her get through her difficult phase.

Diet in Polycystic ovary syndrome:

Dr. Bindu Garg, gynaecologist in Neelkanth hospital explained, eating better and lifestyle changes to keep your weight in control will help in improving Polycystic ovary syndrome. The key to a healthy diet is eating fresh, home cooked food instead of processed, canned, or preserved food. Food with high fibres such as whole grains, legumes, berries, chia seeds will regulate satiety. Including lean meat rather than red meats, fish with low mercury, and plant-based proteins will help in weight control. Add antioxidants to your diet in the form of fruits and vegetables.

Is PCOS and PCOD the same?

Polycystic ovary syndrome , PCOS, is different from Polycystic Ovarian Disease PCOD. Both are diseases. Many times, it is considered as the same entity. Dr. Bindu Garg, gynaecologist in Neelkanth hospital answered this question for all, that PCOS is an endocrine disorder whereas PCOD is due to hormonal imbalance.

Please feel free to contact your gynaecologist for any queries related to infertility. She is one of the best gynaecologists in Neelkanth hospital, Gurgaon, Delhi.