Polycystic ovarian syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a common condition that can affect both fertility and general health. Most women with PCOS will have very irregular menstrual cycles, such that they miss having menses for months or even have no menses at all. This symptom of irregular menses indicates that ovulation (release of an egg) is not happening regularly. Not all women with PCOS have the same symptoms. Many women with PCOS will be overweight, have increased hair growth (hirsutism), acne, pre-diabetes, or high cholesterol.

To be diagnosed with PCOS, a woman must have at least 2 of 3 following issues:

• irregular menses
• high levels of testosterone in the blood
• at least one PCO-appearing ovary by ultrasound

It is possible to treat the infertility associated with PCOS by using medication to induce ovulation. The most common medications are taken by mouth (clomiphene and letrozole). If medications taken by mouth are not successful, gonadotropin given by daily subcutaneous injection can be used. Insulin-sensitizing medications such as metformin may help improve the chance of ovulation in some women with PCOS.

Weight loss will also help improve the chance of ovulation, fertility, and general health. For women who are not attempting to become pregnant, oral contraceptive pills can be used to treat many of the symptoms of PCOS.