Polycystic Ovary Syndrome (PCOS): The Cause of Infertility in Women

Polycystic ovary syndrome (PCOS), which is the most common endocrine disorder in women of reproductive age, is among the important causes of infertility as it reveals the problem of ovulation. In these patients, hair growth, excessive weight gain and acne can be seen along with menstrual irregularity. Insulin resistance can occur in approximately 1/3 of the patients with PCOS, and Type-2 diabetes can occur in 10%. Thanks to diet and exercise under the control of a dietician, and appropriate medication, this disease can be fought.

It is seen in 1 in 10 women

Polycystic ovary syndrome, which is an important ovulation problem in women, is seen in one in 10 women. This problem, which is common in women of reproductive age, manifests itself in the presence of a large number of egg sacs in the ovaries. Polycystic ovary syndrome, which is diagnosed by the sight of cysts smaller than 10 centimeters in ultrasonography, an imaging technique, can lead to infertility as well as infertility, diabetes, coronary artery diseases and blood pressure disorders if left untreatable in women of reproductive age.

If there is no ovulation it could be PCOS

The two ovaries required for reproduction in the female body develop a mature egg suitable for fertilization during the menstrual period. The egg develops and matures in a fluid-filled sac called a ‘follicle’. Every month, a follicle is selected in women, it grows and ovulation occurs. In women with polycystic ovary syndrome, this follicle cannot be selected and therefore ovulation does not occur every month. In the ultrasound examination, the ovaries are seen as many sacs, in other words many cysts with undeveloped eggs.

Menstrual irregularity is an important indicator

It turns out that approximately 20% of women who apply to IVF centers have ovulation problems. Polycystic ovary syndrome is at the top of the ovulation problems of women who are examined by specialist physicians to have children. Women with menstrual irregularity, overweight and hair growth should be diagnosed after a physical examination and ultrasound. Although menstrual irregularity is sometimes seen as a normal condition during adolescence, whether it is caused by PCOS should be determined by imaging techniques as well as laboratory tests, and the appropriate treatment model for the patient should be determined.

7 important symptoms of PCOS

1. In adolescence, after one or two menstrual periods, inability to menstruate, irregular menstruation (menstruation less than 35 days), unusual bleeding.
2. Excessive acne on the face and back, visible change in skin texture, spotting on the hand. Polycystic ovary syndrome is the most common cause of recurrent acne, especially in the 20s.
3. As a result of this disease, it is thought that excessive hair growth and voice thickening in the body are due to the male hormone (androgens). The testosterone hormone, which is present in a certain ratio in every woman, increases and causes hair growth and deepening of the voice.
4. Due to polycystic ovary syndrome, the male hormone, whose level is increased in the body, can cause male pattern hair loss by attaching to the receptors in the hair follicles.
5. In particular, as a result of the decrease in female hormones and the increase of male hormones, breast tissue in women can also shrink over time.
6. Difficulty or infertility is an important symptom of pregnancy. This problem, seen in 10% of young women, is one of the most important causes of infertility.
7. Excessive weight gain is also among the symptoms. Half of the women with polycystic ovaries have been found to have severe weight problems.

Insulin hormone is among the reasons

Despite numerous clinical and experimental studies, the cause of the disease is not known exactly. However, the disease is thought to be caused by the ‘insulin’ hormone, which regulates carbohydrate metabolism. It is assumed that excessive weight causes insulin resistance and insulin resistance triggers polycystic ovary syndrome. Insulin, the main hormone that allows sugar, the main food source in the body, to enter body cells (muscle, fat and liver cells) from the blood to provide energy, is secreted by the beta cells in the pancreas. High insulin levels that occur in the body with insulin resistance increase the production of male hormones (androgens) in the ovaries.

It is important to reach the ideal weight

When planning treatment, it should be ensured that these patients maintain weight control and maintain the ideal weight level under the supervision of a dietician. Drug therapy, which is used in diabetics to break insulin resistance, is used in this period if necessary. As a result of medical treatment and weight loss, menstrual period improves significantly, and sometimes pregnancy can occur spontaneously with the elimination of the ovulation problem. However, if menstrual irregularity continues after these procedures, drugs and hormone injections that stimulate ovulation can be applied. Pregnancy is attempted by suggesting normal intercourse from the eggs developed as a result of these follow-ups or by vaccination method. If pregnancy cannot be achieved with 3-4 follow-up and vaccination, it is recommended to switch to the IVF method.

Controls and examinations should be applied routinely

It is important for women with polycystic ovary syndrome not to leave gynecological follow-ups after pregnancy and to continue their annual examinations. The risk of uterine cancer also increases in patients with PCOS. In these patients, some diseases, especially diabetes, may be seen in advanced ages. To prevent this, excessive weight gain should be prevented, regular exercise should be recommended, and menstrual regularity should be maintained with medications if necessary.