Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects fertility and complicates a woman’s efforts to have a baby. 7-10% of women of reproductive age potentially suffer from Polycystic Ovarian Syndrome. However, most women do not know they suffer from it, until they start exploring their fertility potential and the possibility of a pregnancy.

The most common symptoms of PCOS are:
1. Increased androgens, i.e. hormones such as testosterone, which usually cause acne, increased hair growth on the face and body, and are detected through blood tests only.
2. Menstrual disorders: The cycle may show abnormalities, such as delays in the onset of the period, and sometimes the period may even stop completely, i.e. amenorrhea. Menstrual disorders, on the other hand, may affect ovulation so therefore, women’s fertility.

The term “polycystic ovaries” describes the appearance of the ovaries during the gynecological ultrasound screening. The ovaries appear to contain many small follicles (perhaps 10 or more, each) with the monthly dominant follicle, normally leading to ovulation, not growing so easily.

The Scientific and Clinical Director of Embryolab, Dr. Nikos Christoforidis, MD, FRCOG, DFFP, Obstetrician-Gynecologist, Embryolab Academy co-founder, states that “At Embryolab, women diagnosed with polycystic ovarian syndrome are evaluated and monitored in accordance with the International Evidence Based Guidelines, published in 2018 by Health Professionals internationally, with the support of the American Reproductive Society (ASRM) and the European Society for Human Reproduction and Embryology (ESHRE). We are all aligned, to improve the quality of life of women with polycystic ovarian syndrome and to ensure high quality services in fertility procedures and treatments. ”

1. Once diagnosed with PCOS, do I have to undergo IVF to get pregnant?
No. Many women are diagnosed with PCOS, but most of them eventually get pregnant naturally. Many women with PCOS have a normal cycle, so ovulation is more likely to occur on a regular basis. However, it is usually more difficult to conceive naturally when a woman has irregular menstrual cycles. Interventions in her diet, exercise, normal body weight maintenance, as well as medications aimed to provoke ovulation, can help many women with PCOS to achieve a pregnancy, without further specialized interventions.

In vitro fertilization is indicated for women with PCOS when other medical conditions coexist, such as fallopian tube pathology, low sperm count, or even when simple interventions have been tried without yielding to any positive results.

2. What are the side effects / complications I should expect if I have PCOS and receive IVF treatment?
When a woman with PCOS undergoes an IVF, has increased sensitivity to a hormonal ovarian therapy, which is manifested through the development of a large number of oocytes during hormonal stimulation and increased hormonal production from her ovaries.

Uncontrolled hormonal stimulation can lead to an ovarian hyper stimulation syndrome (OHSS), a condition that charges the body’s function, and symptoms like fluid retention, swelling, a feeling of discomfort in the abdomen, difficulty in urinating, or even breathlessness may occur.

However, today, the OHSS has, for the most part, been annihilated as the newest medical protocols we use, in conjunction with the development of cryopreservation techniques to freeze all embryos, allow the safe completion of the oocyte retrieval and fertilization, while embryo transfer is postponed for a later stage. Thus, on the onset of a new menstrual cycle, a woman is prepared for her embryo transfer under controlled conditions with no further hormonal stimulation.

3. What is the effect of PCOS on IVF?
When PCOS leads to infertility, it is usually due to the absence of ovulation, and can often be associated with other problems, such as a more frequent presence of immature oocytes.

However, with the appropriate stimulation protocols and medications used in IVF treatments, as well as the latest developments on embryo cryopreservation, we aim to change the rate of oocyte maturation and thus, collect as many mature oocytes, appropriate for fertilization, as possible.

Lastly, due to the increased ovarian sensitivity to hormonal stimulation, the dosage of the medications used is lower, to avoid side effects and complications, while frequent and systematic monitoring throughout the treatment is implemented.