What is Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Disease (PCOD)?
The polycystic ovarian disease is a common hormonal disorder amongst women, primarily in their reproductive age. While the primary cause of PCOD is yet to be ascertained, it is largely agreed that hormonal imbalances cause infrequent periods and excessive male hormone prevalence amongst women having this condition. Over a period of time, the ovaries (female gonads) tend to develop small collections of fluid (follicles) and fail to release eggs regularly – these eventually form cysts or sags of fluid.

Women with a polycystic ovarian disorder will develop the symptoms along with puberty and are likely to see excessive weight gain, hirsutism, male-pattern baldness, infrequent periods, severe acne as some of the common signs indicating the condition. The symptoms are likely to be more severe for young girls predisposed to an existing issue of being obese or overweight.

What are the Symptoms of PCOS?
The common symptoms associated with PCOS include:

• Irregular periods
• Painful periods
• Excessive pain during periods
• Male-pattern baldness
• Excessive weight gain

What are the causes of PCOS?
The exact causes of PCOS remain yet unascertained, but certain factors are known to accentuate the possibility of developing this condition. Excessive resistance to insulin is one such factor. Insulin is the hormone produced in the pancreas that allows cells to absorb sugar; however, if they become resistant to the action of insulin, then the blood sugar levels can rise and increase androgen production, causing difficulty with ovulation.

Excessive production of androgen by the ovaries is another prime factor while others include genetic & hereditary ones, as well as a low-grade inflammation that may give rise to PCOS.

How do I know if I have PCOS?
Identifying whether you have PCOS or not could happen when trying to conceive a baby, should you be only mildly symptomatic. For those with more prominent symptoms, the determination can be made much earlier. Irregular periods is one of the primary identifiable factors with PCOS, a patient can opt for a transvaginal scan, which can help conclusively determine the presence of PCOS.

How does normal ovulation work?
Ovulation is the release of an egg from your ovary into your fallopian tube. It typically happens about 13–15 days before the start of each period. Like your period, the timing of ovulation can vary cycle-to-cycle, and you may have the odd cycle where you don’t ovulate at all. A lot goes into every ovulation. And if conditions aren’t right, it won’t happen.

The development and release of an egg in each cycle occur in response to your reproductive hormones’ intricate ups and downs. Ovulation (and the menstrual cycle as a whole) is impacted by energetic, nutritional, emotional, and socioeconomic factors. Tiny eggs develop in sacs called follicles in your ovaries. Follicles develop for several months before they are ready to release their egg; once the follicle is ready, it releases its egg. The egg travels out of the ovary and into the fallopian tube.

After its release, the egg has about 12–24 hours to be fertilized by sperm in the fallopian tube. If the egg isn’t fertilized within this short window, it begins to degrade. If it is fertilized, it travels to the uterus over the following 6–12 days to possibly implant for pregnancy.

What are my chances of conceiving with PCOS?
With good advice and effective fertility treatment, women with PCOS can look forward to having a baby. The chances further improve if you are below the age of 35 at the time of conception.

What is the treatment for PCOS if you are trying to conceive?
Introduction
While PCOS in itself is not a treatable condition, doctors can treat the symptoms associated with the same and manage them effectively such that you can conceive and have a baby. A healthy diet, weight management, a physically active lifestyle, etc., are some of the methods employed for the management and treatment of PCOS.
Weight Loss to Restart Ovulation
One of the primary effects of PCOS is obesity, the inability to absorb insulin results in excessive weight gain. And this excessive weight gain is associated with irregular ovulation, which is a constraint for successful conception. Adequate weight-gain has been evidenced to improve conception rates in women suffering from PCOS.
Fertility-Friendly Eating Tips for PCOS
Diet is a significant component of effectively managing PCOS, and there are several fertility-friendly dietary measures that one can take. Instead of skipping breakfasts in a hurry and ending the day with a big meal, the reverse helps you, should you be suffering from PCOS. Including a lot of greens and proteins is advisable, as is the inclusion of complex carbohydrates such as whole grains and beans. Use healthy oils for cooking – avocado, olive oil, nuts, and avoid habits such as smoking and alcohol consumption.

Medications
Several medications are now readily available for the treatment and management of the symptoms associated with PCOS.

• • Metformin

Metformin helps deal with insulin resistance and thereby helps manage weight. This will, in turn, improve menstrual cycles and reduce the rate of miscarriages.

• • Clomid

Clomid is a commonly used fertility drug and a common form of treatment for PCOS. Although some of the users may face clomid-resistance, many women have found the drug to be extremely helpful.

• • Letrozole

It is an ovulation stimulating drug that is used should both metformin and clomid prove to be unsuccessful in managing PCOS.

• • Gonadotropins

Gonadotropins are hormonal fertility drugs that can be either administered orally or can be injected into the body. They are made up of the hormones FSH, LH, or a combination of the two and help stimulate ovulation.

Fertility Procedures
Fertility treatment for PCOS management becomes essential in case of all drugs failing to show sufficient results. Fertility procedures include IVF or IVM. The treatment will involve an injection of fertility drugs to stimulate ovaries, then retrieval of the eggs to be fertilized in the lab before the fertilized eggs are implanted back into the uterus.

Will You Need an Egg Donor?
It is unlikely that just because a woman is suffering from PCOS, she will require an egg donor. However, the same may be necessary if there are other conditions such as advancing age, additional ovarian issues. Women with low ovarian reserves, those who have undergone ovarian procedures may also require egg donation.