Is IVF Much Harder If You Have PCOS? : Before understanding if IVF is difficult for individuals with PCOS, we need to understand what PCOS is. There are two terms PCOS and PCOD, that is Polycystic Ovarian Disease and Polycystic Ovarian Syndrome.
Normally, between the age of 20-30 years of age, there are around 8-10 follicles in each of the ovaries. From these follicles one will grow and release eggs every month naturally. As the age increases, the follicular number will come down and once menopause is attained, it becomes low. If there are more than 15 follicles per ovary, it is called PCO (Polycystic Ovary). When PCO is linked with symptoms like irregular periods, excessive body hair, and obesity, it is termed PCOD (Polycystic Ovarian Disease). If PCOD is associated with other health issues like high blood pressure, metabolic problems, or diabetes, it becomes PCOS (Polycystic Ovarian Syndrome).
PCOS and infertility
Normally, one egg is released each month. In PCO, the number of eggs is high, causing an increase in hormones like testosterone and DHEA, which can lead to obesity, hyperandrogenic features and hormonal imbalances. This can result in anovulation, where the follicles don’t grow, leading to infertility.
Patients with PCOS are advised to monitor blood sugar levels, thyroid hormones, and any other abnormalities. Doctors may recommend supplements like myoinositol and lifestyle changes, such as increasing physical activity for at least one hour a day, to help regulate hormones, promote weight loss, and restore ovulation. A 5% to 10% reduction in body weight along with dietary changes can also help induce natural menstruation and increase the chances of conceiving.
Success of IVF
If smaller treatments are successful, IVF can also be successful. In PCOD patients, the main problem lies in the quality of the oocyte. The egg quality might be a little compromised because of hyperandrogenism (a condition where male androgenic hormones will be high). The oocytes can be cultured till the blast stage, only the good quality oocytes will go to that stage. Additional supplements during IVF and embryo transfer can further improve success rates, making IVF a viable option for PCOS patients.
Other treatments like Tubal patency test, semen analysis and ovulation induction can stimulate follicles to grow and to release the egg. If these methods don’t work, IVF is considered. However, most patients with regular cycles, weight loss, and proper medical management do well with basic treatments, and about 60% to 70% can conceive without IVF.
Nowadays, 5% to 15% of women in their reproductive age group suffer from PCOS, with 70% to 80% experiencing infertility and requiring medical assistance. Managing weight to maintain a BMI between 20 to 25 is essential for controlling PCOS since there is no cure. If patients are not able to lose weight and are not able to conceive with these measures, there are other medical and surgical measures like laparoscopy, ovarian drilling available.
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