PCOS or polycystic ovary syndrome is a common endocrine disorder of women, which may cause infertility. But what is really about the disorder, and how likely is it for PCOS women to have children in the end?
Polycystic ovary syndrome is a common hormonal disorder of women with approximately 5-15 % prevalence. No single reason is known to cause the syndrome but it is estimated that both environmental and genetics play a role. The disorder typically has symptoms like menstrual cycle disturbances, male hormone over influence in the body, which is seen in the laboratory tests or as acne and excessive hair, and polycystic ovaries, which are seen in a ultrasound examination. For diagnosis, two of the fore mentioned criteria must be met. Thus, a woman may has a PCOS diagnosis without having polycystic ovaries. All in all PCOS symptoms and the degree of difficulty vary a lot from patient to patient.
— Women and their partners typically seek for help when they face problems in having children and usually that’s the moment a woman gets to know she has PCOS. However, it would be important that women recognize the symptoms and get the diagnosis early on, as PCOS is related to other health issues as well. For example, PCOS women are in a higher risk of getting type 2 diabetes, says Liisa Viirmaa.
In polycystic ovary syndrome reproductive problems are due to ovulation problems, which are seen as menstrual cycle disturbances.
— In the worst case ovulation i.e. the monthly egg cell maturation and release doesn’t happen at all. Some women has ovulation to varying degrees, says Elle Talving.
In PCOS excessive male hormone levels cause the ovulation problems by interfering the hypothalamus-pituitary-ovary -axel, which takes care of the regular egg cell maturation and release. If ovulation doesn’t take a place, male hormone levels increase futher and the situation gets worse. Levels of male hormone may also increase due to insulin resistance, which is a common condition in PCOS women. The resistance causes too high blood insulin level, which raises ovaries’ male hormone production.
Luckily, PCOS isn’t the worst problem when it comes to infertility, says Peeter Karits. Often regular ovulation is achieved with proper medication, which normalizes the menstrual cycle and raises the probability of normal conceiving. Medication, which lowers the insulin resistance may also be used in women with this condition as it helps to decrease male hormone levels in the body. Overweight is a typical issue of PCOS women as well, and for that reason even minor weight loss may contribute to normal ovulation.
— Of course it’s possible that there are also other reasons behind the infertility than just PCOS. In that case more demanding infertility treatments may come into question. The situations of patients are unique and thus specific treatment needs are always estimated individually, Elle Talving says.
— It’s good to remember too that not all PCOS women need help to get pregnant.
Tiitinen Aila. 1.10.2018. Munasarjojen monirakkulaoireyhtymä (PCOS). Lääkärikirja Duodecim.
Potilaan Lääkärilehti. 29.8.2017. Kenellä on munasarjojen monirakkulaoireyhtymä?