Polycystic ovary syndrome (PCOS) and endometriosis are two important causes of infertility and women suffering from either condition may be concerned about their chance of falling pregnant. However, treatment options are available which may increase the chance of pregnancy in women eager to conceive.
Causes of Poylcystic Ovary Syndrome (PCOS)
The exact cause of PCOS is not known but a hormonal imbalance is the basic problem encountered in a woman suffering from this disease. This can lead to anovulation (lack of ovulation) or irregular ovulation, scanty or irregular periods, and cysts within the ovaries.
Infertility resulting from ovulation problems can occur due to :
- Abnormally high levels of androgen (male hormone).
- Low follicle-stimulating hormone (FSH).
- Insulin resistance.
Falling Pregnant with PCOS
Infertility is a common problem in women with PCOS but pregnancy is still a possibility and women should not lose hope. Many women with PCOS do not know they have this condition until they undergo investigations for infertility. There are various treatment options for infertility and this must be with a gynecologist. Failure of one therapeutic measure to achieve the desired result does not mean that a woman will not fall pregnant.
Fertility medications such as clomiphene citrate or gonadotropin injections may help to stimulate ovulation and increase chances of pregnancy. Clomiphene citrate can achieve ovulation in a large number of cases and can result in a successful pregnancy within a few months. However, one of the main side effects of this drug is having a multiple pregnancy. If positive results are not achieved within 6 months, gonadotropin injections to stimulate the ovaries may be tried.
- An alternative to ovarian stimulation is ovarian drilling or laparoscopic ovarian diathermy (LOD). Small holes are drilled into the ovary by means of a hot diathermy probe or laser.
- Drugs used to treat diabetes, such as metformin, may help to increase the response to fertility drugs.
- IVF may be tried to achieve pregnancy.
- Losing excess weight with lifestyle changes such as diet and exercise may be helpful.
Causes of Endometriosis
Just as with PCOS, the cause of endometriosis is not clearly understood. Tissues from the endometrial lining of the uterus get implanted in some site other than the uterus, such as the fallopian tubes, ovaries, bladder, abdomen or other abnormal sites and give rise to various symptoms.
Although a many women with endometriosis have no problems with conceiving, the chances of endometriosis causing infertility are relatively high. Infertility may be caused by anatomic factors such as adhesions and scarring caused by endometrial tissues in the pelvis, or hormonal factors which hinder ovulation, fertilization or implantation of the fertilized ovum. Pain during intercourse caused by endometriosis may restrict the act and be a factor in reducing chances of pregnancy.
Falling Pregnant with Endometriosis
Women with mild or moderate endometriosis have a fairly good chance of conceiving, even without any specific treatment. Infertility is more likely to occur in women who have severe endometriosis.
There are various treatment options available for endometriosis which may increase chances of conception. Surgical treatment often gives better results than hormonal or other medical treatments when the aim of treatment is to achieve pregnancy. Assisted reproduction techniques such as intrauterine insemination or in-vitro fertilization (IVF) may provide better results when combined with surgical treatment. Surgery aims to remove any endometrial tissue or adhesions, as well as repair any damage done to organs. Laparoscopic surgery is the method of choice in most cases.