Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "

Case study ( 6899 views as of December 21, 2024 )

Rebecca is a 33 year old woman who has had difficulty achieving a pregnancy. She and her partner have been trying to get pregnant without use of any contraception for one year and have been unsuccessful. She was seen by her family physician and tests were organized. Her testosterone levels were mildly elevated and it was suggested that she might have Polycystic Ovary Syndrome (PCOS). She was referred to a fertility clinic.

The specialists organized a few more hormonal tests and a pelvic ultrasound and confirmed the diagnosis of PCOS. Fertility options were discussed including medications (clomiphene) and other fertility treatment options.

Rebecca could also benefit from recommendations from her pharmacist. It is important to utilize lifestyle options such as yoga, considering nutritional counseling to improve outcomes and activity levels and general well-being.

Author: Dr. Sabrina Gill

Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "

Case Introduction

Fertility and Polycystic Ovary Syndrome

Presented by

Dr. Sabrina Gill

MD, MPH, FRCPC

Endocrinologist

Treatments

Nutritional Medicine

Practitioner help from:

Dr. Carley Squires Squires.

Naturopathic Doctor
Being Diagnosed With Polycystic Ovary Syndrome

Practitioner help from:

Dr. Sarah Capes

Endocrinologist
What Factors Influence Female Fertility?

Practitioner help from:

Dr. Beth Taylor

Book Online Appointments

Fertility Specialist

Treatments

Prenatal Yoga Benefits

Practitioner help from:

Ms. Leanne Kitteridge

Yoga Instructor
Treating Polycystic Ovary Syndrome to Improve Fertility

Practitioner help from:

Dr. Sarah Capes

Endocrinologist
What Lifestyle Factors Influence Fertility?

Practitioner help from:

Dr. Carley Squires Squires.

Naturopathic Doctor

Conversation based on: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "

Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "

Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 20 June 2023

If a woman has a history of irregular periods and exhibits symptoms of excess testosterone, such as excessive hair growth, acne, or hair loss, it is important to consult a physician and undergo evaluation. The physician may recommend blood tests to assess hormone levels, including male hormones (androgens) as well as other hormones that could potentially contribute to the symptoms. Polycystic ovary syndrome (PCOS) is primarily diagnosed based on symptoms and by excluding other possible causes, making it a diagnosis of exclusion. In some cases, the physician may also suggest an ultrasound to assess the ovaries for the presence of cysts. However, it is important to note that around 20% of women without PCOS can also exhibit cysts on ultrasound, so it is not a definitive diagnostic criterion. Due to the increased risk of other hormonal and metabolic abnormalities associated with PCOS, it is important to have additional assessments. This may include checking for diabetes, monitoring blood pressure, evaluating cholesterol levels, and assessing for conditions like sleep apnea. These assessments can typically be done through routine blood tests. In the case of diabetes, a 75-gram glucose tolerance test may be recommended, where the individual drinks a sugary solution and their blood sugar levels are measured before and after the drink. Sleep studies can be conducted to evaluate for sleep apnea. It is crucial to discuss these concerns with a physician and undergo the necessary tests to ensure proper evaluation and management of symptoms related to PCOS. Please note that the information provided is for informational purposes only and should not replace professional medical advice, diagnosis, or treatment. It is recommended to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
Dr. Duncan Miller MD Family Doctor, Vancouver, BC 09 December 2019 Broadway Plaza Family Practice Vancouver

A condition characterized by obesity, menstrual problems, enlarged ovaries and insulin resistance. It is a leading cause of infertility. Women with polycystic ovary syndrome are at higher risk of developing type 2 diabetes

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
K. Michael 11 January 2016

A friend of mine has Polycystic Ovary Syndrome and is experiencing fertility issues. She is attempting to have a second child and made a comment about how having her first child didn't fix her PCOS. Does pregnancy sometimes fix the hormone issues that cause PCOS ?

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
- K. Michael 08 March 2016
  
  Thanks! I thought I had read somewhere that successful pregnancy can reset the hormones in a woman with PCOS. I must have been thinking about something else.
- Michelle Kaarto, BScK, CSEP CEP 14 January 2016
  
  @K.Michael - I have not heard that getting pregnant or having a baby can cure polycystic ovary syndrome. I can't find any evidence of that either in my search. I thought that polycystic ovary syndrome had no cure, and the primary goal is to manage the condition through lifestyle measures (diet, weight loss, exercise), as well as possible medication management to help with fertility.
- AllieS 13 January 2016
  
  It's my understanding that a successful pregnancy doesn't fix hormonal imbalances/PCOS. Women with PCOS are at a higher risk of pregnancy/birth complications, and often undergo treatments to normalize their hormone levels enough for pregnancy to occur in the first place. After delivery, when fertility treatments are no longer necessary, it seems like hormone levels revert back to their pre-pregnancy levels. Perhaps someone can weigh in on this?
Joy 06 April 2015

What role would diet and exercise play in a woman with PCOS achieving pregnancy?

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
- AllieS 13 January 2016
  
  Diet plays a role as excess insulin seems to significantly contribute to PCOS. With excess amounts of sugar (glucose) intake prior to pregnancy, insulin resistance can develop leading to excess insulin in the blood. This increases the levels of male hormones, including testosterone, which can result in a decreased ability to ovulate.
- K. Michael 12 August 2015
  
  PCOS causes hormone fluctuations which can lead to weight gain. Being overweight can contribute to fertility issues.
- K. Michael 27 July 2015
  
  PCOS can prevent you from ovulating regularly. It can also cause low estrogen - both things that would make it harder to get pregnant
Joy 06 April 2015

How does PCOS prevent a woman from achieving pregnancy?

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
- Michelle Kaarto, BScK, CSEP CEP 14 January 2016
  
  Polycystic Ovary Syndrome (PCOS) affects the production of androgens, or testosterone, which impacts how a woman ovulates. Usually it makes ovulation irregular, or even absent, and this can make getting pregnant very difficult. A lot of women with PCOS also have difficulty responding to insulin in their bodies, which can make them more susceptible to diabetes, and can cause weight gain. The higher levels of insulin can result in more testosterone being produced - it's like a vicious cycle.
Bernadette van der Boom-Bebb 04 February 2015

What support is there for people with PCOS who cannot get pregnant?

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
Michelle Kaarto, BScK, CSEP CEP 13 January 2015

I can imagine how fertility issues can also take a toll mentally on a couple who is trying to achieve pregnancy. I would consider Rebecca and her partner also consider counselling to help address any stress or communication challenges that can arise during this process.

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
Ms. Sarah Ware RD Registered Dietitian, North Vancouver, BC 23 December 2014

With the right treatment plan, including diet, exercise and medication, women with PCOS often find their fertility issues resolve. Nutritionists and Dietitians can help women formulate the right diet plan to support healthy hormone levels to achieve pregnancy.

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
- Michelle Kaarto, BScK, CSEP CEP 13 January 2015
  
  A well-rounded exercise plan can definitely support her Rebecca's lifestyle efforts in working toward achieving pregnancy. Yoga is a great place to start, however she will also need to engage in some strengthening and cardio exercise to help support weight loss if this is needed.
- Yuan Lew, MSc MBA 23 December 2014
  
  Weight is a sensitive issue with women trying to get pregnant. However, it is a question a woman with fertility concerns and PCOS should bring up with her doctor. I was overweight and being told to lose weight was hard for me to hear.
Yuan Lew, MSc MBA 21 December 2014

PCOS may not hinder fertility in some women when they are younger but may become an issue (secondary infertility) after the birth of her child(ren). That was the case with me, it affected my fertility 3 years after the birth of my first child.

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
Yuan Lew, MSc MBA 18 December 2014

I have PCOS and have gotten pregnant with metformin and clomiphene

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "
- Joy 04 May 2015
  
  Does the chance of having multiples increase with these drugs?
K. Michael 17 December 2014

I know several people who have PCOS and have gotten pregnant with fertility treatments.

Reply to: Fertility and Polycystic Ovary Syndrome " Rebecca a 33 year old who has had difficulty achieving a pregnancy "