Hope for the leading cause of infertility

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26 February 2019

Couple holding hands

Fertility issues can be very distressing to those trying for a baby. However, an exciting Australian initiative shows positive signs for one major cause of infertility.

Led by a team from Monash University in Melbourne, groundbreaking new international guidelines have been developed – in collaboration with more than 3,000 health professionals and consumers worldwide - for the diagnosis and treatment of polycystic ovarian syndrome (PCOS). They could provide hope to those having trouble conceiving due to PCOS.

Overview: what is PCOS and who does it affect?

The leading cause of infertility in Australia, PCOS affects 12-21 per cent of women, with Indigenous Australians being more at risk. Even more alarming is that 70 per cent of women with PCOS remain undiagnosed.

“PCOS is a complex condition that has both genetic and environmental influences,” explains Dr Elena Yanushpolsky, an Obstetrician Gynaecologist from Boston in the US and member of the global network of Best Doctors specialists. “Women with family history of PCOS and those who belong to ethnicities with higher prevalence are at greater risk of this disorder,” she adds. There are controllable risk markers, too, to be aware of: “Nutritional factors, rapid weight gain, and a high BMI may also lead to developing PCOS, even in women who may not be genetically predisposed,” adds Dr Yanushpolsky.

What are the symptoms of PCOS?

While many women may have polycystic ovaries (Better Health Victoria reveals up to one third of women), not all will have PCOS. To be diagnosed, there are other typical symptoms. “Formal diagnosis of PCOS requires presence of any two of the three following signs,” says Dr Yanushpolsky.

  • Irregular menses (period)
  • Excess androgens (male hormones, which may present and include acne, and facial and body hair)
  • Polycystic appearance of ovaries on pelvic ultrasound.

How does PCOS affect fertility?

“Optimal fertility requires regular menstrual cycles and adequate egg development,” explains Dr Yanushpolsky. “If ovulation doesn’t occur or if egg development is suboptimal, then it would be more difficult for a couple to achieve pregnancy without medical help,” she adds.

How is PCOS currently managed? 

Treatment mainly depends on the symptoms being experienced. “When PCOS is exacerbated by excess weight, weight loss, a healthy diet and regular exercise would help the condition and can often restore regular ovulation resulting in improved fertility,” says Dr Yanushpolsky.

According to a study of 149 overweight or obese women with infertility caused by PCOS, published in the Journal of Clinical Endocrinology & Metabolism, those who underwent a 16-week lifestyle program of a reduced-calorie diet, more regular physical activity, and weight-loss medication, had a much higher chance (60 per cent) of ovulation compared to those who took a daily contraceptive to regulate their hormones.

“Lean women with PCOS, however, often have a genetic predisposition to the condition and may need medical help, including medication or surgery to manage their PCOS,” she adds.

Good news

Not all women with PCOS have trouble falling pregnant and the condition doesn’t mean you won’t ever be able to conceive. “Although women with PCOS often have unpredictable ovulation, they may have intermittently normal cycles, and if they have frequent intercourse, especially at this time of ovulation, they may conceive successfully,” says Dr Yanushpolsky.

Better news 

Early diagnosis can improve the prognosis for many medical conditions, PCOS included. “If PCOS is found to be the main cause of infertility for a couple, then addressing it as early as possible would improve chances of conception,” confirms Dr Yanushpolsky. “With delay in treatment, age of female partner advances – which is critical to falling pregnant – which can negatively impact success rates even when the PCOS symptoms are resolved,” she adds.

The new global guidelines look to address symptoms as early as teenagehood, which could have long-term positive consequences for fertility. With varied health professionals following best-practice methods proposed in the guidelines, it’s believed health outcomes for PCOS sufferers worldwide would be vastly improved.

About Best Doctors

With an eligible policy from MLC Life Insurance, you and certain of your family members can access Best Doctors – a service which connects you with a network of more than 50,000 leading medical specialists from Australia and around the world for a second medical opinion when you need it most, helping to ensure you have the right diagnosis and treatment plan. Learn more about Best Doctors.

References

  1. https://www.monash.edu/__data/assets/pdf_file/0004/1412644/PCOS_Evidence-Based-Guidelines_20181009.pdf
  2. https://blogs.adelaide.edu.au/robinson-institute/2018/07/20/media-release-australia-led-global-push-to-tackle-pcos/
  3. https://www.racgp.org.au/afp/2012/october/polycystic-ovary-syndrome/
  4. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/polycystic-ovarian-syndrome-pcos
  5. https://jeanhailes.org.au/health-a-z/pcos/fertility-management-treatment
  6. https://www.sciencedaily.com/releases/2015/09/150924142533.htm

 

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