PCOS (polycystic ovarian syndrome) is a medical condition which affects the ovaries. In many cases, PCOS stops the female reproductive system ovulating normally. This can lead to infertility, as the ovaries no longer produce mature eggs which can be fertilized. Unfortunately, there is no definitive cure for PCOS, the condition can only be managed. A variety of treatments are available for PCOS, some of which are aimed at helping the PCOS patient to get pregnant, and some of which aim to control and reduce the other unpleasant symptoms of PCOS, such as acne and excessive body hair growth.
PCOS can hinder your attempts to get pregnant by preventing eggs, which would normally develop inside follicles on your ovaries, from ever reaching maturity. This means that no egg is released from your ovaries as it normally would be during a healthy menstrual cycle. As result, no egg ever finds its way to your fallopian tubes and uterus. This may cause you to have light, irregular or even totally absent menstrual bleeding, as neither the egg nor the lining of the uterus (which builds up during the menstrual cycle) are flushed out of the body during what would normally be your monthly period. This causes obvious problems when it comes to trying to get pregnant. PCOS can also cause imbalances in your hormones. Many women with PCOS tend to have higher than normal levels of the male hormone testosterone, which can also hamper their attempts to get pregnant. Therefore, when treatments are administered to help a PCOS patient get pregnant, those treatments usually aim to balance the patient's hormones (reduce her testosterone levels) and induce normal ovulation.
Particularly in PCOS patients who are very overweight, good diet, exercise, and losing weight can go a long way towards inducing ovulation. Medical experts believe there is a link between resistance to the hormone insulin (produced by the body to control blood sugar levels) and PCOS. Losing weight can reduce the amount of insulin that a PCOS patient's body needs to produce. This in turn may reduce her testosterone levels, which can help to kick-start ovulation. Losing weight also helps to prevent diabetes and high blood pressure - two medical conditions which are associated with PCOS. For all these reasons, weight loss is likely to be the first treatment recommended to the PCOS patient who is trying to conceive. Fertility drugs and surgery will probably be tried only after a weight loss program has failed to bring about the desired results.
Fertility drugs (one such drug is clomid but there are others available too) aim to induce ovulation. The advantage of such drugs is that they allow the patient and her doctors to predict almost exactly when she will be fertile. This gives her a better chance of having sex at the right time. These drugs do, however, have certain side effects and pose certain risks, one of which is the increased chance of multiple pregnancy (namely, having twins, triplets, or even more). Metaformin, although not strictly speaking a fertility drug, is being tried out as a treatment for PCOS. This drug is used to decrease insulin resistance in diabetes patients. Results from initial tests show that it may also reduce insulin resistance in PCOS patients, which in turn reduces testosterone levels and may induce ovulation.
Surgery to induce ovulation in PCOS patients will normally be recommended only after weight loss and fertility drugs have failed. Surgery for PCOS aims to reduce the number of cysts on the ovaries (which grow because the eggs in the follicles don't develop to maturity) by destroying parts of the ovaries themselves. Surgery is used as a last resort due to the risk of creating scar tissue which may lead to further infertility problems.
Treatments For Other Symptoms
Anti-acne drugs may be prescribed to PCOS patients who have skin problems. Drugs to combat male hormones may be recommended for patients who find they have excess body hair or other "male" characteristics. The contraceptive pill or progesterone pill may be prescribed to patients who are not concerned about getting pregnant in the near future. The aim of such treatment is to induce a monthly menstrual-type bleed, which will ensure that the endometrial lining of the uterus is shed each month. A woman whose uterus lining does not shed for a prolonged period of time has a greater chance of developing endometrial cancer in the future.