Causes of Infertility: Polycystic Ovary Syndrome (PCOS)

There are a number of causes of infertility, and the polycystic ovary syndrome (PCOS) is to blame for over 25% of infertility cases. The polycystic ovary syndrome is an endocrinologic problem in females that causes irregular or no ovulation. The polycystic ovary syndrome is also known as PCOS, PCO or hyperandrogenic chronic anovulation.

Symptoms of Polycystic Ovary Syndrome

The polycystic ovary syndrome may cause several symptoms such as:

  • Lack or menstruation (amenorrhea) or irregular menstrual cycles, due to irregular ovulation or anovulation
  • Obesity, fat deposits in the hips and abdominal areas more frequent than deposits on the thighs or buttocks due to the presence of excessive male hormones
  • Enlarged ovaries
  • Multiple follicular cysts on the ovaries
  • Elevated levels of insulin
  • Uterine bleeding
  • Hyperpigmentation or dark patches in folds (the HAIR-AN syndrome)
  • Hair loss
  • Acne PCOS is not considered to be a single disease, but rather a compilation of symptoms.

Causes of Polycystic Ovary Syndrome

The polycystic ovary syndrome has been associated with an excessive production of insulin, which leads to excessive amounts of testosterone and abnormal production of female sexual hormones. The occurrence of ovarian cysts may also be associated with poor nutrition or obesity. However, the exact causes of PCOS are not known.

Diagnosing PCOS

The symptoms of polycystic ovary syndrome may often be mistaken for eating disorders or the abnormal function of adrenal glands. The polycystic ovary syndrome can be diagnosed performing a few laboratory tests including:

  • LH and FSH ratio (if it is 3:1 or higher, this is a sign of POS)
  • Levels of testosterone
  • Prolactin
  • TSH and DHEAS

The doctor will also perform an ultrasound to see if ovarian cysts are present. The cysts have the appearance of numerous small pearls. However, if only these are found and the rest of the tests show normal values, the diagnosis is not necessarily POS.

Treatment Options

If the condition is caused by increased levels if insulin, the patient should receive different medications to decrease the insulin production. The diet must also be changed and the carbohydrates must be removed or reduced in the diet. An endocrinologist should be consulted to get the best treatment. If the causes are unknown, the doctor will focus on stimulating ovulation and getting a regular menstrual cycle.

The doctor may prescribe oral contraceptives, as well as a few FSH and LH drugs, such as injectable menopausal gonado tropins. Surgery to remove the cysts may be performed, but may not be successful, as the cysts may grow back. The treatment of polycystic ovary syndrome may be successful and the infertile patients may be able to conceive. However, the conception should happen at least 3 months after the treatment has been administered.

The patient should have regular periods in order to have good chances of conceiving. Women affected by polycystic ovary syndrome may also be more susceptible to developing endometrial and breast cancer or cardiovascular diseases.

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