POLYCYSTIC OVARY SYNDROME

Polycystic Ovary Syndrome (PCOS)

In the entire field of reproduction and infertility, no topic has as many myths and misconceptions associated with it as polycystic ovary syndrome – PCOS. Even its name causes confusion. Is it PCO or polycystic ovary disease (PCOD) or polycystic ovary syndrome (PCOS)? Since the name includes the word “polycystic” does that mean that all women with this problem have cysts in their ovaries?

How Do I Know If I Have PCOS?

Hormonal blood tests and an ultrasound scan need to be done to draw a conclusion. PCOS can be managed while regulating the menstrual cycle or improve fertility respectively.

What signs and symptoms can be found in women with polycystic ovary syndrome (PCOS)?
Ultrasound findings

Some women with polycystic ovary syndrome (PCOS) may have one or more of the following findings:

 

Enlarged ovaries

Large number (>10) of tiny follicles (cysts) just under the surface of the ovaries

The center of the ovaries is echogenic (highly reflective on ultrasound) and with very few follicles seen.

Ultrasound evidence of polycystic ovaries alone are a non-specific finding and are frequently found in women with normal menstrual cycles and regular ovulation. Ultrasound evidence of polycystic ovaries alone does not constitute a diagnose of PCOS. Women with ultrasound findings are said to have polycystic appearing ovaries (PAO).

 

IMPORTANT:

Not all women with polycystic ovary syndrome (PCOS) have polycystic appearing ovaries (PAO).

Not all women with polycystic appearing ovaries (PAO) have polycystic ovary syndrome (PCOS). In fact, many normal women with regular ovulation have polycystic appearing ovaries (PAO)

Miscellaneous laboratory findings These laboratory findings can be found in some women with polycystic ovary syndrome (PCOS). Many women with these findings may not have polycystic ovary syndrome (PCOS).

 

Elevated prolactin levels:

  • High levels of luteinizing hormone (LH)
  • High ratio of LH:FSH
  • High levels of inhibin-B
  • High levels of plasminogen activator inhibitor -1 (PAI-1)
  • High levels of AMH (anti-Mullerian hormone)
  • Causes of PCOS

 

Contrary to popular belief, obesity does not cause PCOS. In fact, 20% of women with PCOS are not obese. Obesity can, however, increase the signs and symptoms of PCOS. The genetic contribution to PCOS remains uncertain. there are currently no recommended genetic screening tests for PCOS. Also, there are no specific environmental substance that has been found to cause PCOS.

PCOS is not caused by eating a diet high in carbohydrates. Eating a low carbohydrate diet or a diet with a low glycemic index does not prevent or treat PCOS.

Health risks associated with polycystic ovary syndrome (PCOS)

Type II Diabetes

Coronary artery disease:

Endometrial cancer (cancer of the lining of the uterus) It is not specific to polycystic ovary syndrome (PCOS) however. Any problem which causes a woman not to ovulate is associated with a higher risk of endometrial cancer.

 

Pregnancy risks associated with polycystic ovary syndrome (PCOS):

  • Gestational diabetes (diabetes that occurs during pregnancy)
  • Pregnancy induced hypertension (PIH)
  • Preeclampsia
  • Preterm birth
  • Babies from PCOS mothers have a higher rate of admission to the neonatal intensive care unit
  • Babies from PCOS mothers have a higher rate of perinatal death

 

The perinatal mortality rate is the combination of two separate death rates: antenatal mortality, which is defined as the death of a fetus after the 20th week of pregnancy but before delivery, plus neonatal mortality which is the death of a baby up to 28 days after birth.

Contrary to popular belief, a recent analysis has found that PCOS patients do not have a higher risk of miscarriage than non-PCOS infertility patients.

Treatment of polycystic ovary syndrome (PCOS)

There isn’t one treatment for polycystic ovary syndrome (PCOS). The type of treatment is dependent on the symptoms that a woman has and her specific desires at that point in her life. Specific goals of treatment might include:

 

Promotion of fertility

  • Desire for regular menstrual cycles
  • Reduction of acne, unwanted hair growth or hair loss
  • Reduction of other health risks associated with polycystic ovary syndrome (PCOS)
Fertility treatment
Surgery

Ovulation problems in women with polycystic ovary syndrome (PCOS) can also be treated be destroying or removing portions of the ovaries. In the medical literature, there have been several methods described for doing this including:

  • Wedge resection
  • Multiple ovarian cystotomy (a.k.a. ovarian drilling)
  • Ovarian diathermy
  • The benefits of surgery include the avoidance of OHSS and multiple pregnancy
Treatment of polycystic ovary syndrome (PCOS) without concern for fertility

Treatment of the other problems associated with polycystic ovary syndrome (PCOS) involve methods to restore normal menstrual cycle pattern.

Your visit with our specialist should be a pleasant one and will begin much as a typical visit to your family physician.You will be asked about your medical and surgical history, medications, health problems, etc. We are committed to providing a pleasant and relaxed environment so that you will be forthcoming in asking questions and discussing your preferences with us. Quality care begins with good communication and a good specialist will take time to listen and to explain the various treatment options.

Planning Ahead

You may wish to prepare a list of questions to ask before seeing us so that you will not miss out anything important. Ask for the appointment on a day when you know you will not be having your period. Be sure to bring a list of all medications and supplements that you are taking.

Can I walk in for an appointment or service?

We want to make sure we cater enough time for your visit with our doctor. As such, we strongly advise that you make a prior appointment with our staff. Our specialist will then meet you on the allocated time for a detailed discussion. Please call or email us for an appointment.

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