What is PCOS?

PCOS (PolyCystic Ovarian Syndrome) is a complex condition where small cysts can be observed in the ovaries on an ultrasound. These can result in:

• Irregular menstrual flow and cycles
• Excess facial and body hair
• Acne
• Male pattern hair loss (due to high levels of androgens/male sex hormones)
• Insulin resistance
• Anxiety and depression
• Infertility
• Weight gain, especially in the abdominal region

While the underlying causes of PCOS are not yet fully understood, we do know that both genetic and environmental factors play a role. This is both good and bad news!

Genetic / hereditary component
If a female relative has PCOS, you are unfortunately more likely to develop the condition as well.

Environmental / behavioural component
While there is no definitive cure for PCOS, many of the symptoms can be reduced or even eliminated through healthy lifestyle changes. In particular, losing weight and making sure to include plenty of high-fibre vegetables and wholegrain foods in your diet. Fibre helps the body eliminate excess hormones effectively) can be very helpful – and that’s under your control! We discuss these dietary and lifestyle changes in greater detail later in this article.

There are a number of ways in which PCOS can impact a woman’s fertility. Higher than normal testosterone levels mean that ovulation and menstruation can be irregular and unpredictable, making it harder to fall pregnant. Some women with PCOS don’t get menstrual periods at all, while others may experience them more regularly than normal.

This hormonal imbalance can also prevent the lining of the uterus from developing properly. This means that even when a mature egg is released by the ovary, it’s harder for that egg to implant.

Wijnland has assisted many women with PCOS to become mothers through IUI and IVF. IVF in particular is a very common polycystic ovarian syndrome infertility treatment, and has extremely high success rates.

There’s no single test to definitively diagnose PCOS, but your Wijnland Fertility specialist  may conduct a physical exam and then recommend the following:

• A physical and/or pelvic exam
• Blood tests – your specialist will look for abnormal androgen (male hormone) levels, diabetes, and eliminate other issues which may be misdiagnosed as PCOS, such thyroid disease.
• A pelvic sonogram or ultrasound – sound waves are used to check visually for cysts on the ovaries

It’s important to note that while PCOS can present in teenage girls, it can be difficult to diagnose at this stage. Some of the symptoms, such as acne and anxiety, may just be part of puberty – or they may not.

Diagnosis of PCOS can be made by your normal gynaecologist, but it’s worth noting they may not manage your condition with fertility in mind, but rather focus primarily on alleviating your symptoms. If you are concerned about preserving your fertility as best as possible, then it’s advisable to consult a fertility expert from the get-go.

In younger women and adolescents, birth control methods like the pill are often used to treat PCOS. These prevent ovulation, which can alleviate symptoms like painful periods, and reduce the number of cysts on the ovary.

In severe cases, a polycystic ovary syndrome surgery known as laparoscopic ovarian drilling (LOD) may be performed, although this is uncommon.

Dr Morrison gives some advice on the management of polycystic ovarian syndrome in the video below:

Wijnland Fertility recommends the following to help manage PCOS:

• Lifestyle – weight loss, quitting smoking, and decreasing alcohol consumption can all reduce the severity of PCOS symptoms.
• Physical activity – increased exercise can help reduce BMI, which has a known positive effect on PCOS.
• Improve diet – increase intake of fibre in the form of wholegrain foods, legumes and vegetables, stick to healthy fats, and avoid refined carbs and sugar to reduce the body’s need for insulin.
• Supplements – A good multi-vitamin and mineral can be taken.

Some women may find it beneficial to eliminate dairy from their diets. Dairy contains a human-identical hormone called IGF-1 (Insulin-like growth factor 1), which is found in higher levels in the blood of women suffering from PCOS, and to which their ovaries might be overly sensitive. You can simply try replacing cow’s milk with a mineral-enriched, unsweetened plant-based milk such as soy, almond milk or oat milk for a few weeks and see if your symptoms improve. 

Wijnland offers some in-depth nutritional advice for patients with polycystic ovarian syndrome here.

We encourage women and teenagers who suspect they may have PCOS to come in for a consultation as soon as possible. Early diagnosis and treatment of PCOS in adolescents, for example, may still alter the clinical course of this syndrome.

The fertility drug clomiphene citrate may be helpful in the treatment of polycystic ovary syndrome in adults or women currently trying to get pregnant. Our fertility experts will be able to guide to the treatment which is best for your specific needs, as well as offer psychological support and advice on managing the condition.

Which fertility treatment is right for you will depend largely on how severe your symptoms are. In mild cases, for example, inducing ovulation might be all that is required for you to fall pregnant naturally.

If your PCOS is more severe, our fertility experts will generally follow the normal route we would for any other couple battling to conceive:

• IUI – Intrauterine Insemination – as this procedure is less invasive than IVF, we generally try this treatment first for our PCOS patients.
• IVF – In Vitro Fertilisation – if IUI is not successful, IVF is the next option. Not only does IVF have a very high success rate, it’s also one of the fastest methods for couples to get pregnant.

Remember that the sooner PCOS is diagnosed, the sooner we can help you take control, manage your symptoms, and get on with life! 

Please contact us today for further information on PCOS or to book a consultation.