PCOS and IVF - Understanding the Complications
IVF, or in-vitro fertilization, is one fertility method that women with PCOS may use to try to get pregnant. This procedure is quite complicated, but has been found to successfully help many couples to conceive. It is, however, complicated even more for a woman who has PCOS. Here's why.
How IVF Works
IVF involves many steps and can cost a couple, or their insurance plan, up to $10,000 for each attempt. It tends to have a success rate between 20% and 50%, depending on a number of variables for each individual couple. First, the woman is given a follicular development suppressant and gonadotrophin injections to stimulate several follicles to develop. Then, she is given an injection of hCG to stimulate the follicles to prime the eggs for release. The eggs are then collected outside of the woman's body and are placed in a culture dish and fertilized with the desired sperm. After 2-3 days, the healthiest fertilized eggs, now embryos, are transferred back to the uterus with a soft catheter through the cervix. Hopefully, one or more of the embryos will then successfully implant into the uterus wall and create a pregnancy.
Hyperstimulation - One Complication for a PCOS Woman Doing IVF
Women with PCOS who receive ovulation induction injections are at risk for cycle cancellation or hypterstimulation. IVF often causes many eggs to be produced and causes rapid rises in estrogen levels. Both of these can increase the chances of hyperstimulation that can place the woman at risk for complications. Such complications can include pelvic pain and swelling, shortness of breath, blood chemistry abnormalities and thrombosis, among others.
Other Complications with IVF for PCOS Women
There are other complications for women with PCOS who are doing IVF. Increased insulin production is often associated with elevated male hormone production. Such excess hormones, such as testosterone, can interfere with normal egg development. It can also increase blood-clotting factors which may interfere with blood supply necessary for the developing follicle and uterine lining.
One solution to these issues with IVF treatment for women with PCOS is the use of insulin-lowering medication. Researchers have been experimenting with the benefits of using insulin-lowering medications for PCOS patients with insulin resistance. Such medications, including metformin, pioglitazone or rosiglitazone can often restore normal ovulation and help the woman to produce only one egg at a time.
When to Try These
Insulin-lowering medications are highly recommended as a fertility stimulant before trying injectable ovulation induction medications. It is important to be aware, however, that most doctors do not have much experience managing PCOS with insulin-lowering medications. This idea is quite new and one that may even need to be introduced to your doctor. It should, however, be considered for women with PCOS who want to become pregnant.