How does PCOS cause infertility?
In women with PCOS, due to hormonal disturbances, there is a problem with egg growth and release which leads to infertility. However, this can be corrected by using simple oral tablets to help with egg growth under the supervision of a fertility specialist which increases the chance of pregnancy.
What are the treatment options for PCOS women to get pregnant?
The first step in the treatment of women with PCOS if they are overweight is to reduce weight. Even a loss of 5-10 kg of body weight can help a great deal to facilitate the process of ovulation. Diet and exercise along with psychological counseling play an important role in achieving weight loss.
The specific treatments related to infertility in PCOS women are
1. Ovulation induction-In this step simple hormone tablets such as clomiphene citrate or letrozole is started on day 2/3 of the period for about 5 days and follicle (sac containing eggs)growth is monitored using ultrasound and once the follicle reaches a mature size medication is given to facilitate egg rupture and this treatment gives a chance of pregnancy of around 20% in each cycle.
Usually, around three or four cycles of treatment are tried failing which the patient has suggested the next step which is IUI-Intra Uterine Insemination.
2. IUI-Intra Uterine Insemination
In this treatment modality medication -tablets followed by gonadotrophin injections are given to facilitate egg growth and at the time of egg rupture, the husband’s sperm is processed and the high concentration of motile sperm is placed using a small plastic catheter at the top of the womb. This procedure is simple and not painful. Each cycle gives around a 20% chance of pregnancy. Around 3-6 cycles of treatment can be tried failing which the next step of IVF is suggested.
3. IVF-In Vitro Fertilisation
IVF involves hormone injections to increase the number of egg growth in the ovaries which are then collected under anesthesia and in the lab fertilization is facilitated to make the embryo which is then replaced inside the women’s uterus. One cycle of IVF in good clinics gives pregnancy rates of around 50-60% if the female age is less than 35 years and 2 blastocysts are replaced.
4.Laparoscopic surgery-ovarian drilling.
In a small group of women, laparoscopic surgery and ovarian drilling procedure are beneficial in correcting the hormone disturbance and facilitating conception.
The good news is that a vast majority of women are successful in achieving a pregnancy with this stepwise approach and hence it is advisable for women with PCOS to take the help of a fertility specialist to achieve conception.
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