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- Treatment for enhancing fertility
- Treatment for symptoms other than infertility
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Treatment for enhancing Fertility |
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Problems in ovulation (formation and release of the egg from the ovary) associated with PCOS, very often create difficulty in conceiving. However, at the Assisted Fertility Unit, we offer multiple options to overcome this problem. |
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Diagnosis |
| When you first seek medical assistance to get pregnant, most doctors will go through a series of tests to determine why you are having trouble conceiving. A diagnosis of PCOS is reason enough to explain infertility, however it is common for doctors to investigate whether other factors may also be present. Doctors are looking for physical abnormalities, hormonal imbalances, menstrual cycle defects, endometriosis or problems with sperm. |
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| Evaluation Cycle |
The evaluation cycle is often used to assist the doctor to understand your menstrual cycle. This can involve observations of cervical mucus and the position of the cervix. It can also be a more involved process of regular ultrasounds, blood tests and ovulation tests.
While the process is designed to observe the body in its various phases of the menstrual cycle, it is also possible for some couples to become pregnant using this method. Doctors have more information available to predict when ovulation is likely to occur, and therefore intercourse can be timed to have the best outcome. |
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| Blood tests |
Blood testing is one of the most common forms of medical diagnosis. When testing fertility, hormone tests are used at various times of the menstrual cycle to assess the function of endocrine glands. |
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| Ultrasound |
This painless procedure involves having a long thin probe inserted into the vagina. The ovaries and uterus can be observed in great detail using this method. Besides, ovulation (follicle) studies are performed with daily ultrasounds. |
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| Laparoscopy |
The Laparoscopy is used for both diagnosis and treatment. This key hole surgery procedure is usually done in day surgery under general anaesthetic. A laparoscope (a telescope with a camera) is inserted in the abdomen through the umbilicus (naval) and the uterus, tubes, ovaries, pelvis, can be studied by direct visualisation.(insert picture of laparoscopy) |
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| Laparoscopic ovarian diathermy (ovarian drilling) is a procedure resorted to by most doctors in case of inability to ovulate with routine medication. Each ovary is punctured 6 to 10 times with the help of a cautery. |
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| Ovarian drilling achieves approximately six months ovulation in women who don’t normally ovulate. After this time, the effects of ovarian drilling have worn off. Women who did not respond to ovulation induction with medication often respond to it after having their ovaries drilled. |
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| Semen Analysis |
Since fertility treatment can be cumbersome and expensive, routine semen analysis is a must to rule out any problem with the male, before starting on . |
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| Ovulation Induction in PCOS |
Inducing ovulation is of prime importance in the treatment of POCS related infertility. Oral medication (Clomiphene Citrate- CC, Letrozole) and injections (gonadotrophins- FSH, HMG), are available for ovulation induction. |
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Clomiphene Citrate is often the first drug used to induce ovulation in women with PCOS. It is a tablet taken for five consecutive days early in the menstrual cycle. It works on the pituitary gland by forcing it to stimulate the production of eggs. Regular ultrasounds should be done to monitor follicle growth and to help predict ovulation |
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CC can be made more effective by increasing the dosage if ovulation has not occurred, or by combining CC with other medications. Many women with PCOS have become pregnant by taking a combination of CC and metformin. |
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CC is known to make cervical mucus more hostile to sperm. This problem can be solved by combining CC treatment with artificial insemination with husband’s sperm. |
Ovulation induction can be done using FSH in a very similar manner to CC. FSH is administered by injection and getting the dosage high enough to ovulate, but keeping it low enough not to superovulate, is a medical challenge. It may take several cycles to get the dosage right. |
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| FSH has a couple of other benefits over CC. FSH acts directly on the ovary, as opposed to the pituitary gland, and therefore does not have the side effects of headaches and extreme mood swings. FSH does not make the cervical mucous hostile to sperm. |
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| FSH can be combined with other therapies like IUI . FSH is the main treatment used to stimulate ovulation in IVF, however IVF uses much higher doses than used in ovulation induction. |
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| Assisted Reproductive Therapies |
Artificial Insemination or Intrauterine Insemination (IUI) with Husband’s Sperm is a procedure performed around the time of ovulation. |
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| A number of other treatment options are available at the Assisted Fertility Unit of Gynaecworld. |
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For details regarding these options, please refer to the Assisted Fertility Unit. |
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| Insulin lowering Agents |
Research over the past decade has shown that treatment strategies aimed at lowering blood insulin levels by exercise, diet, weight loss and medication like Metformin can restore fertility in some PCOS patients. |
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Metformin can increase the ovulation rates, reduce the need for IVF and also increase pregnancy rates. |
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