Fertility for women with PCOD
Polycystic Ovary Disease (PCOD) is a condition is which the ovaries develop cysts. These are not functional cysts which disappear over time but cysts that tend to occupy a large area of the ovary resulting in enlarged ovaries. These cysts also interfere with the way the ovaries function.
The cysts in the ovaries disrupt the menstrual cycle and causes fertility problems by hindering ovulation. Today a large number of young women are affected by cysts in the ovaries as well as hormonal imbalances resulting from the presence of cysts. This has led to infertility and the growing concern for this condition stems from the difficulty to conceive. At some point in their life every woman wants to have a child and this is when the condition of PCOD becomes an inconvenience. Thankfully today fertility treatment offers solutions for women suffering from PCOD. Having a baby is no longer something impossible or a big challenge.
What are cysts?
Cysts are sacs filled with a fluid like substance. There are different kinds of cysts and most of them are non-cancerous. Cysts can be classified as two main types. The most common are the functional cysts and these usually appear around the menstrual cycle. Functional cysts are non-harmful and tend to disappear by themselves after a few months. They form during ovulation when the follicles instead of disintegrating close up again with some fluid inside them. If a woman has too many functional cysts the doctor may recommend oral contraceptives for a few months to prevent ovulation and allow the cysts to disappear. The non-functional cysts do not disappear by themselves and may cause some irregularities in the normal reproductive cycle. Some no-functional cysts can even be cancerous.
The term poly means many and hence polycystic ovaries mean many cysts in the ovaries. Sometimes when there are many cysts in the ovaries it can interfere with the normal functioning of the ovaries.
The presence of the cysts in the ovaries causes it to malfunction in a number of ways. During the reproductive cycle the ovaries produce oestrogen and progestogen. However when there are many cysts in the ovaries it encourages the production of higher levels of androgen instead of oestrogen. Oestrogen is the female hormone and androgen is a male hormone. Androgen is found in very small quantities in the female body.
The increased amount of the male hormone androgen encourages certain changes in the female body. A woman may find that there is hair growth in unusual areas like the chest and face. This is very similar to that of a man.
The greatest fear and cause for concern among women diagnosed with PCOD is the infertility that is associated with it. For an Indian woman her fertility defines the woman that she is. It is her most prized possession. The value of a woman on the marriage market reduces considerably when she has fertility problems. In fact she may have to compromise when settling for a groom.
Causes of PCOD
There is not much information on the exact reason why women develop polycystic ovaries and the factors that induce it. To a large extent polycystic ovaries have been linked to genetics. Researchers believe that if the mother has cysts in the ovaries the daughter has a higher probability of suffering from a similar condition.
Conditions such as hormonal imbalance due to lifestyle factors can also lead to a disruption in the menstrual cycle, anovulation and malfunction of glands are also believed to be possible causes ofPCOD. Other factors like obesity and an excess of fatty tissue can aggravate the hormonal balance by encouraging a higher production of oestrogen. Overactive adrenal glands result in the increased production of androgens. Androgens are the male hormone and disrupt ovulation.
What is ovulation?
Every cycle the female body undergoes a regular process of releasing the follicle stimulating hormone (FSH) which encourages the maturation of an egg in the ovary. When the egg is mature the LH hormone takes charge of the final step when the follicle opens and the egg is released into the fallopian tube. Ovulation is the process of the egg being released into the fallopian tube and waiting there for a male sperm to fertilise it. Ovulation is an important step for pregnancy to take place. While the egg is in the fallopian tube it can be fertilised by the male sperm, which is the first step of pregnancy.
Role of hormones in ovulation
Your hormones play a very vital role in the process of ovulation. For ovulation to take place without a hitch the hormones need to be perfectly balanced and work in sync. There are mainly 4 hormones that are very important for the maturation of the follicle and the final ovulation to take place.
Follicle Stimulating Hormone (FSH): The FSH is released by the pituitary gland to stimulate the follicles to start maturing the egg it contains. This starts immediately after the menstrual cycle and marks the beginning of the next cycle.
Oestrogen: Oestrogen is known as the female hormone. At the start of the menstrual cycle the level of oestrogen is low. The oestrogen level in the body increases as the time for ovulation nears. The increase of oestrogen informs the pituitary gland and the hypothalamus about the presence of a mature egg.
Luteinizing hormone (LH): As soon as the oestrogen informs the pituitary gland and the hypothalamus about the egg maturation the LH is released. This is known as an LH surge and this hormone causes the follicle to open and the egg to be released. It takes about 24 to 36 hours for the release of the egg from the follicle after the LH surge. Once the egg leaves the follicle it travels straight to the fallopian tube where it will wait for fertilisation.
Progesterone: As soon as ovulation takes place and the egg is release into the fallopian tube there is a rise in the progesterone hormone level. The follicle from which the egg was released is called the corpus luteum and this is responsible for releasing the progesterone hormone. The function of the progesterone hormone is to prepare the uterus for the possibility of an implantation. The endometrial lining thickens and gets ready to receive the embryo.
If the egg is fertilised and an embryo is formed the corpus luteum will continue to produce the progesterone hormone until implantation takes places and the placenta begins to perform its function.
Generally the hormones work in harmony and ovulation takes place as scheduled, however with altered lifestyle factors and the presence of other chemicals in the body, it can create a disruption in the proper functioning of the hormones, which in turn affects ovulation and fertility.
Symptoms of PCOD
There are some characteristic symptoms to PCOD which might bring about the awareness that smoothing is not quite right. The symptoms of PCOD usually appear gradually and it is a while before woman realises that things are not the way they should be and she should visit the doctor. Some of the obvious symptoms of PCOD are:
- Irregular periods or absence of periods
- Excessive and unusual hair growth
- Weight gain
- Pelvic pain
- Mood swings
- Infertility – not able to get pregnant
Even though these are the symptoms of PCOD it is not necessary that all women who have PCOD will suffer from the same symptoms. The symptoms vary from person to person and hence it is difficult to tell at the onset of the problem that you might have PCOD. Some women may just have irregular periods and no other symptoms. Some women may have some of the other symptoms but no acne. It is not necessary that all women will have all the symptoms if they have PCOD.
Women with PCOD are insulin resistant. This is due to the fact that they have high levels of insulin in their blood. It also makes them susceptible to becoming diabetic.
The most common symptom of PCOD which is obvious right from the start is an irregularity in the menstrual cycle. If your periods are getting delayed and sometimes do not come for 45 days or longer you need to take note. Some women may experience exceptionally heavy bleeding this could also be accompanied by severe abdominal cramps. A heavy bleeding occasionally, even with pain, is acceptable, but when it seems to be happening every cycle this is a cause for concern and needs medical attention. Sometimes a woman may find that her period is very light. Scanty periods, if it seems to be happening continuously, means that there is something wrong with your menstrual cycle. Some women stop having their periods for several months at a stretch. Any problem with your periods should be reported to a doctor immediately.
Your periods are linked to your fertility. It is a sign of ovulation. Sometimes you can have your periods without ovulating. This happens if there is a problem with your ovaries, which is usually the case with women who have cysts in their ovaries. Keeping track of your menstrual cycle is important not just for getting pregnant but for your fertility health as well.
Treatment of PCOD
There are different kinds of treatment for PCOD depending on the symptoms. Even though PCOD can be treated, it is not curable.
The main aim of treating Polycystic Ovaries Disease is to
- Regulate the insulin levels
- Reduce androgen levels
- Balance the hormone levels
PCOD can be regulated through medicationand by controlling the diet. Losing weight through exercise and healthy diet is an essential initial step for PCOD treatment. Weight regulation helps to restore the insulin levels, hormonal balance and reduce the fatty tissue in the body. Weight loss is recommended through a regimental exercise routine and strict diet control.
Medication to induce ovulation is prescribed by the doctor. This medication is hormone based and increases the required hormone levels in the body which will help the ovaries to mature the follicles. This overcomes the problem of lack of ovulation faced by women with PCOD.
Anti-androgen medication is prescribed for women who have very high level of androgen production. This helps to reduce the hirsutism and limit the excessive hair growth on the face and body.
Most women who suffer from PCOD also experience irregular periods. The menstrual cycle can be regulated through medication which also induces ovulation. Birth control pills are recommended to some women to regulate the menstrual cycle. This is okay for women who are not keen on an immediately pregnancy. For those women who are trying to get pregnant taking birth control pills is not advisable as it takes a few months for the effect of the contraceptive to wear out from the body.
Getting pregnant with PCOD
Women who have polycystic ovarian disease they cannot get pregnant this is due to a number of factors. But the most prevalent one that hinders conception is the lack of ovulation. Women with PCOD usually do not ovulate. The lack of ovulation means there is no mature egg release by the ovaries which can be fertilised by the sperm.
IVF is the best and most highly recommended fertility treatment for ovulation disorders. The treatment comprises of inducing ovulation to mature the eggs. These eggs are retrieved directly from the ovaries through an egg aspiration procedure.
The egg and sperm is fertilised in the lab to avoid any risk of conception not taking place. After a few days the best embryo is selected and transferred to the mother uterus in a procedure called embryo transfer.
Geeta and Anuj were devastated to learn that she had PCOD and would not be able to conceive naturally. Anuj was very fond of children and was looking forward to having some of his own. A friend told Geeta about fertility treatment. Anuj was very excited. They booked an appointment, went for the prescribed tests and started treatment as soon as they could. Excitement turned to disappointment when Geeta’s IVF cycle failed.They were not ready to give up. After several tries and failures they came to Medicover Fertility the IVF speciality clinic. They learnt about Medicover from a newspaper article in the Navbharat Times which raved about the high quality of fertility treatment. Treatment at Medicover was a wonderful experience and they were happy to have a nice doctor who apprised them of the progress at each stage. They felt good to be involved in the treatment decision making and know what was happening. Finally Geeta was pregnant and this was a period of true excitement for them.
Fertility treatment at Medicover
Medicover is a leading fertility clinic in Delhi and has a number of centres around North India. Medicover is a specialised fertility clinic with a very high success rate. It uses advanced technology fertility treatment to ensure that women with all kinds of severe fertility problems like PCOD and many other conditions are able to conceive successfully.
Medicover Fertility imbibes European standards and offers patients an international level of treatment and facilities. Each Medicover Fertility Clinic in India is equipped with the latest technology facilities and infrastructure. Medicover has a team of highly qualified in-house fertility doctors.
“I had a severe case of PCOD and doctors had told me that I could never be a mother.We decided to select a specialised fertility clinic with the most advanced and latest technology treatment options. We found that Medicover Fertility suited our requirement. After the diagnostic tests were complete the fertility consultant warned us that our case was indeed critical and that we should be prepared for a 50% probability of failure of the treatment. We desperately wanted to have a baby and were willing to take the risk. The doctors were extra vigilant and cautious with our case. At each step the treatment was reviewed. Everything worked well and finally after much treatment and medication we were pregnant after 7 months. It was a long journey, but the positive attitude of the medical team at Medicover Fertility who all pitched in to keep encouraging us, was what made the whole experience so wonderful.”
Q: I was told that I could never have a child when I was diagnosed with PCOD at the age of 16. Can I try for an IVF baby?
A: Women with PCOD can most definitely have IVF treatment to have a child.
Q: What is the treatment for PCOD?
A: The treatment for PCOD depends on your condition and the symptoms you have. Doctors prescribe ovulation medication for those who are not ovulating, medication to regulate the menstrual cycle for women who do not have regular periods, anti-androgen medication for those women with high levels of androgen, insulin regulation medication for those suffering from increased insulin levels and the list goes on.
Q: I have PCOD. Can I try for a baby with induced ovulation?
A: You can try to get pregnant with induced ovulation, however, there are risks attached and you might not get pregnant or suffer a miscarriage.
Q: Is it possible to have a natural pregnancy with PCOD?
A: If you are ovulating (which is very rare in PCOD cases) you might be able to get pregnant and have a baby. However, if you have been diagnosed with PCOD the probability of a natural pregnancy is minimal. You should consider IVF treatment.
13 November, 2018
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