Everything You Need To Know About IVF For Women With PCOS
Poly Cystic Ovarian Syndrome is one of the leading causes of infertility in women. One in every ten women of reproductive age is diagnosed with PCOS across the world. Many cases go undiagnosed too. However, that does not mark the end point of all hopes for women with PCOS.
Women who fail to conceive naturally despite lifestyle changes and ovarian stimulation medications, resort to IVF and usually get incredible results. Successful in-vitro fertilization occurs in 70% of cases and lives birth has been reported in 60% of the cases for women under the age of 40. If you are intrigued by the success of PCOS IVF, then this article is for you. We will help you delve into the details and clarify your concepts regarding that.
PCOS is caused due to hormonal imbalance. It kicks in when the male hormone, testosterone gets elevated in the female body. That has adverse effects on the ovaries and the process of ovulation, leading to delayed and missed periods, evidently making it tough for women to get pregnant.
One of the most common symptoms of PCOS is multiple cysts in the ovary, hence the name polycystic ovarian syndrome. Cysts are nothing but fluid-filled sacs inside which the eggs develop. However, in women with PCOS, the immature eggs remain trapped in the cysts and never mature or get released. This leads to missed menstrual periods.
Higher male hormones also lead to acne and unusual development of hair on the face and body in some women. While the exact cause of PCOS is yet to be determined, research says that it might be due to increased weight and the combined effects of a collection of genes.
Obesity is often a major contributing cause. That often leads to insulin resistance in which the cells do not respond to the hormone insulin. This triggers the pancreas to produce more of that hormone in response to the body’s demand. Higher insulin stimulates the ovaries towards the production of more male hormones. Inflammation also remains a significant contributor to PCOS.
Since there is no regular cycle of ovulation, it becomes difficult for women to track their fertile period and get effective results in conceiving the natural way. Sometimes, however, there is multiple ovulation in which more than one egg is released at a time. This increases the risk of multiple pregnancies in women with PCOS, which can be fatal. In addition to these, the quality of eggs decreases, and the chances of endometriosis and gestational diabetes increase. Therefore, a lot of women with PCOS choose to achieve pregnancy through IVF which is known to have impressive success rates.
IVF treatment for PCOS is usually pretty similar to IVF treatment given to women with other fertility issues. First, the ovary is stimulated to produce multiple eggs. That is followed by the retrieval of eggs from the ovary with the help of a transvaginal ultrasound. Then the eggs are mixed with the semen collected from the male partner to facilitate fertilization. If the semen has quality issues, then Intra Cytoplasmic Sperm Injection is done to increase the chances of fertilization. After 3-5 days, a healthy embryo is released into the uterus where it is expected to implant in the inner lining, resulting in pregnancy.
GnRH Agonist And Antagonist Protocol
PCOS IVF is no different. However, since women with PCOS are more susceptible to developing Ovarian Hyper Stimulation Syndrome, the IVF treatment for PCOS proceeds by the addition of GnRH agonists and antagonists in the procedure to keep that condition in check.
GnRH agonists are certain drugs that initially stimulate the pituitary gland to secrete GnRH( Follicle Stimulating Hormone and Luteinizing Hormone) and eventually stop their response to the drugs. On the other hand, GnRH antagonists completely construct the activity of the pituitary gland. These are administered to control the indigenous LH surge and mature the follicles for a timed retrieval.
Lupron is the most common GnRH agonist used in IVF treatment. Usually, HCG is administered before retrieving the eggs to help mature the eggs in the follicles. However, to prevent OHSS(Ovarian Hyper Stimulation Syndrome), Lupron is given in its place. After the eggs are retrieved, recommended doses of estrogen and progesterone are usually given to decrease the possibility of a miscarriage.
Sometimes, GnRH antagonists are used. They are administered along with HCG and FSH. The most common drug is Ganirelix. After six of ovarian stimulation by FSH, the treatment with Ganirelix starts and it continues till HCG is administered to allow the eggs to mature.
Though you will most likely achieve pregnancy through IVF, there are certain other options that your doctor might want you to try before starting the IVF treatment. Intra-Uterine Insemination is one of them. In that technique, your ovaries will be stimulated to release eggs but you will be treated with GnRH to prevent hyperstimulation. Concentrated sperm from the semen collected from your partner will be released into your uterus just around the time you are expected to ovulate. This might help you conceive naturally. This has also shown commendable results for women with PCOS. However, if this fails, there is always IVF to which you can switch.
There is absolutely no reason to be disappointed if you have been diagnosed with PCOS. It might interfere with the ease at which you could have gotten pregnant, but all doors are not closed. IVF is a trusted technique with impressive results that can help you start your family.
However, you must keep in mind that PCOS IVF is more successful in women who have proper body weight. Therefore, before considering starting the treatment, exercise to bring your body back in shape. Ample physical activity and healthy lifestyle choices are not only important to regulate your BMI but also to keep all other physiological systems working properly and maintain the quality of your eggs. A healthy body will help you nourish a healthy baby.
Give your best and have faith in your doctor. It might take more than once to get success. So, do not lose hope.