What is it?
Polycystic ovarian syndrome is a common hormonal disorder that is clinically characterized by irregular menstrual cycles, lack of regular ovulation, abnormal facial hair growth, infertility, obesity and polycystic ovaries (enlarged, cystic ovaries). This disorder affects approximately 6% of all reproductive age women. Recent evidence indicates that polycystic ovarian syndrome is a disorder characterized by insulin resistance and a compensatory elevated insulin level, which are found in both the overweight and non-overweight women with the syndrome.

Diagnosis
The diagnosis of polycystic ovarian syndrome is typically made by your physician by taking your history, doing a physical exam, performing an ultrasound and measuring some of your hormone levels. Once the diagnosis is established treatment options can be discussed. If you are not trying to get pregnant the best therapy is weight reduction if you are overweight and birth control pills to regulate your menstrual cycle. 

Treatment
Traditional therapy for women with infertility secondary to polycystic ovarian syndrome has been ovulation induction using clomiphene citrate as a first line agent. Due to this recognition regarding insulin levels and resistance, the use of insulin sensitizing agents such as metformin (Glucophage®) for ovulation induction have recently been studied with promising results. Frequently clomiphene citrate and metformin are used together. Insulin-lowering agents for ovulation induction in women with Polycystic Ovarian Syndrome are an attractive alternative due to their low cost, minimal side effects and decreased risk for multiple pregnancies compared with other agents.

Since the use of metformin for ovulation induction in women with polycystic ovarian syndrome is relatively new, the best method for ovulation induction is yet to be determined. The physicians at MUSC and Southeastern Fertility Center individualize patient care and your treatment may involve the use of metformin alone or in combination with other medications.

by:  John Schnorr, M.D.

Request an appointment with a MUSC provider.

Infertility is very common.  Studies show that approximately one in nine couples in the United States have infertility at some time in their life.  The sad part about those statistics is that only 50% of these patients actually seek treatment.  Of those who do seek treatment, ultimately over 90% will conceive, making it vital that patients with infertility seek treatment.

Infertility is typically defined as one year of regular sexual intercourse without conception.  Signs that infertility may be happening to you would include irregular menstrual cycles in which you actually miss a menstrual cycle for an entire month, significant pelvic pain with your menstrual cycles, a history of sexually transmitted diseases, and/or a prior history of pelvic surgery.

If you are over 35 years of age, there is also mounting evidence that it would be beneficial to you to seek care for infertility if you have been trying to conceive for six months or more.  In women over 35 years of age, we have an increased concern about egg quality and egg number which can be quickly assessed with your OB/GYN.

A frequent comment by patients is that they have been having regular intercourse for several years, however, have not been "trying" to get pregnant.  Studies very clearly show that patients do not need to "try" to get pregnant but rather regular intercourse, once to twice per week, should be adequate for a patient to conceive within a year without another form of birth control.

I look forward to discussing this topic further.

by:  John Schnorr, M.D.