Many women with polycystic ovary syndrome (PCOS) are often told that conception might be a challenge in the future. Indeed, PCOS is one of the leading causes of infertility, affecting about one in five women in the UK. Thankfully, you can explore many fertility treatments if you have PCOS, although these treatment options have their unique risks. Here is some insight to help you in understanding the problems involved with PCOS and fertility treatment.
Clomiphene Citrate (Clomid) Treatment Risks
Clomid is typically the first line of treatment recommended to boost fertility in women with PCOS whose infertility is due to ovulation problems. Clomid is used early on in the menstrual cycle to increase the chances of the ovary releasing an egg, enabling this egg to undergo natural fertilisation. However, one of the most widespread problems that arise from using Clomid to treat PCOS is the increased risks of multiple births since Clomid use results in the release of numerous eggs. Additionally, there is a slightly increased risk of ovarian cancer from long-term Clomid use, so many experts recommend using it in the short term only. Finally, Clomid affects how your body perceives estrogen, so it can impact your mood and lead to mood swings.
Metformin Treatment Risks
Metformin effectively addresses infertility in women with PCOS who do not ovulate and have no other reasons for infertility. It improves insulin’s function in the body, may reduce androgen production in the ovaries, and boost ovary function and ovulation rates. However, Metformin use can lead to transient gastrointestinal side effects like vomiting, loss of appetite, nausea, and abdominal bloating. This reality is because Metformin increases glucose uptake, lactate production, and the bile acid pool within your intestine, altering your gut microbiome.
Gonadotrophins Treatment Risks
Gonadotrophins are natural hormones the body produces to regulate ovulation. However, these hormones can be used to medically treat infertility in women who have experienced no success with Metformin, Clomid, and other treatments. Multiple gestations is a typical problem that arises from using gonadotrophins to treat PCOS. Gonadotrophins stimulate the release of multiple eggs so that this ovarian stimulation can result in multiple pregnancies. There is reportedly a 20%-25% occurrence of twins and a 5% occurrence of triplets in all gonadotrophin pregnancies. Furthermore, ovarian hyperstimulation syndrome is an exaggerated response that can occur with gonadotrophin treatment. This phenomenon arises due to overstimulation of the ovaries to produce more eggs than usual, resulting in nausea, diarrhoea, and chest pain.
Assisted Reproductive Technology Risks
Assisted reproductive technology is an excellent solution for women who fail to conceive naturally or use lifestyle treatments or medications to boost their fertility. In vitro fertilisation (IVF) is one of the most common treatments that a fertility specialist would recommend to address infertility. However, the procedure is costly and demanding and may be less effective in older women with unhealthy weights. Also, IVF may result in preeclampsia since women who undergo IVF do so under a cycle involving suppression of reproductive hormones, ultimately preventing the cells that maintain and help the body adjust to pregnancy from developing. Additionally, women undergoing IVF treatment may lack relaxin, the hormone that helps relax blood vessels, leading to preeclampsia.