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  • How To Get Pregnant With PCOS: Know The Treatment To Help You Conceive

    Many women with polycystic ovarian syndrome have conceived and given birth to kids (yes, plural).
    by Esper Abrajano-Bitare .
How To Get Pregnant With PCOS: Know The Treatment To Help You Conceive
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  • One of the reproductive issues a woman may encounter is polycystic ovarian syndrome (PCOS). It is a hormonal imbalance that is characterized by the body’s production of too many androgens, or male hormones. It may also affect a woman’s chances of getting pregnant when it interferes with her menstrual cycle.

    Women with PCOS do not ovulate each month, or their ovaries do not release an egg every month. That is because the eggs do not mature or develop fully. In fact, there may PCOS cases where no ovulation occurs at all.

    The cause of PCOS is still unknown, but it could be genetic. There is a higher chance of you having PCOS if women members of your family (e.g., mother, sister, aunt, etc.) have it.

    Symptoms of PCOS

    PCOS is a complex condition because there is no specific test to diagnose it. Instead, your doctor will refer to your symptoms. Dr. Maynila Domingo, an obstetrician-gynecologist who specializes in maternal-fetal medicine at ManilaMed Medical Center in Manila, shared in a previous article with SmartParenting.com.ph, an ob-gyn will need “at least two out of three” of the following to diagnose PCOS. 

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    • Irregular menstruation as the patient does not ovulate regularly
    • Excess body hair and acne due to high level of androgen, a sex hormone for males
    • Follicular cysts that are at least nine millimeters in diameter on one or both ovaries. This can be examined by a doctor via a transvaginal ultrasound.

    Unfortunately, according to Dr. Domingo, women wait up to a year after their last menstruation before they consult a doctor. Periods are irregular when the length of the cycle, or the gap between the start of the periods, keeps changing. The average menstrual cycle lasts 28 days, although it is still considered normal for it to be a bit shorter or longer.

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    How to get pregnant with PCOS

    Some women do not know that they have PCOS until they try to conceive because women do not know the symptoms, or they ignore it. You can, however, still get pregnant even if you have PCOS, but you need to work closely with your doctor.

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    Doctors turn first to natural methods (read more below), such as advising the woman to lose weight, eat healthily, exercise regularly, and live a healthy lifestyle. If these don’t work, the doctor turns to medications to increase your chances of getting pregnant. Below are some treatment procedures and courses of action you and your doctor may discuss.

    Manage your weight

    If you have PCOS, you may hear "insulin resistance" from your doctor. It means your body may not respond to insulin, so you have higher levels of glucose in your body. Having high levels of insulin in your body can result in weight gain and fertility problems. Women diagnosed with PCOS are at increased risk of developing diabetes in later life.

    Monitor your ovulation

    You have better chances of becoming pregnant when you monitor your ovulation period and time sexual intercourse during your fertile days. This is essential, especially when your menstrual cycle is irregular. Below are some signs that ovulation is happening or about to happen:

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    • Mucus changes
    • Abdominal pain
    • Premenstrual symptoms like breast tenderness, abdominal bloating, moodiness

    (Click here to check for more signs that you’re ovulating, and here for how long ovulation period lasts.)

    Consider contraceptive pills

    For women with PCOS and irregular periods, intermittent use of contraception pills, such as progestin-only pills, may help regularize their menstrual cycle. These pills are usually prescribed every three to four months but can also be given monthly. This course of treatment reduces the long-term risk of developing endometrial cancer, which is associated with not having regular periods.

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    Ovulation induction through medication

    If three to six months of lifestyle change and weight loss still don’t help you conceive, your doctor may start ovulation induction. Ovulation induction is a treatment procedure that uses medication to prompt the ovaries to increase a woman’s egg production. But doctors often do not recommend it for women with PCOS who are also obese or have a body mass index (BMI) greater than 35.

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    Clomiphene citrate is an anti-estrogen drug most commonly used for ovulation induction. Women with PCOS take it at the start of their menstrual cycle to increase the chances of egg production. It can work by itself, but it may also be combined with other drugs such as metformin, which lowers insulin and blood sugar levels in women with PCOS.

    Although it has very high chances of effectivity, ovulation induction also involves risks, such as headaches, blurred vision, and mood swings. It also ups a woman’s chances of getting pregnant with multiples (e.g., twins, triplets) because more than one egg is released and may be fertilized. With long-term use, ovulation induction also presents a small increased risk of ovarian cancer. This is why clomiphene medication is only taken for no longer than six to nine months.

    Metformin is given to women with PCOS who do not ovulate as it can aid in reducing androgen levels and improve the rate of ovulation. This drug may also help a woman with PCOS lose weight and is usually taken with clomiphene. Some side effects of metformin include nausea, vomiting, and loss of appetite.

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    Drugs that contain gonadotropins, or hormones such as follicle-stimulating hormones (FSH) and luteinizing hormones (LH), can also induce ovulation. These hormones are injected into the woman to stimulate the growth and release of eggs. After injecting the hormones, the ovary is carefully monitored through regular ultrasounds to avert overstimulation of the ovaries. Like clomiphene, women who use gonadotropins also increase the risk of getting multiple pregnancies.

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    Ovarian drilling

    Ovarian drilling is a minimally invasive laparoscopic procedure, which involves drilling small holes on the surface of the ovary to remove tissue responsible for the excessive production of androgens. After ovarian drilling is performed, ovulation is reinstated for up to six to twelve months.

    Ovarian drilling is not commonly advised and is only used after all the methods have proved unsuccessful. Some side effects of ovarian drilling include a small risk of scar formation around the ovaries and damage to some internal organs, such as the bladder and blood vessels.

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    According to the American Society of Reproductive Medicine (ASRM), ovarian drilling does not fix irregular periods or ovulation for some women with PCOS. Still, it may help them respond better to fertility medicines.

    Typically, a healthier lifestyle, a healthy diet, regular exercise, no smoking, less stress, control of diabetes, and other medical conditions should give women with PCOS increased chances of getting pregnant. It’s always best to work with reproductive medicine or fertility specialists to help you choose the right treatment or medication for you.

    Women with PCOS can choose to get pregnant via assisted reproductive technology (e.g., intrauterine insemination (IUI), in vitro fertilization (IVF), etc.). Click here to know more about it.
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