Polycystic ovaries & infertility
1. Polycystic ovaries are the most common cause of infertility in women who do not ovulate. If a woman has irregular cycles and suspects that she has PCO, she should not wait for 1 year, but visit a reproduction gynaecologist sooner.
2. Prior to a pregnancy, women with PCO should discuss with their doctor the medical problems linked to PCO. In this way, they will maximise their chances of achieving a healthy pregnancy with no problems.
3. When a woman stops taking the pill, she can try for a pregnancy as early as the following month.
4. In all women with PCO, it is important to maintain a normal body weight in order to have a healthy pregnancy with no problems for the mother and the embryo.
5. If a woman’s cycle is longer than 35 days or if she does not ovulate or if ovulation is late (in that case, oocyte quality is poor and the risk of miscarriage is higher), she will need treatment to induce ovulation. This will help her achieve a pregnancy. The use of clomiphene tablets is not recommended for more than 6 months. Treatment with gonadotrophin injections might be necessary after 3-6 cycles of trying for a pregnancy with no result.
6. The risk of miscarriage is higher in women with PCO whether the pregnancy has been achieved by natural conception or by treatment. The risk of miscarriage is normally 10-15% for every pregnancy. Male factors also involve an increased risk of miscarriage; thus, a sperm analysis should be performed in all cases.
7. Let’s assume, for example, that a woman who does not ovulate normally is 60% fertile. This means that she can get pregnant if there are no problems with her partner (male infertility). Minor male infertility factors - e.g. slightly reduced sperm count or motility- combined with ovulation problems of the female partner, can lead a couple to being infertile. When minor infertility factors are combined they can cause a big problem.
8. Quite often, a 2nd or 3rd pregnancy is achieved without any therapy in women with PCO, even if they have followed a treatment in order to get pregnant for the 1st time. This is probably due to the beneficiary effect of the pregnancy on the hormone mechanism.
9. Ovulation induction in women with PCO can be tricky. The doctor must be very careful not to cause Ovarian Hyper-Stimulation Syndrome. It is important to make sure that the doctor has the necessary experience. The induction should be monitored very closely by ultrasounds and blood tests (hormone levels).
10. 90% of women with PCO will get pregnant, provided there aren’t any other important factors contributing to infertility.