Polycystic ovary syndrome (PCOS) is a common endocrine disorder that can be a major cause of infertility in women. PCOS can cause cysts to form in the ovaries and cause hormonal imbalances, which interfere with ovulation.
PCOS is an important public health problem and one of the most common hormonal disorders affecting women of reproductive age. The condition affects an estimated 8-13% of women of reproductive age, and up to 70% of cases remain undiagnosed. The biological and psychological effects of PCOS, particularly those related to obesity, body image, and infertility, can lead to mental health challenges and social stigma.
Following are some basic principles and protocols for managing infertility due to PCOS:
Lifestyle changes
Weight Management:- Weight loss can help reduce PCOS symptoms and improve ovulation. Regular exercise and a balanced diet are helpful in keeping weight under control.
Healthy Diet:- A high-fiber, low-sugar, and low-fat diet can improve hormonal balance. Intake of whole grains, fruits, vegetables, and lean proteins should be increased.
Medical treatments
Ovulation induction:- The following drugs can be given to induce ovulation:
Clomiphene citrate:- It is a first-line drug that stimulates ovulation.
Letrozole:- An aromatase inhibitor used to stimulate ovulation.
Metformin:- If insulin resistance is present, metformin can be used.
Gonadotropins:- Hormone injections can be given to induce ovulation, but this is more expensive and more complicated.
Assisted Reproductive Technologies (ART)
In Vitro Fertilisation (IVF):- If other treatments fail, IVF may be an option. This involves removing an egg from the ovary, fertilising it in a laboratory and then implanting it in the uterus.
Intrauterine Insemination (IUI):- In this procedure, sperm is inserted directly into the uterus at the time of ovulation.
Hormonal Treatments
Progesterone:- Progesterone medications may be given to maintain regular menstrual cycles.
Anti-Androgens:- Medications may be given to reduce androgen levels so that hormonal balance is maintained.
Surgical Options
Laparoscopic Ovarian Drilling:- This is a surgical procedure in which small holes are made on the surface of the ovaries to improve ovulation.
Mental And Emotional Support
Counselling and support groups may be beneficial to manage the mental and emotional stress caused by PCOS and infertility.
Regular Monitoring And Follow-Up
Hormonal And Metabolic Profile:- It is important to monitor the hormonal and metabolic profile through regular blood tests and other diagnostic tests.
Ultrasound:- Ultrasound is routinely used to monitor the ovaries and eggs.
