Polycystic ovaries (PCOD) and Infertility: Is there a way out?

PCOD or polycystic ovarian disease is the name given to the presence of multiple cysts in a woman’s ovaries.

Every woman carries hundreds of thousands of oocytes (eggs) in her ovaries since birth. Each month, one of these eggs matures to prepare itself to be fertilized by the male sperm. The release of a mature egg from the ovary is known as ovulation which takes place once every month.In some women, the ovaries tend to develop a large number of follicles (tiny sac-like structures each containing one egg), causing what we can call an ‘overcrowding’ of the ovary. This results in the formation of cysts which are in fact nothing but underdeveloped follicles that did not release an egg and did not break down.

PCOD is a hormonal disorder and one of the most common causes of infertility in women worldwide.

How does PCOD affect fertility?

A woman conceives a baby when the egg released by her ovary is fertilized by the man’s sperm. Having polycystic ovaries disturbs a woman’s monthly ovulation cycle, making it difficult for her to get pregnant despite regular unprotected sexual activity.

Women who have PCOD experience heavy and irregular periods, unexplained weight gain, and high insulin levels. They have abnormally high levels of male hormones which interfere with ovulation and menstruation, and can causeexcessive facial and body hair (hirsutism), baldness and acne.

Coping with infertility along with the physical symptoms of PCOD can be extremely stressful for a woman. If you are having problems conceiving naturally, and have been experiencing any of the symptoms described above, it would be wise to consult a fertility doctor who would run some basic tests and provide treatment accordingly.

After obtaining your medical history and doing a physical examination, your doctor would confirm diagnosis of PCOD through:

•   Blood tests to check levels of androgens (male hormones) and other reproductive hormones
•  Ultrasound scan to check the health of ovaries and presence of any cysts

Do all women with PCOD need fertility treatment?

No health disorder affects everyonein the same way.While some women with PCOD may require only basic treatment and lifestyle guidance from the doctor, others may need longer and more comprehensive fertility treatment.

Your gynaecologist is qualified to do a preliminary diagnosis of your condition;however infertility caused by PCOD is best handled by a fertility specialist. This is because a fertility specialist routinely handles cases of PCOD-related infertility and has the necessary skill and experience to provide appropriate treatment.

As PCOD is not completely curable, fertility treatment of a woman with PCOD revolves around restoring her ovulation cycle with the help of medication, correcting hormonal imbalance, and helping her with weight management. To improve your chances of conceiving naturally, your doctor would closely monitor your ovulation cycle to guide you about your most fertile days in a month.

If lifestyle changes, weight management and preliminary treatment do not work, your doctor may need to intensify your fertility treatment, which can include:

•          Ovulation induction: Stimulate the ovaries to release more than one egg at a time. This is done with the help of medication.
•          Hormone therapy: Hormone injections to stimulate ovulation and promote growth of follicles
•         Surgery: In severe cases of PCOD, your doctor may recommend a laparoscopy to remove the cysts.
•          IVF or ICSI: If medication and hormonal therapy do not get desired results, your doctor would recommend an assisted reproductive technology (ART) procedure such as IVF or ICSI.

To sum up, most women who have PCOD and are having difficulty getting pregnant require some form of fertility treatment. The extent of your treatment would depend on a number of factors –the severity of the problem, your age, history of pregnancy, body weight, and any other health disorders such as diabetes or hypertension.

Apart from problems with getting pregnant and an increased risk of miscarriage, women with PCOD are at a higher risk of developing heart disease,type II diabetes, and sleep apnea. Therefore, you should seek treatment for PCOD even if getting pregnant is not your immediate goal.

Looking for unbiased, honest and expert fertility advice? Consult our fertility specialist Dr. Anubha Singh for a free second opinion.