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PCOS

Treating PCOS and Infertility

Polycystic Ovarian Syndrome (PCOS) is one of the most under-diagnosed diseases in the United States despite it affecting 8-10% of women of reproductive age.

 

Surprisingly, most women with PCOS don't even know they have it. Estimates say that less than 25% of women with PCOS have actually been diagnosed. Most women are never officially diagnosed until they begin struggling with infertility and seek help in getting pregnant.

 

Since it is hormonal disease that results in irregular or absent periods or ovulation, it is a leading cause of infertility.

Even more serious, women with PCOS may be at higher risk for developing cardiovascular disease, Type 2 Diabetes, and endometrial cancer.

 

PCOS is also a difficult disease to cope with, accompanied by weight gain (obesity), acne, excessive hair on the face, back, thighs and abdomen. If you are struggling to become pregnant and also experience any of these symptoms, it is essential you schedule a consultation with Dr Morgan. The earlier PCOS is treated, the better.

 

PCOS can  be diagnosed if the patient has 3 simple presentations:

  1. irregular menstrual cycles that occur more than 35 days apart

  2. excess hair growth on face and body, or loss of hair on the top of the head (male pattern baldness or hair growth)

  3. ultrasound findings demonstrating the ovaries with multiple tiny cysts (follicles) with more than 10 per ovary

 

In the past we used blood hormone levels to help, but it is not one of the three MOST important parameters.

Those hormones that we used to use to help were;

 

  • LH (luteinizing hormone)- if it is 2 or 3 times higher than FSH

  • FSH (follicle stimulating hormone)

  • Testosterone- over the normal range for women

  • DHEAS (dehydroepiandrosterone sulfate)- elevated

  • Insulin- elevated . when fasting

In addition to bloodwork, we will also perform an intravaginal ultrasound to examine your ovaries for multiple tiny follicles around your ovaries that look similar to strings of pearls.

 

Getting Pregnant with PCOS

The most effective treatment options for women trying to conceive with PCOS is the use of medications to trigger ovulation (ovulation induction). Clomiphene citrate or other injectable medications often restore ovulation and stabilize menstrual cycles. Ovulation Induction can  be combined with artificial insemination (also called Intrauterine Insemination, or IUI) for very good results. In difficult cases, In Vitro Fertilization (IVF) may be recommended.

 

If insulin-resistant, insulin sensitizer medications may also be needed to control abnormal insulin production and sugar metabolism.

Dr Morgan is our area's leading expert and has countless women with PCOS cope with symptoms and overcome infertility. 

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