Polycystic Ovarian Syndrome (PCOS)

Fertility and Polycystic Ovarian Syndrome (PCOS)

Did you known that up to 10% of women of childbearing age have Polycystic Ovarian Syndrome (PCOS), but most don’t know until they experience difficulties getting pregnant?

It is one of the leading causes of infertility in women, and a common hormonal problem.

If your ovaries appear to contain many small follicles on an ultrasound scan, this is described as ‘polycystic’. The dominant follicle, where the egg matures, may not develop as easily, and many of the small follicles will produce varying levels of hormones.

How do I know if I have PCOS?

Symptoms include irregular periods (or no periods at all), increased hair growth, acne, obesity and difficulty falling pregnant. You might experience very heavy yet infrequent periods, along with pain, bloating and tenderness.

Imbalances in hormonal production affect ovulation, which may occur irregularly or not at all. There may also be a mild increase in testosterone levels, causing darker and thicker hair growth and acne. Hormonal imbalances also cause problems with sugar metabolism, leading to weight gain - and a higher risk of gestational diabetes if you do fall pregnant.

All these issues, along with a documented increase in the risk of miscarriage, mean the chance of conceiving naturally is low if you have PCOS, and you should seek medical support.

How do you test for PCOS?

An ultrasound scan can indicate the presence of many small follicles. Blood tests can reveal anomalies, with higher levels of testosterone and LH (often in conjunction with a higher LH to FSH ratio) than women with normal cycles.

These levels may vary considerably and are best assessed early in the menstrual cycle (if there is one). Blood tests may also indicate a change in blood glucose and insulin levels.

The presence of polycystic ovaries is not always bad news.  If you are younger, you may experience severe side effects, but as you get older the number of follicles drop, and the hormone imbalance corrects itself.  So some women with PCOS in their teens and twenties may end up having more eggs in their 30s without the syndrome – and therefore a better chance of conception.

Treating PCOS

There are several ways to treat PCOS, depending on the main symptoms you’re experiencing.

• Weight loss helps to balance hormones and restore regular periods in obese women. So exercise and a change of diet alone could have a significant impact.
• Insulin sensitisers, such as Metformin, reduce the impact of insulin resistance and can also assist in weight loss.
• Ovulation inducing drugs such as Clomiphene (Serophene or Clomid) can stimulate the ovaries
• If you do not respond to Clomiphene, injectable drugs (FSH) can be used, but these require specialist facilities and close monitoring of the response to avoid severe side effects and multiple pregnancies
• IVF treatment may be necessary in advanced PCOS.

For more information about PCOS, visit our Patient Information Booklets page where you can browse through a number of informative booklets and download the PDF versions. These booklets have been designed to help you manage any pressures associated with fertility problems as well as better inform of you about the possible causes and treatments available.

You may also find the following Fertility Drug Information Booklets very helpful, as well as these helpful videos on how to self-administer your fertility drugs. Note: You will need your batch number to access this information.

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