Infertile women with PCOS consider various fertility treatments
By Dr. Andrea Lee
PCOS (Polycystic Ovarian Syndrome) is a major cause of infertility. A symptom of the condition, often referred to as polycystic ovaries, can be nine or fewer menstrual cycles per year. This is the result of the ovaries failing to produce hormones that keep the menstrual cycle regular. When women with PCOS have infrequent or no ovulation, they may be unable to become pregnant. Many women suffering from PCOS seek fertility treatment.
Most heterosexual women with PCOS try Assisted Reproductive Therapy (ART) before proceeding to in vitro fertilization (IFV). ART does not have the risks or the costs of IVF. Since the main reason women with PCOS have trouble conceiving is erratic menstrual cycles, ovulation induction is the most common ART method used.
Ovulation induction often involves taking Clomid, one of the most popular fertility drugs prescribed, to encourage ovulation by stimulating ovary follicles. Women with PCOS may be all too familiar with Clomid side-effects: mood swings, hot flashes and headaches and may choose an alternative fertility drug after several unsuccessful cycles, or move on to IVF.
Artificial insemination (AI), another form Assisted Reproductive Therapy, involves the injection of sperm, either from a known donor (this person may be the woman’s unmarried partner, a friend or even family member of the non-biological partner) or from a donor bank, directly into the cervix or uterus. AI is not typically used in heterosexual couples where PCOS is the only obstacle to conception. AI is a common treatment when the male has a low sperm count or the female suffers from endometriosis.
Because PCOS seems to be more prevalent among lesbians, female couples opting for a combination of ART and artificial insemination or in vitro fertilization over adoption may be more likely to face the challenges of conceiving with PCOS. And with the recent “Gayby Boom,” the trend of lesbians and gays becoming parents, the number of lesbians undergoing ART and IVF is on the rise.
“Each year we’re seeing an annual increase of about 50 percent in the number of same-sex couples coming to us for IVF to have their children and build their families,” said Dr. Samuel Pang, Medical Director of the Reproductive Science Center of New England.
In vitro fertilization is a complex, expensive procedure used as a last resort when all other methods of assisted conception have failed. One cycle of IVF may cost as much as $12,000. Risks include: Ectopic pregnancy (pregnancy outside the womb), multiple pregnancy, ovarian hyperstimulation syndrome (OHSS), and the possibility of increased risk for ovarian cancer. IFV success rates vary from clinic to clinic. The Society for Assisted Reproductive Technology (SART), representing over 85% of ART clinics in the United States, provides national statistics of member clinics.
Before undergoing ART, women with PCOS may consider non-pharmaceutical methods to achieve conception. One of the underlying causes of PCOS is insulin resistance, and when this condition is reversed natural conception may be achieved. Non-pharmaceutical methods include: a high-protein, low-carbohydrate diet, with lots of green vegetables and fruits, specific exercises to increase insulin sensitivity, nutraceuticals (vitamins, minerals and herbs that are disease specific) to balance blood sugar or a complete system that incorporates all of these elements.
You Tube Video of a Woman suffering from PCOS tells her story of conceiving naturally, after being told by doctors she would never be able to conceive naturally. She became pregnant after using a systematic approach to reverse insulin resistance and PCOS symptoms.
References
U.S. Dept. of Health and Human Services
2004 Assisted Reproductive Technology Success Rates
American Reproductive Medical Society
Fertility and Sterility
November 2007 | Vol. 88, No. 5
Dr. Andrea Lee is a Naturopathic Doctor practicing at Arizona Advanced Medicine
http://www.azadvancedmed.com/ in Scottsdale, where she treats a number of women with Polycystic Ovarian Syndrome (PCOS) among other conditions. As a member of Insulite Laboratories’ Medical & Advisory team www.pcos.insulitelabs.com, Dr. Lee provides guidance and coaching to individuals who contact the Insulite Support Network, including those using the various Insulite Systems.
Prior to attending Southwest College of Naturopathic Medicine, Dr. Lee worked as a senior research study associate and volunteered with a breast cancer support group in Oklahoma City, OK. Her Bachelor’s degree is from the University of Alaska where she studied Psychology and Exercise Science.
I am 22 years old and i have PCOS and i’ve been trying to have a baby for almost 2 years now. I found out that i had PCOS from a fertility specialist. Since i was 16 i was having irregular periods, i did’nt know what that was about. I would have never found out if i didn’t go to a fertility specialist about it. Now i’m stressed out and don’t know what to do. I want a baby and can’t have one because of PCOS.
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Hello Theresa,
Although it is distressing to find out PCOS is preventing one from conceiving, it does not have to keep women from eventually becoming pregnant- there are things to do to lessen its impact.
The underlying cause of PCOS in most cases seems to be Insulin Resistance. With Insulin Resistance, the body becomes insensitive to the insulin it produces, which leads to elevated circulating levels of insulin. This in turn leads to hormonal imbalances such as increased testosterone and other androgens (male hormones). The increased testosterone is responsible for many of the symptoms such as hair growth and abnormal menstrual cycles.
Elevated insulin also contributes to the formation of cysts in the ovaries in part due to the hormonal imbalances and also because the ovaries are highly sensitive to the influence of insulin. In women with PCOS, the ovaries are over-sensitized to insulin’s effects.
Finally, the weight gain often associated with PCOS is intricately related to Insulin Resistance. Research has shown that for overweight women with PCOS, losing at least 5% of their weight increased the likelihood of restoration of regular menstruation. Regular menses increase the likelihood of ovulating; therefore losing weight can increase the chances of becoming pregnant.
Changing one’s diet by decreasing the amount of carbohydrates intake, and increasing whole foods and green leafy vegetables is one way to remedy the situation. Often, it’s necessary to decrease carbohydrate intake to around 60-80 grams a day. Also, it’s important to eat 3 times a day, and have a couple of healthy snacks too.
Exercise is essential- ideally it will be a mix of cardiovascular and weight-bearing work, 3-5 days a week. Toned muscles are more insulin sensitive than untrained muscles, which means that getting in shape (if you aren’t already) will help control and reverse Insulin Resistance, and thus PCOS.
Insulite Labs specializes in helping women with PCOS get control of their condition by providing specifically chosen nutrient and herbs, lifestyle advice, and customer support. Again, PCOS does not have to keep a woman from becoming pregnant, it just requires her to look more closely at what is happening with her body, and to her body function more optimally.
Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Medical & Advisory team
i am married.. i don’t enjoy sex with my husband.i used to attract with girl’s boobs.
now i want to get pregnent but i am not conceving because all my harmones are high..can i be pregnent??
Dear Gita,
I am glad you found our website! Trying to conceive can be a very challenging and heart wrenching process for some couples. We understand how difficult this can be and hope that we can be a source of support and information for you. Thanks for writing in!
The best way to determine if you are pregnant or not is to either do a home pregnancy test or see your doctor for a blood test (the blood test can determine pregnancy earlier than the home test kits). Early detection of pregnancy is important so prenatal care can begin. Many vital nutrients are needed in the beginning of pregnancy to help ensure that the baby has what it needs to grow and form properly.
You mentioned in your email that your hormones are “high”, have you been diagnosed with PCOS? PCOS (Polycystic Ovarian Syndrome) is a major cause of infertility. A symptom of the condition, also known as polycystic ovaries, can be nine or fewer menstrual cycles per year. The disorder may
also cause heavier than normal bleeding during periods. These conditions are the result of the ovaries failing to produce hormones that keep the menstrual cycle regular. Because women with PCOS don’t have regular periods, many are unable to become pregnant. To read more about PCOS and
infertility please visit the following link:
http://www.pcos.insulitelabs.com/PCOS-and-Infertility.php.
I hope this information is helpful for you! There is amazing customer support at Insulite Labs; we are here to help you through this healing journey. Please don’t hesitate to contact us again if you have any other questions or concerns.
Best Wishes,
Dr. Andrea Lee, ND
Insulite Laboratories Consulting and Advisory Team
DISCLAIMER: The information contained in this email and the Insulite Labs
website is for the sole purpose of being informative. This information is
not and should not be used or relied upon as medical advice. Always seek
the advice of your physician, nurse or other qualified health care
provider before you undergo any treatment, take any medication,
supplements or other nutritional support, or for answers to any questions
you may have regarding a medical condition.
I reguarlly use carb cycling as im a bit of a body builder but its a good way for anyone looking to lose fat.
Im 20 years old and im having irregular periods, its so slow and only lasts for two days,im a lesbian, could it be that i also have PCOS?
Dear Wendilyn,
Thank you for writing into the PCOS Support blog. I am glad that you found us.
This is a great question and indeed irregular periods are one of the symptoms of PCOS. However, it is not the only reason for an irregular period. What is important is to be evaluated to see if PCOS is a possibility or something else.
According to research, lesbian women are more likely to develop PCOS than heterosexual women. PCOS is notoriously difficult to diagnose. It is a diagnosis of exclusion. In other words, it is important to rule out other diseases that can cause symptoms similar to PCOS (such as Congenital Adrenal Hyperplasia).
To diagnose PCOS, we use a combination of clinical symptoms (what you experience as the patient, such as excess facial/body hair growth, irregular menses, acne, skin tags, weight gain, hair loss or male pattern baldness, infertility, etc.) and lab tests. Some of the tests that help rule PCOS in or out include the following:
The blood tests to consider are:
- free testosterone- elevated in PCOS
- DHEA-S- often elevated in PCOS
- Sex Hormone Binding Globulin (SHBG)- usually low in PCOS
- Fasting insulin- elevated in PCOS. Some doctors may hesitate to order this test because the normal range (0-20) is so wide. However, we find that results greater than 9 indicate insulin resistance. Insulin resistance is usually the underlying cause of PCOS, as you may have read about on our site. Some doctors may also order a 2-hour post-prandial insulin test, along with a 2-hour post-prandial glucose test. For the post-prandial insulin, results over 25 or 30 may indicate insulin resistance.
- Fasting glucose or 2-hour post-prandial glucose test- elevated in PCOS. Using this information in combination with the insulin levels helps to diagnose insulin resistance. Also, women with PCOS have a higher risk of diabetes so it is important to screen for this early and often.
- LH: FSH- Some doctors may also look at the ratio between these two hormones. In PCOS, we would expect LH to be elevated in comparison to FSH.
- You could get an ultrasound to check for the presence of ovarian cysts. Even if the ovaries do appear normal, the absence of ovarian cysts does not mean that you don’t have PCOS. Not everyone with PCOS has ovarian cysts.
- I would also check your cholesterol levels and liver function tests, as these can also be abnormal in PCOS (as well as in many other conditions).
Lab testing is not mandatory for diagnosing PCOS, especially if you are experiencing so many of the symptoms. However, the above tests do give us numbers which, along with the improvement of your clinical symptoms, help us monitor your progress.
I do want to let you know that there is another condition called Cushing’s disease that has many symptoms of PCOS and is sometimes mistaken for PCOS. If you did have Cushing’s disease it may exacerbate the symptoms. Cushing’s is not very common, but I still wanted to mention it to you. This would be something to discuss with your doctor to ensure it has been ruled out.
I also want to direct you to some information on this the topic of lesbian women and PCOS. It was a radio interview with one of our doctors, Dr. Andrea Lee ND. To hear Dr. Lee’s interview “What Lesbian and Bi-sexual Women Need to Know about PCOS” on PCOS Challenge Radio Visit http://www.blogtalkradio.com/pcoschallenge and look for “On Demand Episodes.” The original airdate was 10/28/2009 3:00 PM.
Wendilyn, I hope that this helps and gives you the information needed to further investigate what is going on. Please let us know how you are doing and if we can help further.
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Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Consulting & Advisory teams
DISCLAIMER: The information contained in this email and the Insulite Labs website is for the sole purpose of being informative. This information is not and should not be used or relied upon as medical advice. Always seek the advice of your physician, nurse or other qualified health care provider before you undergo any treatment, take any medication, supplements or other nutritional support, or for answers to any questions you may have regarding a medical condition.