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Polycystic Ovary Syndrome affects menstrual cycles, obesity, acne and hirsutism due to hormonal disturbances. There is often the presence of elevated insulin resistance. One of the main challenges faced by women with PCOS is irregular or absent ovulation, due to which women with PCOS may experience difficulties in getting pregnant. Depending on the severity of PCOS, fertility treatments like IUI (Intrauterine Insemination) or IVF (In Vitro Fertilization) can assist in conception.
During IVF, external medication in the form of injections is given to the patient to control the formation of eggs. Then, these eggs from the ovaries are collected under anaesthesia at the right time. Parameters like Antimuellerian Hormone levels, the weight and age of the woman decide the dosages of these injections. There are many challenges when a woman with PCOD undergoes the treatment of IVF.
The presence of many follicles and elevated levels of the AMH and LH hormones characterise PCOS. Women with PCOS are often labelled as Hyper-responders as they will produce a very high number of follicles in response to the injections. This leads to very high levels of estradiol hormones in the blood, which can be a precursor to the development of the complication of Ovarian Hyperstimulation Syndrome. To prevent this complication of OHSS, IVF in PCOS women is done in two segments. The first segment consists of Ovarian Stimulation and Ovum Pickup, followed by the making of the embryos in the IVF Lab and Vitrification or Rapid Freezing of the embryos. The second segment consists of the embryo transfer process done the following month.
Obesity contributes to metabolic disturbances and hormonal Imbalance in PCOS. Increased insulin resistance in PCOS leads to subsequent impaired glucose tolerance and other metabolic abnormalities like diabetes mellitus, metabolic syndrome, and an increased risk for cardiovascular disease. Hence, it is imperative to address and treat obesity before starting the IVF treatment. A low-calorie diet with adequate nutritional intake hea, healthy food choices, and an exercise regime can bring about weight loss, improving the quality of eggs in these women.
Navigating obesity, infertility, and PCOD can be physically and emotionally demanding. Though IVF in PCOS is challenging, with current IVF techniques, success rates are about 70% in women less than 35 years of age. Segmentation of an IVF cycle with the transfer of frozen embryos in PCOS women makes it safer and has a better outcome.