How to Manage PCOS

By Dr. Jessica McLaughlin

September is Polycystic Ovarian Syndrome Awareness Month and its goal is to empower women with PCOS to prioritize their health and open doors to get their questions answered.

PCOS is a syndrome meaning that affects multiple organ systems.  It is known to affect fertility through irregular ovulation, but is also associated with obesity, insulin resistance and obstructive sleep apnea.  The diagnosis of PCOS can be controversial and assessment and management inconsistent.  Because of this, in 2018, international guidelines were published on PCOS.  This publication was so prominent that it was actually published in 3 different medical journals simultaneously.

The publication specifically addressed assessment and treatment of infertility in women with polycystic ovarian syndrome.  It emphasized that factors such as blood glucose, weight, blood pressure, exercise and mental and emotional health need to be optimized in women with polycystic ovarian syndrome to improve reproductive and obstetric outcomes.

Letrozole should be considered a first-line medication for ovulation induction in women with polycystic ovarian syndrome and infertility related to anovulation with use of gonadotropins (injectable FSH) as either the first or second line.  The guidelines also specifically address in vitro fertilization as an appropriate therapy when first-line ovulation induction has failed. The publication emphasized treatment strategies used during IVF to optimize success rates and lower the risk of overstimulation of the ovaries including use of metformin, a GnRH antagonist cycle, triggering before egg retrieval with Lupron and choosing a freeze all cycle.

If you have infertility and PCOS or think you may have PCOS, we are here for you. Using the most updated guidelines and years of experience, we will work to answer your questions and make a treatment plan that is right for you.