Trying to get pregnant with pcos

How to Get Pregnant with PCOS

Polycystic ovary syndrome, or PCOS, is a hormonal condition that tampers with more than just your fertility, but you might first receive a diagnosis when you’re trying to get pregnant. This is because it’s a common — and treatable — cause of infertility in women.

According to the Centers for Disease Control (CDC), up to 12 percent of women in the United States have difficulty getting pregnant because of untreated PCOS. In reality, this number might be bigger because almost 50 percent of women with this syndrome don’t know they have it or are not diagnosed correctly.

Having PCOS doesn’t mean you can’t get pregnant. It just might be a bit trickier and you may need extra help. There is plenty that you can do at home and with medical treatment to keep PCOS symptoms at bay and raise your chances for a healthy pregnancy.

Getting pregnant with PCOS involves some of the same steps that women without PCOS should take for a healthy pregnancy.

Have your weight and body mass index (BMI) measured by your doctor. Your BMI shows whether you have a healthy body weight and how much of your body composition is fat. If you are carrying extra weight, talk to your doctor about how much weight you need to lose before you get pregnant.
Start a healthy diet and exercise plan. Get into the habit of choosing healthier food choices and being more active.
Use an ovulation calendar or app to track when you have your period. This helps you make a better guess about which days of the month you are more likely to get pregnant.
Check your blood sugar levels. See your doctor to make sure your blood sugar levels are balanced. Your blood sugar levels are important in getting pregnant, having a healthy pregnancy, and even in your baby’s future health.

Being overweight has been linked to PCOS, but many women who have this condition are not overweight at all. Still, if you are carrying extra weight, you may improve your fertility and reduce other PCOS symptoms by losing just 5 percent of your weight.

Exercise daily by going for a walk and getting in your steps. Use a standing desk rather than sitting down while you’re working. Lift light weights while watching TV as building more muscle helps bring down PCOS symptoms and improves your health.

Any woman who is trying to get pregnant needs to have the right levels of nutrients. Switch out sugary foods, simple carbs, and unhealthy fats for healthier choices, including:

fresh and cooked fruit and vegetables
whole grains like brown rice, oats, and barley
beans and lentils
chicken
fish

Certain vitamins and minerals are important for a healthy pregnancy and a growing baby. Ask your doctor about the best supplements for you. Supplements that may help fertility include:

folic acid (vitamin B9)
vitamin B6
vitamin B12
vitamin C
vitamin D
vitamin E
coenzyme Q10

Your doctor will test your blood sugar levels if you’re having trouble getting pregnant. PCOS sometimes leads to high blood sugar levels or type 2 diabetes. This may cause fertility problems.

This happens because PCOS may change how your body uses insulin. This important hormone moves sugar (glucose) out of the blood and into the muscles and cells where it is burned for energy. PCOS makes your body less sensitive to insulin — making it harder for it to do its job.

Balancing your blood sugar levels may help you get pregnant. Eat a healthy diet with more fiber, protein, and healthy fats. Getting plenty of daily exercise and strength training can also help your body use insulin better.

In some cases, your doctor might recommend medications to help balance your blood sugar levels. A common type 2 diabetes drug called metformin (or Glucophage) makes your body use insulin better to help lower high blood sugar. This can also help you get pregnant with PCOS.

You might need to take metformin in low doses and only temporarily, depending on your blood sugar levels. For best results, eat a healthy diet and exercise regularly along with taking any prescribed medications to help you get pregnant.

If you have high blood sugar levels or type 2 diabetes, it’s important to check your blood sugar levels with a home monitor every day.

Your doctor will check your blood sugar levels with tests, including:

random blood sugar test
overnight fasting blood sugar test
oral glucose tolerance tests (after fasting and drinking a sugary drink)
hemoglobin A1C test (checks your blood sugar levels for the last two to three months)

If you have PCOS your body might make more of both the male hormone testosterone and the female hormone estrogen. Too much (or too little) of these hormones can make it tricky to get pregnant. Your doctor might recommend prescription medications to help balance your hormones.

Medications to help you get pregnant with PCOS include:

metformin to balance insulin levels
clomiphene citrate (or Clomid) to help balance estrogen levels
birth control pills to balance estrogen and testosterone levels (before beginning fertility treatment)
fertility medications to jump-start the ovaries to send out more eggs

You may need in vitro fertilization (IVF) treatment to help you get pregnant with PCOS. Your fertility doctor will give you a checkup that may include more blood tests, ultrasounds scans, and a physical exam.

IVF is a process that can take months or even years whether you have PCOS or not. However, medical research shows that women with PCOS have a high success rate of getting pregnant with IVF treatment.

Some clinical studies found that women with PCOS who took birth control pills before the IVF treatment had better results. You may also need other mediations to help balance hormones and get your body ready for the IVF treatment.

For all women, the first step in IVF treatment is to eat a balanced diet and get plenty of exercise to reach a healthy weight. Women with PCOS who are a healthy weight are twice as likely to get pregnant with IVF than women with PCOS who are obese.

Before exploring IVF, your doctor might suggest a less-costly alternative called intrauterine insemination (IUI). This process increases the chance of pregnancy because it directly injects a high concentration of sperm closer to the egg.

PCOS may make it harder to get pregnant because it can impact your menstruation cycle (your monthly period). Symptoms include:

too few menstrual periods
having your period for longer than usual
not getting your period
very heavy periods
higher levels of male hormones like testosterone
acne breakouts
getting facial hair and extra hair in other places
small cysts or bundles of fluid in the ovaries
fewer eggs released from the ovaries

If you don’t get treated for PCOS, it also raises your risk for other health conditions, like:

type 2 diabetes
sleep apnea (snoring)
heart disease
high blood pressure
high cholesterol
stroke

No one knows why some women get PCOS. Nothing you did — or didn’t do— caused you to have this condition. But getting an early diagnosis and treatment along with making other lifestyle changes may help you get pregnant and prevent health complications from PCOS.

If you are trying to get pregnant with PCOS, you may only need treatment with medications. A medical study found that almost 80 percent of women with PCOS treated with the drug clomiphene citrate successfully ovulated. Out of these, half of the women got pregnant naturally within six period cycles.

If medications don’t help you get pregnant, your doctor may recommend IVF treatments. Most women with PCOS have a 20 to 40 percent chance of getting pregnant with IVF treatment. Women who are 35 years old and older or who are overweight have a lower chance of getting pregnant.

You can get pregnant with PCOS. You will likely need to have moderate weight, balance your blood sugar levels, and treat other PCOS symptoms with healthy lifestyle changes and medications.

In some cases, fertility medications alone will help you get pregnant. If that doesn’t work, you may need IVF treatment.

But regardless of what treatment you explore, don’t lose hope. Success rates are optimistic. In time you may be smiling, positive pregnancy test in hand.

I have PCOS and I want to have a baby, what do I need to know?

12 Feb 2019

This article is republished from The Conversation under a Creative Commons license.

Sara Holton, Deakin University and Karin Hammarberg, Monash University

Most women want and expect to have children. But women who have a chronic health condition such as polycystic ovary syndrome (PCOS) often have concerns about childbearing, including whether they can become pregnant.

PCOS is a complex hormonal condition which affects up to one in five women of reproductive age. Most women with PCOS have elevated levels of a type of hormone called luteinising hormone, which brings about ovulation, and reduced levels of a hormone called “follicle stimulating hormone”, which is essential for pubertal development and the function of women’s ovaries and men’s testes.

Women with PCOS also have an underproduction of oestrogen (“female” hormones) and an overproduction of androgens (“male” hormones). This causes tiny cysts on the surface of the ovaries.

Due to these hormonal imbalances, women with PCOS often have irregular menstrual cycles because they don’t ovulate or ovulate only occasionally. So women with PCOS are more likely to have trouble conceiving than other women.

While most women who have PCOS become pregnant, they often take longer to fall pregnant and are more likely to need fertility treatment than women without PCOS.

In a recent study by Monash University, women with PCOS took part in an online discussion group. They talked about their concerns about pregnancy and what they could do to improve their chances of falling pregnant, the sort of information they would like about fertility and PCOS, and when they would like to receive this information.

Their greatest worry was about whether they would be able to get pregnant. They also wanted to know how best to prepare for pregnancy and what they should do before trying to conceive. They had trouble finding up-to-date, relevant and reliable information.

Read more: Explainer: what is polycystic ovary syndrome?

How to increase chance of pregnancy

As for all women, being in the best possible health before trying for a baby increases the chance of pregnancy and gives the baby the best start in life.

According to the international evidence-based guideline for the assessment and management of PCOS, adopting a healthy lifestyle – including being in the healthy weight range, not smoking, cutting back on alcohol, eating a healthy diet, getting plenty of regular exercise and enough sleep – is the first thing to do to improve a woman’s chances of becoming pregnant and having a healthy baby.

To get the right kind of advice and support, women planning to get pregnant should have a preconception health check with their GP. This is also an opportunity to discuss a plan of action in case the PCOS causes fertility difficulties.

For women with PCOS who are overweight or obese, a modest weight loss sometimes results in more regular ovulation, which increases the chance of pregnancy. For those who know they ovulate, having sex during the “fertile window” (the five days leading up to and including ovulation) boosts the chance of conception.

Overall, women with and without PCOS have a similar number of children. john looy unsplash

Read more: Women's fertility: does 'egg timer' testing work, and what are the other options?

What are my options?

If you have tried for a baby for 12 months without success (or six months if you are aged 35 or over) it’s time to seek medical advice. Your GP is your first port of call, but she might refer you to a fertility specialist.

If you have very irregular or only sporadic periods, this is an indication you are not ovulating and need medical help to have a baby. The first line of medical treatment is ovulation induction. This involves a course of tablets or injections to stimulate the ovaries to release an egg that can be fertilised, either during intercourse or through intra-uterine insemination (IUI).

If this doesn’t work, there may be other reasons why pregnancy can’t be achieved and more invasive treatments such as IVF may be needed.

IVF involves a course of injections to stimulate the ovaries to produce multiple eggs. When they’re mature the eggs are retrieved in an ultrasound-guided procedure under light anaesthetic. Sperm are added to the eggs in the laboratory for embryos to form.

A few days later, an embryo is placed in the uterus where it may implant and grow into a baby. If there is more than one embryo, these can be frozen for later use if there is no pregnancy.

While IVF is safe in the hands of specialists, there are some possible health effects to be aware of, including ovarian hyperstimulation syndrome. This is an over-response to the fertility drugs that are used to stimulate the ovaries to produce multiple eggs. This can lead to abdominal pain, nausea and vomiting, rapid weight gain and blood clots.

Read more: Better health and diet well before conception results in healthier pregnancies

For more information

The Your Fertility website has more information on PCOS and fertility. The Centre for Research Excellence in Polycystic Ovary Syndrome has also produced a list of questions for women with PCOS to use in conversations with their healthcare provider and a fact sheet about PCOS, fertility and pregnancy.

While fertility problems are common among women with PCOS, it’s reassuring that, overall, women with PCOS and women without PCOS have similar numbers of children. And, although PCOS is associated with fertility difficulties, women with PCOS should also be aware conception is possible and effective contraception is needed to avoid pregnancy when it’s not wanted.

This article was co-authored by Louise Johnson, CEO of the Victorian Assisted Reproductive Treatment Authority (VARTA). Louise has no conflicts of interest to note.

Sara Holton, Research Fellow, Deakin University and Karin Hammarberg, Senior Research Fellow, Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

PCOS Fertility Pregnancy

How to get pregnant with polycystic ovaries?

Polycystic disease is a common hormonal disease that affects the functioning of 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.

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.

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. 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.

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).

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.

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.
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.

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.

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.

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.
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.
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.

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 to treat PCOS and help with infertility.

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.

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.

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.

Is it possible to get pregnant with PCOS?

Polycystic ovary syndrome (PCOS) is a pathological change in the structure and function of the ovaries, which is provoked by hormonal - endocrine, scientifically speaking, disorders in the body of a woman. The chain is as follows: hormonal failure leads to thickening of the walls of the ovaries, ovulation in PCOS is disturbed, because the mature egg cannot overcome such an obstacle and remains in the ovary. A “stuck” follicle fills with fluid and transforms into a cyst. This happens with each follicle that has matured during the menstrual cycle, therefore, over time, the ovaries are literally “woven” from many small cysts.

Many of us may wonder why endocrine disorders can lead to such consequences? What is the relationship between hormones and ovaries? In reality, everything is obvious: our puberty begins with the first hormonal changes - the ability to have children in principle. Therefore, a healthy endocrine system is the key to reproductive health.

Hormonal disorders and PCOS can lead to pathological changes in egg maturation and disruption of ovulation. PCOS is one of the most common causes of female infertility. But the cause is reversible, polycystic ovaries can be cured and is not an insurmountable obstacle to having children.

Pregnancy with PCOS is a reality if you undergo adequate treatment in time and, if necessary, seek help not only from gynecologists-endocrinologists, but also from reproductologists. Let's talk about this disease in more detail in order to understand what "enemy" we have to defeat. After all, forewarned is forearmed.

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Medical history

In modern gynecology and endocrinology, the occurrence and development of polycystic ovaries is undoubtedly associated with pathological changes in the activity of the hormonal system of a woman. At the same time, experts also identify the genetic factor of the disease, that is, we inherit it through the female line; diabetes mellitus and even overweight can provoke PCOS. Polycystic ovaries can be considered a multifactorial disease.

However, scientists say with confidence that PCOS provokes excessive production of male sex hormones - androgens in a woman's body. Androgens negatively affect oocytogenesis - the development of female germ cells and thicken the outer shell of the ovaries, which leads to disruption of ovulation. Therefore, ovulation with polycystic ovaries is quite rare. Let us explain why once again: even if the egg manages to mature - to turn into a follicle ready for fertilization, it cannot overcome the barrier from the deformed ovarian wall. There can be no talk about the process of further fertilization - the "meeting" of the sperm and the egg simply does not occur. Pregnancy with PCOS in this case is impossible. Therefore, when planning a pregnancy for each of us, it is necessary to exclude polycystic ovary syndrome. How to do it - we will find out right now.

Anxiety symptoms

The first thing every woman should pay close attention to is her menstrual cycle. An irregular cycle, frequent and prolonged delays, painful menstruation are a sure sign that some pathological changes are taking place in the body.

PCOS may have external manifestations: increased hair on the face and body, disturbed fat balance of the skin and hair, a tendency to acne - all this may indicate hormonal disorders in the body. And where there are hormonal disruptions, there is a high risk of developing polycystic disease.

It is worth paying attention to excess weight: of course, this can be a temporary phenomenon, we just spoiled ourselves with gastronomic excesses and forgot about the physical activity that is so necessary for the body. But persistent excess weight can be a risk factor for the development of a wide variety of diseases. Obesity can lead to pathologies of the endocrine system, and can also become a clear confirmation of serious hormonal disruptions. Therefore, if we observe at least one of the "alarming symptoms", while neglecting regular consultations with a gynecologist and endocrinologist, it's time to go to specialists.

Diagnosis of PCOS

Adequate diagnosis of polycystic ovaries traditionally includes several stages:

examination by a gynecologist-endocrinologist
ultrasound examination (ultrasound) of the pelvic organs c, 17-OH progesterone)
blood chemistry (PCOS may have elevated cholesterol, triglycerides and glucose levels)
oral glucose tolerance test to determine insulin sensitivity
in some cases, diagnostic laparoscopy is prescribed

Based on the examinations, the doctor can diagnose polycystic ovary syndrome, and, depending on the reasons that provoked it, recommend effective treatment. If we are planning a pregnancy with PCOS or polycystic disease - the main factor in infertility, the specialist will answer our main question, is it possible to get pregnant with PCOS and recommend how to get pregnant with polycystic ovary syndrome.

PCOS and pregnancy

It is impossible to get pregnant with PCOS because the woman does not ovulate. It would seem that to restore ovulation - and everything will be in order. Everything is not so simple, because, as we know, all systems in our body are interconnected, and for the best result, an integrated approach is needed. So, the first thing experts talk about is weight loss. Many women neglect this recommendation, but weight normalization is an important step in the treatment of PCOS. The second stage is general hormone therapy. It is necessary to eliminate the root cause of the disease - that is, hormonal failure in the body. The third stage is the stimulation of ovulation. Note that ovulation stimulation in PCOS may be necessary for women planning a pregnancy in the very near future. Stimulation of ovulation in PCOS is carried out after exclusion of the tubal infertility factor in a woman and the male factor in a couple.

If conservative treatment does not help, doctors may recommend surgery - laparoscopy, partial or complete resection of the ovaries. The decision on the method of surgical intervention largely depends on whether the woman plans to have children.