PCOS: A common condition that can affect fertility

When a woman has difficulty becoming pregnant, it can be due to one of many reasons. However, perhaps the most common reason can be overlooked or go undiagnosed

When a woman has difficulty becoming pregnant, it can be due to one of many reasons. However, perhaps the most common reason can be overlooked or go undiagnosed: polycystic ovary syndrome (PCOS).

Doctors aren’t quite sure of the exact cause of PCOS, but up to one in 10 women of childbearing age may have it. They do know it’s largely linked to being overweight or obese. And with an obesity epidemic in this country — more than two out of every three people are overweight or obese — it’s no wonder so many women are struggling with fertility.

What is PCOS? It’s a condition in which the ovaries do not produce mature eggs. Symptoms can include irregular periods, too many male hormones, acne or facial hair. Most women with PCOS have a hormone imbalance or too much insulin in the bloodstream, commonly caused by having excess weight. The raised insulin level can cause a woman’s ovaries to produce too many male hormones, potentially disrupting the development of her eggs.

During normal ovulation, tiny sacs in the ovaries, called follicles, build up fluid as eggs grow inside them. When an egg matures, its follicle breaks open and the egg is released toward the uterus. But when an imbalance of male and female hormones keeps eggs from maturing, the fluid-filled follicles may build up in the ovaries as cysts, sometimes in large numbers — thus the name “polycystic.”

Signs that a woman may have PCOS include irregular or delayed periods, acne, facial hair, weight gain or obesity, thinning hair and pelvic pain.

But these can also be indicators of other medical conditions, which can make PCOS hard to diagnose, according to Dwight Pridham, M.D., a reproductive endocrinologist and OB/GYN with Associates in Obstetrics & Gynecology.

Doctors often do tests to rule out other conditions, such as thyroid disorder, diabetes and cancer, before concluding a patient has PCOS.

Even though it isn’t life-threatening, the condition shouldn’t go untreated, because women with PCOS are at risk for developing diabetes and even endometrial cancer, which can result from not ovulating.

The good news about PCOS is unlike other causes of infertility, it doesn’t necessarily mean a woman can’t have children — only that it may take extra time and treatment. In addition, treatment is relatively simple compared with treatment for other causes of infertility.

“It’s not a difficult fertility issue to solve,” Dr. Pridham said.

Treatment depends on the woman’s goals for having a family. If the woman doesn’t want to get pregnant, her doctor can prescribe a birth control pill that reduces male hormone levels, restores regular periods and helps eliminate other symptoms. If she does want to get pregnant, fertility medications typically will improve the condition.

Lifestyle changes can also help and sometimes are all that’s needed to overcome PCOS. These include eating healthfully, cutting down on carbohydrates and processed foods, exercising and losing excess weight.


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