Pregnant with pcos ultrasound

How to Detect Pregnancy with PCOS

PCOS and Pregnancy Tests: How to Detect Pregnancy with PCOS

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Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Dorian Smith-Garcia — Updated on June 18, 2020

Trying to conceive can be stressful. Getting pregnant requires a series of events that must each happen at just the right moment.

When you research the whole conception process, you realize that there’s only a very small window in which a woman can get pregnant — a window that can be hard to figure out if your menstrual cycles aren’t exactly clockwork.

If you have a condition that can impact your cycle like polycystic ovary syndrome (PCOS), it’s not impossible to get pregnant — but it can be significantly more difficult. And you may have questions, like:

If my cycle isn’t regular, how do I know when my “fertile window” of opportunity is for getting pregnant?
I’ve heard that you should take a pregnancy test a couple days after your missed period, but I haven’t had a period in months. How do I know when to test if I don’t even know when my period is due?
Can having PCOS result in a false positive on a pregnancy test? A false negative?
Whenever I read about pregnancy symptoms, it’s like I’m reading about my usual PCOS experience. How can I tell the difference between pregnancy symptoms and PCOS symptoms?

You’re not alone

Roughly 1 in 10 women in their childbearing years are impacted by PCOS. Many have had successful pregnancies. So, if you’ve been diagnosed with this condition, please know that you’re not alone.

So why is PCOS an issue when it comes to getting pregnant? Generally speaking, PCOS is a hormonal condition that can impact your fertility. Common symptoms associated with the condition include:

ovarian cysts
higher levels of male hormones like androgen
an inconsistent menstrual cycle that causes you to have either skipped or irregular periods

With PCOS, essential hormones necessary for a regular menstrual cycle — estrogen, progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) — aren’t present in the necessary levels. This equates to the body not always ovulating (releasing a mature egg) on its own. No ovulation = no egg to fertilize = no pregnancy.

It’s in the few days before ovulation up until the day after that you’re most fertile. Often women with PCOS — who may not ovulate as often as those without — must guess when they think they’re ovulating.

This is because they may not get the same telltale signs that others would use as reliable indicators.

What about using an ovulation monitor or test strips?

Ovulation monitors aren’t ideal if you have PCOS because these tests rely on detecting estrogen and LH, two critical hormones that are often depressed when you have this condition. You may receive inaccurate readings that give a larger number of “high fertility” days in an ovulation monitor.

With the exception of a missed period or morning sickness, most early pregnancy symptoms are frustratingly similar to regular symptoms of an impending period. These include common symptoms such as:

increased fatigue
sore or tender breasts
abdominal bloating
headaches
mood swings
lower back pain

Sounds familiar, right?

But if you routinely have an irregular menstrual cycle because of PCOS, you might not get those key indicator signals — or you may assume you’re getting your period or just having symptoms of your condition.

Here are a couple of things to remember:

Not getting those symptoms doesn’t mean that you aren’t pregnant.
If you’ve had unprotected sex 2 to 3 weeks (or more) ago and haven’t had a period, it may be worth taking a test — even if you haven’t had a period in months and aren’t necessarily expecting one.

Women with PCOS are generally advised to avoid using “early result” pregnancy tests — you know, the ones that claim on the front of the box that they can detect pregnancy 6 days before your missed period — as it’s not uncommon to get false negatives with such tests.

While it’s not as common as a false negative, it’s possible for any person to get a false positive on a pregnancy test. However, PCOS is not the culprit if you get one of these rarities.

Specifically, pregnancy tests rely on the presence of human chorionic gonadotropin (hCG) — the “pregnancy hormone” — to determine whether you’re pregnant or not. And that’s not a hormone that’s directly affected by PCOS.

However, if you’re undergoing fertility treatments that require taking certain medications, you may have detectable hCG (from the medication) that can lead to a false positive pregnancy test result. Other common causes of a false positive include:

using an expired pregnancy test
not following the instructions correctly
waiting too long to review the results on a test

There’s one other possibility that we don’t like to talk about: If you have PCOS, your risk of early miscarriage is higher. So it’s possible to initially test positive for pregnancy and then experience a negative result with a later test.

Your hormone levels are irregular when you have PCOS, so false negatives are definitely possible.

You may attempt to test for pregnancy shortly after your missed period and get a negative result even though you’ve conceived. In fact, some women with PCOS may not discover they’re pregnant until many weeks after conception.

So again, avoid those early pregnancy tests. You may even want to test well after your expected period to avoid false positives or negatives.

If getting pregnant is your goal, speak with your physician as there are options to help increase your chances of getting pregnant. These include:

Hormonal birth control methods (the pill, shot, intrauterine device, or vaginal ring) to better regulate your menstrual cycle before trying to conceive.
Anti-androgen medications to block the impact of increased androgen levels.
Metformin, a type 2 diabetes drug that can reduce androgen levels and secondary PCOS symptoms, such as facial hair growth and acne.
Weight loss. If you’re currently carrying extra weight, healthy eating and consistent physical exercise can help to regulate your menstrual cycle. (These 13 tips may help.)
Ovulation medications — such as clomiphene — to help encourage ovulation.
In vitro fertilization (IVF). If medication and lifestyle changes don’t work, IVF is an option in which your eggs are retrieved and fertilized outside your body. A resulting embryo is then placed directly in your uterus.
Surgery. If none of the above have worked, a surgery that removes the outer shell of your ovaries (known as the cortex) that is often thicker in women with PCOS can be performed to help restore ovulation. But this option usually only works for 6 to 8 months.

RECALL OF METFORMIN EXTENDED RELEASE
In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.

It’s not a secret that PCOS can make conceiving harder simply because you don’t have the reliability of a predictable menstrual cycle to anchor your timeline. But that doesn’t mean that it’s impossible or that you should give up on pregnancy.

Focus on testing for a positive result well after the date of your expected period has passed. You’ll be more likely to receive an accurate result as opposed to relying on early pre-period testing methods that can lead to faulty results for women with PCOS.

Always confirm pregnancy with a blood test ordered by a doctor. And work with an OB-GYN familiar with PCOS throughout your pregnancy — it’ll give you peace of mind.

Last medically reviewed on April 29, 2020

Parenthood
Becoming a Parent
Getting Pregnant

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Does PCOS affect pregnancy? (2017).
nichd.nih.gov/health/topics/pcos/more_information/FAQs/pregnancy
Foxcroft KF, et al. (2013). Development and validation of a pregnancy symptoms inventory.
bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-3
Goodarzi MO. (2016). Genetics of common endocrine disease: The present and the future. DOI:
10.1210/jc.2015-3640
Polycystic ovary syndrome. (2019).
womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jun 18, 2020

Written By

Dorian Smith-Garcia

Edited By

Phil Riches

Apr 29, 2020

Medically Reviewed By

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

Share this article

Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Dorian Smith-Garcia — Updated on June 18, 2020

How to Detect Pregnancy with PCOS

PCOS and Pregnancy Tests: How to Detect Pregnancy with PCOS

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Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Dorian Smith-Garcia — Updated on June 18, 2020

Trying to conceive can be stressful. Getting pregnant requires a series of events that must each happen at just the right moment.

If my cycle isn’t regular, how do I know when my “fertile window” of opportunity is for getting pregnant?
I’ve heard that you should take a pregnancy test a couple days after your missed period, but I haven’t had a period in months. How do I know when to test if I don’t even know when my period is due?
Can having PCOS result in a false positive on a pregnancy test? A false negative?
Whenever I read about pregnancy symptoms, it’s like I’m reading about my usual PCOS experience. How can I tell the difference between pregnancy symptoms and PCOS symptoms?

You’re not alone

Roughly 1 in 10 women in their childbearing years are impacted by PCOS. Many have had successful pregnancies. So, if you’ve been diagnosed with this condition, please know that you’re not alone.

So why is PCOS an issue when it comes to getting pregnant? Generally speaking, PCOS is a hormonal condition that can impact your fertility. Common symptoms associated with the condition include:

ovarian cysts
higher levels of male hormones like androgen
an inconsistent menstrual cycle that causes you to have either skipped or irregular periods

This is because they may not get the same telltale signs that others would use as reliable indicators.

What about using an ovulation monitor or test strips?

With the exception of a missed period or morning sickness, most early pregnancy symptoms are frustratingly similar to regular symptoms of an impending period. These include common symptoms such as:

increased fatigue
sore or tender breasts
abdominal bloating
headaches
mood swings
lower back pain

Sounds familiar, right?

Here are a couple of things to remember:

Not getting those symptoms doesn’t mean that you aren’t pregnant.
If you’ve had unprotected sex 2 to 3 weeks (or more) ago and haven’t had a period, it may be worth taking a test — even if you haven’t had a period in months and aren’t necessarily expecting one.

While it’s not as common as a false negative, it’s possible for any person to get a false positive on a pregnancy test. However, PCOS is not the culprit if you get one of these rarities.

using an expired pregnancy test
not following the instructions correctly
waiting too long to review the results on a test

Your hormone levels are irregular when you have PCOS, so false negatives are definitely possible.

So again, avoid those early pregnancy tests. You may even want to test well after your expected period to avoid false positives or negatives.

If getting pregnant is your goal, speak with your physician as there are options to help increase your chances of getting pregnant. These include:

Hormonal birth control methods (the pill, shot, intrauterine device, or vaginal ring) to better regulate your menstrual cycle before trying to conceive.
Anti-androgen medications to block the impact of increased androgen levels.
Metformin, a type 2 diabetes drug that can reduce androgen levels and secondary PCOS symptoms, such as facial hair growth and acne.
Weight loss. If you’re currently carrying extra weight, healthy eating and consistent physical exercise can help to regulate your menstrual cycle. (These 13 tips may help.)
Ovulation medications — such as clomiphene — to help encourage ovulation.
In vitro fertilization (IVF). If medication and lifestyle changes don’t work, IVF is an option in which your eggs are retrieved and fertilized outside your body. A resulting embryo is then placed directly in your uterus.
Surgery. If none of the above have worked, a surgery that removes the outer shell of your ovaries (known as the cortex) that is often thicker in women with PCOS can be performed to help restore ovulation. But this option usually only works for 6 to 8 months.

RECALL OF METFORMIN EXTENDED RELEASE
In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.

Always confirm pregnancy with a blood test ordered by a doctor. And work with an OB-GYN familiar with PCOS throughout your pregnancy — it’ll give you peace of mind.

Last medically reviewed on April 29, 2020

Parenthood
Becoming a Parent
Getting Pregnant

How we reviewed this article:

Does PCOS affect pregnancy? (2017).
nichd.nih.gov/health/topics/pcos/more_information/FAQs/pregnancy
Foxcroft KF, et al. (2013). Development and validation of a pregnancy symptoms inventory.
bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-3
Goodarzi MO. (2016). Genetics of common endocrine disease: The present and the future. DOI:
10.1210/jc.2015-3640
Polycystic ovary syndrome. (2019).
womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jun 18, 2020

Written By

Dorian Smith-Garcia

Edited By

Phil Riches

Apr 29, 2020

Medically Reviewed By

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

Share this article

Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Dorian Smith-Garcia — Updated on June 18, 2020

How to get pregnant with polycystic ovaries?

Polycystic disease is a common hormonal disease that affects a woman's ovaries. The dangers of PCOS include irregular menstrual periods, excessive hair growth, acne, weight gain, and other problems. Left untreated, PCOS can even lead to infertility. In this article we will tell you more about causes of polycystic , polycystic ovaries and pregnancy , and also give an answer to the question: “ Is it possible to give birth with polycystic ovaries? ".

What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have menstrual irregularities and elevated levels of male hormones (androgens). Numerous small collections of fluid (follicles) may form in the ovaries, and an egg may not be released regularly. This condition should not be confused with multifollicular ovaries, because with multifollicular ovaries, ovulation and a normal menstrual cycle can persist, unlike polycystic disease. nine0019

50-75% of cases of endocrine infertility. 20-22% of marital infertility. It is detected in 5-16% of women of reproductive age. These are the figures for the diagnosis of "Polycystic Ovary".

Symptoms of polycystic ovary syndrome

Polycystic ovary syndrome is accompanied by characteristic symptoms, upon noticing which it is necessary to seek advice from an endocrinologist or gynecologist. For some women, symptoms begin around the time of their first menstrual period. Others discover symptoms of PCOS only after they have gained a lot of weight or have problems getting pregnant. In some cases, PCOS may be asymptomatic. nine0019

The most common symptoms of PCOS:

Irregular periods. Lack of ovulation prevents the lining of the uterus from falling off every month. Some women with PCOS have fewer than eight periods a year, or none at all.
Severe bleeding. The lining of the uterus builds up over a longer period of time, so menstruation may be heavier than usual.
Hair growth . More than 70 percent of women with this condition grow hair on their face and body, including on their back, abdomen, and chest. Excess hair growth is called hirsutism.
Acne . Male hormones can make the skin more oily than normal and cause breakouts on areas such as the face, chest, and upper back.
Weight gain. Up to 80 percent of women with PCOS are overweight or obese.
Male pattern baldness. nine0039 The hair on the scalp becomes thinner and may fall out.

Darkening of the skin. Dark patches of skin may develop in body folds, such as the neck, groin area, and under the breasts.

Headaches. Hormonal changes may cause headaches in some women.

Irregular periods

Infrequent, irregular periods, long or no periods are the most common symptom of PCOS. For example, with PCOS, you may have fewer than nine periods a year, more than 35 days between periods, and abnormally heavy periods. nine0019
Hyperandrogenism

Hyperandrogenism is a disease characterized by high levels of androgens. It is more common in women than in men. Symptoms of hyperandrogenism may include acne, seborrhea (inflammation of the skin), hair loss on the scalp, increased body or facial hair, and infrequent or absent periods.

Hyperandrogenism is a defining feature of women and young girls with PCOS. Polycystic disease causes a malfunction of the ovaries or adrenal glands, which leads to the production of excess androgens (male sex hormones). nine0019
Anovulation

Anovulation occurs when an egg is not released from the ovary during the menstrual cycle. The egg is essential for pregnancy. Since several hormones are involved in ovulation, there are many causes of anovulation, one of which is PCOS. Chronic anovulation is a common cause of infertility.

Diagnosis

There is no test to definitively diagnose polycystic ovary syndrome (PCOS). The doctor will likely begin by discussing your medical history, including menstrual periods and weight changes. A physical exam will include checking for signs of excessive hair growth, acne, and weight gain. nine0019
Your doctor may recommend:

Gynecological examination. A physician visually and manually examines the reproductive organs for growths or other abnormalities.

Blood tests. A blood test is given to determine the level of hormones. This will help rule out possible causes of menstrual irregularities or excess androgens that mimic PCOS. An additional blood test may also be needed to measure insulin resistance as well as fasting cholesterol and triglyceride levels. nine0041
Ultrasound examination (ultrasound). The doctor will check the appearance of the ovaries and the thickness of the lining of the uterus. A rod-shaped device (sensor) (transvaginal ultrasound) is inserted into the vagina, which emits sound waves and converts them into images on a computer screen.

Is it possible to get pregnant with PCOS

How to get pregnant with PCOS? Getting pregnant with PCOS can be difficult, but that doesn't mean it's impossible. While PCOS can affect your hormones and therefore your fertility, there are medical treatments and lifestyle changes you can make to improve your chances of pregnancy. nine0019
Is it possible to get pregnant with polycystic ovaries? To get pregnant, you must ovulate, which PCOS most often prevents. Women who do not ovulate regularly with PCOS do not release enough eggs for fertilization. Pregnancy with PCOS is further complicated by the fact that PCOS causes a hormonal imbalance that changes the quality of cervical fluid, making it difficult for sperm to survive.

It is impossible to say categorically that PCOS is infertility, but PCOS is one of the main causes of infertility in women. nine0019
Is it possible to get pregnant with PCOS? And although there are no exact statistics on the chances of pregnancy, 70 to 80 percent of women with PCOS have fertility problems. PCOS disrupts the normal menstrual cycle and makes it difficult to conceive.

Is it possible to get pregnant with PCOS? Polycystic ovary syndrome is not a sentence and it is possible to get pregnant, albeit problematic. However, if PCOS is left untreated, the chances of getting pregnant decrease with age.

It is possible to get pregnant with polycystic disease, but most often pregnancy with polycystic disease is difficult. This condition can increase the risk of pregnancy complications. Women with PCOS are twice as likely to have a preterm birth than women without. They are also at greater risk of miscarriage, high blood pressure, and gestational diabetes. However, by managing the symptoms, many women with PCOS can become pregnant and have a healthy baby.

How to get pregnant with PCOS? Women with PCOS can become pregnant using fertility treatments that improve ovulation. Losing weight and lowering your blood sugar can increase your chances of a healthy pregnancy. nine0019
Pregnancy planning for PCOS

How to get pregnant with PCOS? While your chances of getting pregnant with PCOS may be lower, there are a few things you can do to increase those chances.

Call your doctor. How to get pregnant with polycystic ovaries? Normalization of hormones and menstruation is the first step. Your doctor may prescribe medications to help your body deal with insulin better and regulate your menstrual cycle. nine0039

Maintain a healthy weight. Is it possible to get pregnant with PCOS? Weight loss can lower insulin levels, androgen levels, and restore ovulation. Ask your doctor about a weight management program and meet with a nutritionist regularly for help with your weight loss goals.

Eat right. Polycystic Ovarian Diet includes sugary foods, simple carbohydrates and unhealthy fats. Add to your menu: fresh and cooked fruits and vegetables, whole grains such as brown rice, oats and barley, beans and lentils, chicken, fish. nine0041
Be active. Exercise helps lower blood sugar levels. How to get pregnant with insulin resistance? If you have PCOS, increasing daily activity such as walking, exercising, walking can help treat or even prevent insulin resistance, control your weight, and avoid developing diabetes.

Lead a healthy lifestyle. Follow a healthy lifestyle with PCOS, give up bad habits, unhealthy diet, lack of sports and irregular sleep. nine0041

Treatment for PCOS

Treatment for PCOS focuses on your individual problems such as infertility, acne or obesity. Also, the direction of PCOS treatment largely depends on whether a woman is planning a pregnancy or not. Specific treatment may include lifestyle changes or medications.

How to treat PCOS?

Lifestyle changes

Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise. Even small weight loss - like losing 5 percent of your body weight - can improve your condition. Can you get pregnant with PCOS? Losing weight can also increase the effectiveness of medications your doctor recommends for treating PCOS and help with infertility. nine0019
Treatment with drugs for polycystic ovaries

To regulate the menstrual cycle, the doctor may recommend:

Combination birth control pills. Estrogen and progestin tablets reduce androgen production and regulate estrogen. Hormone regulation can reduce the risk of endometrial cancer and correct abnormal bleeding, excess hair growth, and acne. Instead of pills, you can use a skin patch or vaginal ring containing a combination of estrogen and progestin. nine0019
Progestin therapy. Daily progestin may: restore normal hormonal balance, regulate ovulation, stop excessive hair growth, protect against endometrial cancer, and help get pregnant with sleep deprivation.

How to induce ovulation in PCOS? To help induce ovulation in PCOS, your doctor may recommend:

Clomiphene is a fertility medication that can help women with PCOS get pregnant.

Metformin is a drug used to treat type 2 diabetes. It also treats PCOS by increasing insulin levels.

Operation

How to get pregnant with PCOS? Surgery may be an option to improve fertility if other treatments don't work. Ovarian drilling is a procedure in which tiny holes are made in the ovary using a laser or a thin, heated needle to restore normal ovulation and the possibility of pregnancy with PCOS. nine0019
Important! To determine the right treatment and choose the right drug, you need to consult a doctor!

Help Doc.ua: you can make an appointment with a gynecologist-endocrinologist on the website.

Polycystic ovary syndrome

Burlakova Elena Vladimirovna

Pediatrician

Clinic "Mother and Child" Kuntsevo,

The criteria for the diagnosis of PCOS are:

lack of ovulation (anovulation),

hyperandrogenism,

the presence of polycystic disease (multifollicular ovaries) with an increase in the volume of the ovaries according to ultrasound.

The diagnosis can be made if two of these three manifestations are present.

As a rule, the examination of a woman begins with an ultrasound examination of the pelvic organs. Often, if the conclusion indicates the presence of "multifollicular ovaries" (MFO), on this basis, the diagnosis of PCOS is erroneously established. The term "multifollicular ovaries" is simply a description of the ultrasound pattern, which reflects the presence of a large number of antral follicles in the ovaries. nine0019
Such a conclusion, of course, is one of the criteria for PCOS, but, I remind you that not one symptom, but two, is required for a diagnosis. The presence of MFN by ultrasound performed at the beginning of the menstrual cycle does not make it possible to judge from the presence or absence of ovulation in a woman's menstrual cycles. The detection of a large number of follicles in the ovaries and by ultrasound is the norm for young women! With preserved ovulation, the absence of menstrual irregularities, this treatment does not require and does not prevent pregnancy! nine0019
To diagnose anovulation, it is necessary to perform ultrasonic folliculometry (FM), preferably within 2-3 menstrual cycles. Moreover, when performing FM, you need to decide on the period until which it makes sense to wait for the appearance of the dominant follicle. This is where mistakes often happen. The fact is that most women have a menstrual cycle of 28-30 days, while ovulation occurs on days 14-16 of the cycle.

But, if this is the case for the majority, should it be so for everyone? No. The normal length of a menstrual cycle is 21 to 42 days. This means that with a 21 day cycle, ovulation occurs on days 7–8 of the cycle, but with a 42 day cycle? On the 20th day? No. With a cycle duration of 42 days, ovulation should occur on days 26-30 of the cycle. Thus, when folliculometry is stopped on the 14th-16th day of the cycle due to the absence of a dominant follicle, an erroneous conclusion is made about anovulation. Although, with a regular, but long (32–42 days) menstrual cycle, ovulatory function can be preserved. Such a delusion is very dangerous, because it entails the start of stimulation therapy in women who are planning a pregnancy, although, in fact, they do not need it. Conversely, women who are not currently planning a pregnancy get the wrong impression that there is no need for contraception, which leads to unwanted pregnancies and, as a result, to abortion. nine0019
The next symptom of PCOS is hyperandrogenism, which is an increase in the content of male hormones (androgens). This is a sufficient general statement. Characteristic of PCOS is an increase in testosterone, which is produced in excess in the ovaries. This can lead to appearances such as excessive hair growth on the skin of the abdomen, thighs and even the face (this is called hirsutism), as well as increased activity of the skin sebaceous glands, which is manifested by oily skin and a tendency to acne. But testosterone is not the only androgen in the body. nine0019
In addition, other male hormones are present in the body: androstenedione, DEHA, 17-OH progesterone, etc., which are produced mainly by the adrenal glands. Their determination is necessary during the examination in case of suspicion of PCOS, the presence of manifestations of hyperandrogenism, anovulation, but is not a sign of PCOS, since they are produced not in the ovary, but in the adrenal glands. So the determination of DHEA is necessary to exclude formations of the adrenal glands that produce hormones (hormone-producing tumors), the determination of 17-OH progesterone is performed to diagnose such a congenital disease as VDKN (formerly called adrenogenital syndrome - AGS), which can also lead to cycle disorders and anovulation, but, however, is not synonymous with PCOS and requires different treatment. With HCHD, there is at least a three-fold increase in the level of 17-OH progesterone, while a slight increase of 1-2 ng / ml or nmol / ml is neither a sign of HCHD nor PCOS, and, as a rule, is asymptomatic and does not require treatment. nine0019
Often, hormonal disorders in PCOS are accompanied by impaired insulin function (insulin resistance) and/or its excessive production (hyperinsulinemia). This leads to the fact that PCOS is accompanied by a complex of symptoms called metabolic syndrome (MS) and is manifested by obesity, hypertension, high cholesterol, and impaired glucose uptake. This manifestation of PCOS is dangerous with very serious consequences: if left untreated, type 2 diabetes mellitus, coronary heart disease, etc. develop over time, which is the main cause of death along with cancer. Insulin resistance, of course, requires medical correction with special drugs, but a woman herself can help the drugs work more efficiently. How? Weight loss, proper nutrition and regular physical activity. Agree, it is available to everyone. nine0019
It's time to move on to treating PCOS.

Speaking about the treatment of this disease, it is important to answer the question: is a woman planning a pregnancy at the moment or not? So, if pregnancy is not planned in the near future, then combined oral contraceptives (COCs) are the best suited to normalize the cycle, prevent and treat endometrial hyperplasia, dysfunctional bleeding, and cosmetic problems. These drugs are quite effective, inexpensive and easy to take, which allows you to solve these problems. nine0019
On the topic "COC - to drink or not to drink?" many copies have been broken, but there is still no tool more effective, safer and easier to use. Like any other drug, COCs have both contraindications and side effects, so these drugs should be prescribed by a doctor who has experience working with them, after identifying possible contraindications to taking, for example, a tendency to thrombosis. There are a lot of drugs from this group on the market now, and their tolerance can be quite different. But I am convinced that among the existing variety it is possible to choose the right drug, it just does not always happen the first time, even if the appointment is made by a very experienced doctor. Unfortunately, in the medical literature, there is no unequivocal answer to the question of how long it is safe to take COCs. Based on my own experience, I can say that on average this is up to 5 years. I emphasize that this is an average value - in each individual case, this issue should be resolved individually. nine0019
If a woman diagnosed with PCOS is planning a pregnancy, she needs to contact a reproductive specialist in a specialized clinic. Since for the onset of pregnancy it is necessary not only to make the menstrual cycle regular, but to establish the ovulatory function of the ovary, since without the release of the egg from the ovary, that is, ovulation, pregnancy is impossible. In such cases, ovulation induction is performed (stimulation of ovulation, stimulation of ovarian function) with the use of special preparations. nine0019
It is good if ovulation is stimulated by a reproductive specialist who knows ultrasound and can independently monitor the growth of follicles and prescribe appropriate drugs. Before using ovulation induction, it is necessary to perform a study of the patency of the fallopian tubes and a diagnosis of the state of the sperm in the husband/partner (spermogram, MAP test, strict morphology according to the Kruger criteria) and other examinations that are mandatory when planning a pregnancy. Since, unfortunately, the lack of ovulation may not be the only reason for the lack of a desired pregnancy. nine0019
Often, a replacement for ovulation stimulation is the appointment of progesterone preparations from days 16 to 25 of the cycle. However, this is not at all the case. The appointment of these drugs will help to even out the cycle, make it 28 days, may be an alternative to COCs for the prevention and treatment of endometrial hyperplasia, but will not help the onset of pregnancy. On the contrary, it's more likely to get in the way. The fact is that under the influence of these drugs, changes occur in the endometrium that are characteristic of the second phase of the cycle, that is, after ovulation has occurred, which allows you to get a menstrual-like reaction, but their effect does not extend to the ovary, does not allow you to establish ovulation. But, in the event that ovulation suddenly decides to occur (this happens, including with PCOS once a year or once every several years), then taking these drugs can desynchronize the development of the embryo and the preparation of the endometrium, and this is one of the necessary conditions for pregnancy . nine0019
Previously, to normalize the cycle and restore ovulation, the method of ovarian cauterization (“notches”, resection of the ovaries) was used, which was performed during laparoscopy. For a long time, this was almost the only means of restoring the functioning of the ovaries in the absence of special drugs, the wide availability of ultrasound and qualified reproductologists.
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