Despite the fact that the polycystic ovarian syndrome (PCOS) can become an obstacle to pregnancy, many women with polycystic disease succeed in conceiving and giving birth to a healthy child. In some cases, pregnancy occurs on its own. Sometimes in order to become pregnant a woman needs to undergo a course of drug treatment or even to undergo surgery on the ovaries. So, how compatible is PCOS and pregnancy?
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS, polycystic ovary syndrome, Stein-Leventhal syndrome) is a disease of the female genital area, characterized by impaired production of female sex hormones, an increase in the size of the ovaries with the appearance of cysts in them, menstrual cycle disorder, infertility and other symptoms. The causes of the development of the polycystic ovary syndrome are currently unknown. Still, it is assumed that a certain role in the development of the disease is played by hereditary factors, traumas, inflammatory diseases of the genital organs, etc. The diagnosis of polycystic ovary is based on the definition of characteristic symptoms, ovary ultrasound, the study of hormone level of the blood, etc.
In general, the treatment of polycystic ovaries depends on the age, weight, the desire of a woman to become pregnant and other factors. It also includes normalization of body weight, hormonal or surgical treatment.
Why Does the Polycystic Ovarian Syndrome (PCOS) Develop?
High level of estrogen and a lack of progesterone (which stimulates ovulation – the release of the egg from the ovary) lead to a delay in ovulation, excessive thickening of the inner layer of the uterus (endometrium) and the development of amenorrhea (absence of menstruation) or uterine bleeding. In half of the cases, PCOS combines with obesity. The causes of the development of the polycystic ovary syndrome are not clear. Still, there are predisposing factors, the presence of which increases the risk of the disease:
- Hereditary factors (the presence of PCOS in close relatives).
- Chronic infectious diseases.
- Abortion in the past.
- Pregnancy and childbirth with complications.
Symptoms and Signs of Polycystic Ovarian Syndrome
Typically, the first symptoms of the polycystic ovarian syndrome appear during puberty and worsen over time. The main signs of polycystic ovary are:
- Violations of the menstrual cycle usually begin with the appearance of the first menstruation. It is characterized by irregular menstrual cycles, rare menstruation, dysfunctional uterine bleeding (abundant prolonged uterine bleeding, which usually occurs at intervals of about 1.5 months).
- Infertility. The inability of a woman to become pregnant is associated with the lack of ovulation (the release of the ovum from the ovary).
- Hair growth (hirsutism) – is characterized by the growth of hair on the face, chest, abdomen, etc. Hirsutism in women with polycystic ovarian syndrome is caused by a high blood level of male sex hormones (androgens).
- Change in the voice timbre also happens due to the increased production of male sex hormones.
- Oily skin on the face, the appearance of acne on the face, etc.
- Obesity is one of the possible causes of the development of polycystic ovarian syndrome. In addition, increased body weight can also serve as a symptom of polycystic ovary.
- Diabetes mellitus is not an obligatory symptom of PCOS. Still, hormonal disorders in the body of a woman against the background of PCOS can lead to the development of this disease.
- The appearance of seals in the chest (fibrocystic mastopathy) is a breast disease characterized by an increased proliferation of connective tissue in the mammary glands. It is associated with hormonal disorders in the body of a woman with polycystic ovaries.
The prevalence of the disease is quite high. Every fifth woman is sick. Despite the fact that the PCOS gives a lot of trouble, it is not a verdict. You just need to carefully take care of your health.
With PCOS, there is an increase in luteinizing hormone (LH) and male sex hormones in the blood. The reasons are insufficiently studied. Still, the probability of a hereditary factor in the development of pathology is rather high.
The main feature is polycystic or enlarged, due to the formation of numerous cysts, ovaries.
Women often wonder about the compatibility of PCOS and pregnancy. Due to cystic changes, normal functioning of the ovary, blood supply and nutrient intake are disrupted. As a result, the egg ripens, but ovulation does not occur. Thus, the level of estrogen increases and the amount of progesterone decreases.
This disrupts the normal development of the endometrium of the uterus. It actively grows under the influence of estrogens and then thickens. This can cause a delay in menstruation and irregular menstrual cycle. And the menstruation itself becomes abundant. The development of uterine bleeding is also possible.
Polycystic ovary can cause serious complications:
- Disorder of the menstrual cycle.
- Oncological disease of genital organs.
- Cardiovascular disorders.
- Diabetes mellitus of the second type.
Patients with polycystic disease should be informed about it and often take preventive examinations as they are at risk.
In case of polycystic disease, the body’s sensitivity to insulin decreases. This condition is called insulin resistance. It leads to a significant increase in the insulin index. In turn, a high level of insulin contributes to the excessive synthesis of androgens. This leads to changes in the ovaries, reducing their function and changing the structure.
Male hormones interfere with the normal growth of eggs, cause a thickening of their outer shell. As a result, the ripened follicle is unable to break through the thickened wall of the egg to release it outward for fertilization. The rest of the follicles become cysts, filled with fluid. Therefore, the ovaries increase in size.
Treatment of Polycystic Ovarian Syndrome
Treatment of polycystic ovaries depends on the age, the most pronounced symptoms of the disease, the desire of a woman to get pregnant, the presence or absence of obesity, diabetes, etc. The main principles of treatment of the polycystic ovary syndrome are: weight loss in the presence of obesity, normalization of hormonal disorders in the body, stimulation of ovulation (if a woman is planning a pregnancy). There is a conservative treatment of polycystic ovary (with drugs, diet, etc.) and a surgical one. In women with polycystic ovary syndrome in combination with obesity, an important stage of treatment is weight loss. In some cases, after normalization of weight, all the symptoms of polycystic ovary disappear. Menstruation becomes regular and ovulation occurs. This makes PCOS and pregnancy possible.
PCOS and Pregnancy: How to Conceive?
A woman, who wants to become a mother, should apply to a medical institution and consult a competent doctor who will choose for her the best way to treat infertility against the background of polycystic ovarian syndrome.
PCOS and Pregnancy: 6 Methods of Conception
Ovulation with polycystic disease is rare. But sometimes it is enough to track the time when the egg leaves the ovary to try to conceive a child. The charts of basal temperature can be very helpful. You can also use ovulation tests. You can buy them at any pharmacy. The control of the dominant follicle growth and the exit of the egg are controlled by ultrasound.
The frequent cause of the polycystic ovarian syndrome is endocrine disorders, namely insulin resistance. To neutralize this hormone, the drug “Metformin” is prescribed, which is used for the treatment of type 2 diabetes. It increases the sensitivity of tissues to insulin, and as a consequence – reduces the level of androgens. In the treatment of PCOS doctors prescribe drugs that stimulate the production of female hormones, necessary for ovulation.
Most doctors prescribe COCs (combined oral contraceptives) for at least three months and then cancel the prescription. While taking the pills, the ovaries are inactive. But after the withdrawal of the drug, the ovaries begin to work with a double force. Thus, ovulation occurs in 80% of cases in the first cycle after cessation of COC. As a result, pregnancy is possible.
Stimulation of ovulation
The induction of ovulation includes taking several groups of hormonal drugs according to a certain scheme, which is prescribed by the doctor. Stimulation is carried out under the strict supervision of a doctor and ultrasound monitoring. Also, doctors prescribe special drugs, which allow the follicles to ripen, then the HCG is injected – to rupture the follicle and release the mature egg from it. Preparations containing progesterone are prescribed immediately after ovulation, in order to create optimal conditions for attaching a fertilized egg and supporting pregnancy (if it has occurred).
This is one of the most effective means in the issue of PCOS and pregnancy. The procedure is based on the removal of cysts on the ovaries, by surgical intervention. In polycystic ovary syndrome, this method is most effective, since in 95% it allows a woman to become pregnant within the first 3-6 months.
IVF (in vitro fertilization)
This method is the most difficult and expensive. At the same time, it gives a great chance for PCOS and pregnancy. It is based on the injection of a fertilized egg into the womb of a woman’s uterus. IVF is used in the syndrome of polycystic ovaries, when other methods of conception didn’t work.
In modern medicine, PCOS is not a verdict for pregnancy. Nowadays there are many proven methods which can help you get pregnant.
PCOS and Pregnancy Success
If a woman managed to get pregnant with the above methods – this is only half of the success. The next goal is the successful course of pregnancy. The statistics shows that in women with PCOS the risk of spontaneous abortion is three times higher than that of healthy future mothers. That’s why, the doctor who observes a woman during pregnancy, prescribes a course of drugs to prevent miscarriage and premature birth. The hormone therapy with progesterone is also prescribed from the beginning of pregnancy and until the end of 16 weeks. In some cases, these drugs are taken until 28-30 weeks.
Keep in mind that polycystic ovarian syndrome limits the ability to regulate insulin in the blood. That’s why it is important to follow a low-carb diet, and reduce the amount of simple carbohydrates (sweet, floury).