Getting Pregnant – The Enemy Within: Polycystic Ovarian Syndrome

Like many young couples, Kristin Chapman and her husband, Mark, waited until they’d been married a few years before trying to have a baby.

“We thought it would be no big deal,” says Kristin, 33, who lives in Atlanta.

After a year of dashed hopes and frustration, they sought help at a regional fertility clinic. That was where they learned that Kristin, who was 25 at the time, suffered from Polycystic Ovarian Syndrome (PCOS).

PCOS is the most common hormonal disorder in women during childbearing years, and one that is now being taken seriously because of its connection not only to infertility, but also to serious health problems later in life.

PCOS basics

Getting Pregnant - The Enemy Within: Polycystic Ovarian Syndrome

Women with PCOS produce too many male hormones, or androgens, which stop the ovulation process before it can be completed. Partially developed eggs die inside the ovaries and develop into cysts, which serve as barriers to regular ovulation and menstrual cycles.

One of the earliest signs of PCOS can be irregular and/or infrequent periods, which some young women view as more of a blessing than a curse. Because of the overload of male hormones, some PCOS sufferers have more obvious symptoms like excessive hair growth on the face and chest, weight gain, high blood pressure, and acne. In many cases, like Kristin’s, where there are no visible signs of the condition, the diagnosis is made when women seek help for infertility.

Close to one-fifth of American women suffer from PCOS, though no two will show the exact same symptoms. The wide range of symptoms has made it difficult for doctors to diagnose or define PCOS, let alone treat it.

Doctors have yet to discover what causes this mysterious condition, but they suspect it is related to insulin and genetics, according to Kristin’s doctor, Mark Perloe, a founding partner of Atlanta’s Georgia Reproductive Services. Research shows that high insulin levels can stimulate a woman’s ovaries to produce more of the male hormone testosterone and that the ovaries of women with PCOS may be more sensitive to insulin.

PCOS and infertility

Some doctors believe that PCOS is the most common cause of female infertility, and Dr. Perloe, who estimates he sees about 10 new PCOS patients a week in his clinic, agrees that it’s a serious problem. While there is no cure for PCOS, he has found that treatment for it can increase chances of pregnancy.

“By pinpointing where the genetic abnormalities that result in PCOS may be and targeting treatments at those specific abnormalities,” says Dr. Perloe, “we will make fertility treatment and the outcomes a lot better.”

For Kristin, that meant trying a diabetes drug, metformin, which doctors think helps regulate ovulation in PCOS patients by controlling their insulin levels. Since she had already tried the ovulation-stimulating hormone injections and had known the heartbreak of two failed in vitro fertilization attempts, Kristin didn’t get her hopes up when she began taking metformin.

“I really didn’t think it was going to work,” says Kristin, who became pregnant when her natural ovulation cycle took place after only one month on the diabetes treatment.

Kristin gave birth to baby Grace after 39 weeks. Her parents’ dream come true, Grace weighed 8 pounds, 11 ounces. “That’s a positive thing for women with PCOS,” says Kristin, who enjoyed a healthy pregnancy. “You can have a normal pregnancy and a normal delivery.”

PCOS and pregnancy dangers

But Jennifer in Michigan, who was 26 when she found out she had PCOS, didn’t fare as well during her high-risk pregnancy. Like many others who have the syndrome, Jennifer began showing signs of PCOS as soon as she stopped taking birth-control pills, which had regulated her periods and simulated an ovulation pattern that didn’t happen naturally in her body.

When she was nine weeks pregnant, Jennifer started bleeding and was put on bed rest. After that, she was allowed only restricted activity for five weeks. Since she also had dangerously high blood pressure, she was not allowed to go back to work as a registered nurse, and ended up in the hospital at 29 weeks pregnant. “My blood pressure was so high they later told me it was a miracle I did not have a stroke,” Jennifer says.

In addition, Jennifer suffered from severe gestational diabetes, which is also common for PCOS patients, and had to take insulin five times a day. She feared miscarriage, which some studies purport happens in as many as 45 percent of PCOS pregnancies. When her son was born four and a half weeks early, she felt relieved and exhausted. Though her little boy is healthy, Jennifer has been warned against any future pregnancies.

PCOS and long-term health

Both Jennifer and Kristin are currently taking diabetes drugs regularly to control the symptoms and the impact of PCOS. They hope that the treatment will help them avoid serious and potentially life-threatening complications.

Studies have shown that women with PCOS are much more likely to have or develop adult-onset diabetes because many of them have trouble using their body’s insulin efficiently. In addition, since people with high insulin levels are likely to have high blood pressure and low levels of good cholesterol, PCOS patients have a greater chance for developing heart disease, resulting in higher rates of heart attacks and strokes. Because women with PCOS don’t ovulate regularly or menstruate, which result in the shedding of the uterine lining, they also run greater risks of endometrial cancer.

For women like Kristin, who might never have been diagnosed if she weren’t having trouble getting pregnant, the good news is that treatment for PCOS helped her to minimize her risks of future complications.

“By looking at this in a new light, we not only will help these people conceive, we may help them live a healthier and longer life,” explains Dr. Perloe, a pioneer in treating PCOS patients for long-term as well as short-term benefits.

Continued research into the treatment of PCOS offers more hope to women who struggle to live with infertility, as well as other PCOS-related conditions. “I know I learned patience,” says Kristin. “Not everything is going to happen on my timing.”

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