Polycystic ovary syndrome: can you get pregnant? – 06/04/2021

Polycystic ovary syndrome: can you get pregnant? – 06/04/2021
Polycystic ovary syndrome: can you get pregnant? – 06/04/2021
Polycystic ovary syndrome (PCOS) is an endocrinological disorder, but frequent in gynecology, and affects up to 6 to 10% of women of childbearing age. It is characterized by the absence of menstruation and an increase in some hormones, besides it is among one of the main causes of infertility.

With the current knowledge we believe that PCOS happens due to genetic factors triggered by environmental issues such as lifestyle, nutrition and obesity, which acts both as a trigger and as a complicator. In addition, women who become pregnant have a higher risk of early abortion and gestational diabetes.

Approximately 50% of women with PCOS are obese, but this is not a disease exclusive to obese women and in the presence of signs suggestive of the syndrome all should be investigated, because in the long term women with PCOS may have diabetes mellitus, metabolic syndrome, hypertension and cardiovascular diseases.

The manifestations of PCOS can start near puberty and even delay the first menstruation, the symptoms can be: hirsutism (excessive hair growth), acne, seborrhea, alopecia (hair loss), acanthosis nigricans (brownish stain on the neck, armpits, groin and below breast), menstrual irregularity, obesity and ovarian cysts.

The diagnosis is made through criteria developed by the Androgens Society (2006) and Rotterdam (2004), and evaluates blood tests, patient history, physical examination and ultrasound with ovarian evaluation, however for those who are using hormonal contraceptives it may not be possible. possible to close the diagnosis.

For this investigation, the dosage of hormones should preferably be made between the fourth to the tenth day of the menstrual cycle for women with regular cycles and transvaginal ultrasound.

An obese patient with PCOS should not wait until weight reduction is started before treatment, as weight reduction can help. Lifestyle changes, with diet and exercise, should be considered, but with it other options can and should also be used.

The treatment of PCOS is complex because it addresses several different aspects and with particularities, depending on the expected objective, focusing on reducing the hormonal response to allow cycles to remain regular and reducing cardiovascular risks.

For most patients, weight loss of 5 to 10% may be sufficient to reestablish ovarian function and improve response to ovulation induction.

In all cases, a change in lifestyle, diet and weight reduction is indicated. Those who do not wish to become pregnant can use medications that alter the sensitivity to insulin, oral contraceptives, hormonal blockers and hormones to regulate the menstrual cycle.

Those who want to get pregnant can use medications that alter insulin sensitivity, stimulate ovulation, video surgery with ovarian perforations, transvaginal ovarian puncture and fertility treatment, such as fertilization in vitro.

With proper evaluation and treatment, women with PCOS can have regular menstrual cycles and those who wish can seek guidance and treatment for becoming pregnant.

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References:

SANTANA, Laura Ferreira et al. Treatment of infertility in women with polycystic ovary syndrome. Rev. Bras. Ginecol. Obstet., Rio de Janeiro, Vol. 30, n. 4, p. 201-209, abr. 2008;

MOURA, Heloisa Helena Gonçalves de et al. Polycystic ovary syndrome: dermatological approach. An. Bras. Dermatol., Rio de Janeiro, Vol. 86, n. 1, p. 111-119, Feb. 2011;

Clinical therapy in gynecology / [editores] Edmund Chada Baracat, Angela Maggio da Fonseca, Vicente Bagnoli, Barueri, SP: Manole, 2015.

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