August 17, 2020
Author Name: Dr. Parth Joshi on August 17, 2020
PCOS is complex hormonal disorder, characterized by hormonal and metabolic manifestations. In current era trend of infertility rising mainly due to altered lifestyle, late marriages, addictions etc. Reason of infertility is equally divided in males and females. Major reasons of infertility in females are PCOS, diminished ovarian reserve, blocked fallopian tube, uterine abnormalities. PCOS is commonest reason for infertility in Young women. World data suggests 15 to 20% incidence of PCOS in Young infertile women.
Main pathophysiology of PCOS lies in defects in HPO axis, insulin secretion and ovarian function. Patient presents with multiple manifestations like irregular periods, obesity ,infertility , acne, unwanted hair growth and Diabetes type 2.
Diagnosis of PCOS mainly done by history, physical examination, hormonal reports and sonography.
There is no definite treatment of PCOS, but mainly symptomatic treatment options available.
When a female has one year of infertility along with irregular periods, she should consult nearby fertility expert. Fertility experts usually do TVS, hormonal reports, semen analysis and tubal patency test initially to decide optimum treatment options.
First line of treatment in such cases is usually Ovulation induction with plan relation. In this method drugs/ injections are given for ovulation induction, serial sonographic monitoring done, when 1/2 follicles have reached to optimum size, HCG injection for follicle rupture is given and then couple is advised to have plan relationship/intercourse for coming 4-5 days. Couples can try for 5-6 such treatment cycles for max success.
IUI is second treatment option, works on same principle of Ovulation induction but difference is after follicle rupture, husband’s semen sample is processed in IUI lab , then prepared semen sample is injected into endometrial cavity through pipet to deliver concentrated good quality sperms. IUI cycle gives success rate of 12-14% in good centers per cycle. Couples can try for such 3-4 IUI cycles to get max success rate.
But after trying for such traditional methods for 1-1.5 years at good Fertility centre, still no success in getting pregnancy, then couple should go for IVF. Through IVF, couple can get maximum success rate in case of PCOS because, in IVF, experts have choice of selection of quality eggs, sperms and finally embryos. In current era, IVF with advance technologies like ICSI, Blastocyst culture, Laser Assisted Hatching, PGS are offering very high success rates in cases of PCO infertility. IVF is a pure scientific technique to achieve desired pregnancy, with no night stays at hospital, no need of painful operations even after achieving pregnancy no extra precautions needed. It’s absolutely safe procedure.
Finally with years of experience, I advise couples with PCOS infertility, that they should be vigilant enough in choosing Fertility centre, so that they can achieve their dream of parenthood as early as possible.
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