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Is PCOS the Problem?

PCOS and Pregnancy Part Two

In the first part of our series on polycystic ovarian syndrome (PCOS) and pregnancy,  we asked the question, “How do I know if I have PCOS?”  Now let’s look at the relationship between PCOS and difficulty getting pregnant.

How do I know if PCOS is the cause of my inability to get pregnant?

Obviously there are numerous factors which can impact fertility. One can have blockage of the fallopian tubes. The male partner can have a low sperm count.

One of the major causes of infertility in women is lack of frequent, regular ovulations. Problems with ovulations, as evidenced by irregular or absent menstrual periods, are a hallmark of PCOS no matter which definition is used. Among PCOS women who are trying to conceive, lack of ovulations is the most common cause of below normal fertility (Thessaloniki ESHIRE/ASRM, 2008).  So if nonovulation has been determined by basal body temperature charting, ovulation predictor kits, or by the presence of very irregular cycles, chances are high that PCOS may be part of the problem.

As you might have guessed, based upon the diverse definitions of PCOS, there is no single test which can diagnose PCOS. Blood tests to rule out other causes of nonovulation can include those for thyroid (TSH) and pituitary function (prolactin). Documentation of increased male hormone levels can be done with blood tests for testosterone, sex hormone binding globulin, or a free androgen index. A pelvic ultrasound may be used to look for multiple small ovarian cysts.

Because of the linkages between PCOS and increased risks for type 2 diabetes, an overweight woman may also give blood for a glucose tolerance test. Women with PCOS convert to impaired glucose tolerance at a younger age (Ehrmann, 1993). While an abnormal glucose test result is not diagnostic for PCOS, it can suggest increased risks during pregnancy. Women with PCOS have a greater risk of developing gestational diabetes (Boomsma, 2006).

Next week: What treatments might help me?

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