Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is an endocrine system disorder observed in approximately 1 in 5 women of reproductive age. Normally, the ovaries contain structures called follicles where eggs develop. In PCOS, the number of these follicles and the size of the egg are increased. These follicular structures appear as multiple cysts on ultrasound imaging. The disadvantage of these cysts is that they disrupt the hormonal balance in the affected area, often leading the patient to seek medical attention due to irregular periods or absence of menstruation. Additionally, these follicular cysts increase the production of male hormones, resulting in symptoms such as hirsutism (excessive hair growth resembling male patterns), hair loss, and acne.

Patients with PCOS commonly express two main concerns: irregular menstrual cycles and difficulty conceiving. Depending on the specific issue a patient is experiencing, the treatment approach may vary. If the patient desires regular menstrual cycles, the first step is to examine the hormone levels in the blood. Since the follicles in these patients produce insulin-like hormones, fluctuations in blood sugar levels, such as hypoglycemia and hyperglycemia, are often observed. There’s also a risk of developing diabetes in the later stages. Various tests, including glucose loading tests, HOMA-IR index, and hormone profiling, are conducted to assess any pathological conditions. If there is evidence of sugar imbalance or hormone imbalance, treatment typically involves birth control pills to regulate the patient’s menstrual cycle.

In cases where the patient is experiencing infertility and seeking help from fertility clinics, PCOS is a common factor, often ranking high among causes of female infertility. However, patients with PCOS usually respond well to treatment. In patients presenting to the clinic due to their inability to conceive, an assessment is initially made to determine if the patient is ovulating or not. For this purpose, the follicles and egg development are monitored in the patient. If ovulation is not detected, egg development medications are prescribed. If pregnancy does not occur, intrauterine insemination is often added to the treatment plan. Patients who do not respond to these treatments are referred to in vitro fertilization (IVF) clinics. The success rate of IVF is notably high in patients with polycystic ovaries. In conclusion, despite the challenges, it can be confidently stated that women with PCOS have a good chance of conceiving.