I was just diagnosed with PCOS, and I was wondering how likely is it that I will ever get pregnant?

Question

Me and my fiance have been trying for almost a year now, in the past I have had 1 live birth of my 6 year old son and 1 miscarriage about 2 years ago. please any advice help!!! I am working kind of with my dr. and she put me on provera just last month for 7 days to help start my cycle.

Answer 1

Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5–10% of women. It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The symptoms and severity of the syndrome vary greatly between women. While the causes are unknown, insulin resistance (often secondary to obesity) is heavily correlated with PCOS.

PCOS develops when the ovaries are stimulated to produce excessive amounts of male hormones (androgens), particularly testosterone, either through the release of excessive luteinizing hormone (LH) by the pituitary gland or through high levels of insulin in the blood (hyperinsulinaemia) in women whose ovaries are sensitive to this stimulus.

This syndrome acquired its most widely used name because a common symptom is multiple (poly) ovarian cysts. These form where egg follicles matured but were never released from the ovary because of abnormal hormone levels. These generally take on a 'string of pearls' appearance. The condition was first described in 1935 by Dr. Stein and Dr. Leventhal, hence its original name of Stein-Leventhal syndrome.

PCOS is characterized by a complex set of symptoms, and the cause cannot be determined for all patients. However, research to date suggests that insulin resistance could be a leading cause. PCOS may also have a genetic predisposition, and further research into this possibility is taking place. No specific gene has been identified, and it is thought that many genes could contribute to the development of PCOS.

A majority of patients with PCOS - some investigators say all - have insulin resistance. Their elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis that lead to PCOS. Specifically, hyperinsulinemia increases GnRH pulse frequency, LH over FSH dominance, increased ovarian androgen production, decreased follicular maturation, and decreased SHBG binding; all these steps lead to the development of PCOS. Insulin resistance is a common finding among both normal weight and over weight PCOS patients.

Medical treatment of PCOS is tailored depending on the patient's goals. If restoration of ovulation and fertility are desired, then metformin and or clomiphene citrate are indicated. In cases of clomiphene resistance, injections of follicle stimulating hormone may be used. If hirsutism is a primary concern, then oral contraceptives and either cyproterone acetate or spironolactone (a blocker of androgen receptors) are indicated. If the goal is to prevent the unopposed estrogen effect of anovulation, which can lead to endometrial hyperplasia and endometrial cancer, then oral contraceptives or cyclic progestins are indicated.

Low-carbohydrate diets and sustained regular exercise are also beneficial. More recently doctors and nutritional experts are recommending a low-GI diet in which a significant part of the total carbohydrates are obtained from fruit, vegetables and wholegrain sources. These diets help women with PCOS to maintain steady blood sugar and insulin levels and may assist in weight loss. A diet composed of mainly low-GI foods combined with regular exercise will also help to combat the effects of insulin resistance.

Many women find insulin-lowering medications such as metformin hydrochloride (Glucophage®), pioglitazone hydrochloride (Actos®), and rosiglitazone maleate (Avandia®) helpful, and ovulation may resume when they use these agents. Many women report that metformin use is associated with upset stomach, diarrhea, and weight-loss. Such side effects usually resolve within 2-3 weeks. Both symptoms and weight loss appear to be less with the extended release versions. Most published studies use either generic metformin or the regular, non-extended release version. Starting with a lower dosage and gradually increasing the dosage over 2-3 weeks and taking the medication toward the end of a meal may reduce side effects. The use of basal body temperature or BBT charts is an effective way to follow progress. It may take up to six months to see results, but when combined with exercise and a low-glycemic diet up to 85% will improve menstrual cycle regularity and ovulation.

Ian Stoakes, a UK based scientist has recently found some success in treating PCOS through tailored diets. Stoakes believes that there is a strong link between PCOS, Diabetes etc and Inflamation caused by the failure of the blood to absorb specific foods. Blood samples are taken and then tested to see how they react to different food types. The patient is then provided with a list of foods they can eat and foods to avoid. A number of people have claimed success in losing weight, alleviating symptoms and successful pregnancies as a result of this approach. It however remains a controversial approach.

Initial research also suggests that the risk of miscarriage is significantly reduced when Metformin is taken throughout pregnancy (9% as opposed to as much as 45%); however, further research is needed in this area.

For patients who do not respond to insulin-sensitizing medications and who wish to achieve pregnancy, there are many options available including, clomiphene citrate to induce ovulation or ART procedures such as controlled ovarian hyperstimulation and IVF.

Though surgery is usually the treatment option of last resort, the polycystic ovaries can be treated with surgical procedures such as

laparoscopy electrocauterization or laser cauterization
ovarian wedge resection (rarely done now because it is more invasive and has a 30% risk of adhesions, sometimes very severe, which can impair fertility)
ovarian drilling


But remember, each case is different, please see a doctor.

Answer 2

Hi,

I had the same experience about 15 years ago. Provera can make you hersute and it can cause depression in some women when taken without estrogen. I had lost my period for over 3 months. My doctor sent me to a gynocologist who did hormone testing and an ultrasound. She put me on provera, I started getting a hairy chin. When my doctor saw he told me he thought I should change the treatment. She denied the provera was making my chin hairy and said it was genetic, but it is listed as a possible side effect by the company.
She then put me on androcur and estrogen and flipped the doses estrogen for a short period and androcur for a long period. It affected my health again my doctor caught the mistake and she denied it. My doctor then reffered me to an endocrinologist who fixed everything and he was angry at the gynocologist he said only endocrinologists should be giving hormone therapy. The endocrinologist also did a hormone test and he found my results were in the normal range, he then sent me to get a second ultrasound which also came out normal. I had been under severe stress at the time; I think it must have caused the condition. After I was no longer stressed, I guess I got over the condition. I've always been irregular and I'm always somewhat stressed. I am a worry wart but it was just intense stress at the time. I f you stress easily, I'd say that could have something to do with your condition.
I've had 2 kids. For the first, I used the reverse Billings method ie Billings method but for conception instead of birth control. Take your temperatured daily over a few cycles...and it will help you find your fertility day...The second was an accident. Try to avoid hormone therapy if possible sometimes it does damage.
If you know a Chinese or eastern medicine practitioner in your area I'd say try that first. It tastes nasty, but it has helped some people.

Answer 3

I have PCOS & you can have children, but it's just a more difficult process than the average female. You should be seeing a Reproductive Endcronolgist (RE). From my experience, RE's know how to handle PCOS cases better than a OBGYN. I saw a OBGYN for 4 years with no improvement before finding a RE & after just 4 months I got pregnant (but miscarried at 7 weeks).

Provera will start your cycle, but you should also be on Clomid. You will probably start out at 50 mg for the first three months/tries & if that doesn't work, they will up you to 100, etc. Make sure you are being monitored while on Clomid to make sure it's making you ovulate. If your eggs are at least 20mm or bigger then you should get a shot of Norval to make you ovulate within 36 hours.

Good Luck!!!!

Answer 4

Southern California Edison, our electric company, puts fliers in with their bills about the effects of EMF (electro magnetic fields) on the body. The scientists who have studied the effects do conclude that there could be a link between EMF and miscarriage. What this means to you is you will want to try to stay away from appliances that produce a high amount of EMF like the vacuum cleaner, can opener, hair dryer, flourescent lighting, electric clothes dryer... anything with a strong electric motor. God bless your journey.

Answer 5

The only thing I can tell you is my friend has PCOS and she no has a healthy baby boy. I am not saying it was easy for her to get pregnant b/c it wasn't. She tried for a baby for nearly 5 years. She did all she could even took Clomid to help, but it didn't. After months of ferility treatments she stopped them all together and even stopped trying to get pregnant. Then out of the blue about 6 months after stopping fertility treatments she turned up pregnant.

It happened for her and with any hope it will happen for you. Be patient and good luck to you.