By. Dr. Kristi Maas, MD, FACOG
PCOS stands for polycystic ovarian syndrome. This is a disease that contributes to infertility from multiple factors. Women with PCOS have infrequent or absent periods because they are not releasing an egg or ovulating. This means that sperm and egg do not have a chance to meet so pregnancy doesn’t occur. Additionally, women with PCOS are more likely to have obesity and an elevated BMI has been associated with reduced chances of achieving and/or maintaining a pregnancy.
PCOS is technically a “diagnosis of exclusion” meaning that other conditions that can mimic PCOS must be ruled out. These include abnormalities of the pituitary gland, thyroid, adrenal glands, or ovaries. Additionally, to be diagnosed with PCOS patients must exhibit two of the following:
1) Irregular periods or no periods
2) Clinical signs/symptoms of elevated androgens (excessive hair, male patterned balding, acne) or elevated androgens on laboratory testing
3) Polycystic appearing ovaries on ultrasound
If someone meets two of these criteria and other causes have been ruled out then she has a diagnosis of PCOS. Women with PCOS are often able to get pregnant with ovulation induction. This is generally a process where a woman takes a pill for 5 days to stimulate the ovaries to select and grow an egg for the month. These medications are generally Letrozole or Clomid and recent research demonstrates that Letrozole is favorable in women with PCOS. Some women with PCOS require the use of injectable medications (gonadotropins) to select and grow an egg.