Polycystic Ovary Syndrome

It is estimated that perhaps 5% to 15% of all women are born with some degree of polycystic ovary syndrome (PCOS). Most of these women will never know since they will be able to conceive. These women have a mild degree of PCOS.

Women with more severe PCOS will, at least temporarily, lose the regularity of their menstruations (become anovulatory) and may need medical help to conceive. In its most severe forms, the polycystic ovarian syndrome can make it quite difficult for a woman to ovulate and conceive even with ovarian stimulation.

This lack of ovulation is accompanied by a hormonal imbalance that, in some women, involves abnormal insulin production and glucose metabolism.

Polycystic ovaries are by far the most common cause of anovulation. The term "polycystic" refers to the increased number of ovarian follicles (not cysts) present within the ovaries of most women with PCOS.

 

This ultrasound image shows an unstimulated PCOS ovary. Notice the periphery of the ovary studded with follicles like a necklace of pearls - a hallmark of PCOS.

Women with PCOS who need medical treatment to get pregnant comprise a unique group of patients. Their ovaries can be very sensitive to stimulatory medications, their eggs tend to be more immature, and there is an increased risk of multiple pregnancies and ovarian hyperstimulation.

The physician must be aware of the presence of even the mildest degrees of PCOS before In Vitro Fertilization ovarian stimulation begins. PCOS ovaries do need to be stimulated differently than the ovaries of women without polycystic ovary syndrome.

We rely primarily on the Ovarian Reserve Assay and ultrasound ovarian assessment to guide us in selecting the most appropriate method of ovarian stimulation for women with PCOS.

In Vitro Fertilization is the recommended treatment for women with moderate and moderately severe degrees of PCOS. It allows for precise modulation of ovarian stimulation and minimizes the risk of multiple pregnancy by limiting the number of transferred embryos.