Why can’t I conceive?

Polycystic Ovarian Syndrome (PCOS) is a common syndrome which is a hormone disorder and affects approximately 10% of women.  It is a collection of problems that are found together and doesn’t affect everyone equally.

What is PCOS?

To be diagnosed with PCOS a woman has 2 out of three issues – lack of ovulation (anovulation), chronic high testosterone hormone levels (hyper-androgenism) and ovaries that have multiple follicles (over 20)

PCOS is diagnosed by a combination of history taking, examination, pelvic ultrasound and blood tests.

SYMPTOMS OF PCOS

  • Irregular or missed menstrual periods 
  • Difficulty with weight (50% of women with PCOS are overweight)
  • Increased hair growth (hirsutism)
  • Acne
  • Infertility
  • Thick endometrial lining as the lining is not shed regularly which can lead to episodes of abnormal bleeding and can be a precursor to endometrial hyperplasia (stage pre cancer) and then endometrial cancer
  • Metabolic syndrome – which leads to elevated blood pressure, diabetes, increased risk of heart disease, obesity with weight increasing around the abdomen mainly

INVESTIGATIONS:

  • Hormone evaluation including male hormones (often elevated)
  • Full blood examination with LFT (there is a increased risk of fatty liver)
  • Lipid profile (often abnormal lipid profile is detected)
  • Glucose testing

TREATMENT

  • If pregnancy is not desired the oral contraceptive pill with an antiandrogen the best form of treatment and prevention
  • If pregnancy is desired the oral therapies such as clomid or letrozole can be used (increased risk of multiple pregnancy of 10%)
  • Lifestyle changes are important and a low carbohydrate diet should be followed
  • Metabolic issues should be treated with metformin
  • Resistance to clomid – ovarian drilling may be considered – a surgical procedure to burn the follicles – this comes with risk of scarring and damage to ovary and its function
  • Low dose Gonadotropins if oral agents do not induce ovulation (there is an increased of multiple pregnancies between 20-30 %)
  • IVF is generally considered if ovulation therapy fails or if the patients wish to avoid multiple pregnancy.

 

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To our valued Clients,

All appointments with Dr Lynn Burmeister will now be available through Facetime or Zoom and will be rebated through Telehealth.

This means you will not incur any out of pocket fees.