19 June 2019

What are polycystic ovaries?

Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London

 

One of the main questions a woman asks when told that she has polycystic ovaries is: will it affect my fertility?  Although, not so common, there are some cases where this condition can cause problems when a woman wants to become pregnant.

Do you know exactly what polycystic ovaries are and how they can affect fertility?

Polycystic ovaries is a common condition in women. These type of ovaries will increase in size and consist of more follicles (smaller than 10mm) that exist in the ovaries in a dormant state.  It’s important to know if you have polycystic ovaries, but it doesn’t mean that you have ovarian cysts.

Consequently, a woman should understand that having polycystic ovaries (detected by ultrasound) is not the same as having polycystic ovarian syndrome (accompanied by a medical condition). Normally, polycystic ovarian syndrome is an endocrine disorder that comes with the following symptoms: obesity, irregular periods and hyperandrogenism (increased male hormones), which can result in excess body hair, persistent acne and other male characteristics).

Polycystic ovaries and pregnancy: is it more difficult to get pregnant with polycystic ovaries?

No, it does not affect a woman’s fertility if she has polycystic ovaries and shows no symptoms. However, other women may have a small problem with ovulation, with delayed periods, and no other symptoms. This is an easy problem to solve with a simple treatment that induces ovulation, the ovary will then resume its cycle of 28-30 days and facilitate pregnancy. The treatment is to either take a course of clomiphene tablets, or a course of gonadotropins, which are much stronger.  However, all medical treatments should be taken with the guidance and under the control of an experienced gynaecologist.

In less frequent cases, polycystic ovaries can produce poor quality eggs.  However, this outcome is very rare and cannot be an assumed diagnosis as it is indicated only after the woman has had failed attempts to become pregnant, either spontaneously or with induced ovulation, or even with artificial insemination when performing IVF that indicates poor ovarian quality.

Does having polycystic ovarian syndrome (PCOS) make getting pregnant more difficult?

It depends on each case. Women with this syndrome, that have irregular periods but do not show any other symptoms, often experience problems when trying to get pregnant. However, it’s a very easy problem to solve with a simple treatment that induces ovulation.  In a small minority of cases polycystic ovarian syndrome can result in sterility, due to the poor quality of the eggs. However, treating the problem as soon as possible can help and reduces the chance of this outcome.

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