Posts Tagged ‘fertility treatment’

Polycystic Ovaries Linked to Pregnancy Problems and Heart Disease

Polycystic ovary syndrome (PCOS) is one of the most common causes of women not ovulating and can lead to fertility problems.

PCOS has also been linked to pregnancy problems and heart disease.

Women with the condition typically have small cysts around the edge of their ovaries.

Symptoms include irregular periods, problems with ovulation, weight gain, and excessive hair growth.

Women with PCOS are also more likely to have fertility treatment.

A new Swedish study just reported online in the British Medical Journal indicates that women with PCOS are at increased risk of pregnancy complications, regardless of whether they are undergoing fertility treatment.

The nationwide study on 3,787 births among women with PCOS found these women were 45% more likely to experience pre-eclampsia (pregnancy–induced high blood pressure) and were more than twice as likely to give birth prematurely or to develop diabetes while pregnant.

Fertility is not the only health consequence these women face, however.

PCOS has been associated with an increased risk for cardiovascular disease (CVD), the leading killer of women and men alike.

PCOS has been associated with increases in artery-clogging triglycerides (fats) and insulin resistance, which boosts the chances for diabetes, a risk factor for heart disease.

“Some women need intervention based on existing guidelines, either to control their blood sugar to head off diabetes, or reduce their cholesterol to moderate the risk of premature heart disease.

For the rest, it’s a matter of treating each woman based on their individual needs,” said Sarah Berga, MD, former Chair of the Department of Gynecology and Obstetrics at the Emory University School of Medicine, at the “The Physiology of Cardiovascular Disease: Gender Disparities” conference held earlier this week at the University of Mississippi in Jackson.

“We know that PCOS puts these women at risk for CVD-related disease, but we do not yet understand the extent to which it does so.”

Experts recommend that women with PCOS be periodically screened for diabetes and treated for it if they meet certain formal criteria.

However, drug treatment to forestall diabetes has not been endorsed and it has not been established that giving women with PCOS metformin will delay or prevent diabetes.

Metformin is an oral drug used to manage diabetes, either alone or in combination with sulfonylureas or other agents.

Fertility experts often prescribe metformin to treat PCOS.

To identify whether an infertile woman who has PCOS will benefit from metformin, simple tests are performed to see whether she has insulin resistance, says Zev Rosenwaks, MD, director and physician-in-chief of the Center for Reproductive Medicine at the Weill Cornell Medical College in New York.

“If she does, then I prescribe metformin,” says Dr. Rosenwaks.

“Over 2 to 3 weeks, she slowly builds up to the usual dose of 500 milligrams of metformin 3 times daily or 850 milligrams twice daily with meals.”

If the woman does not start ovulating regularly over the next 6 to 8 weeks, then he initiates treatment with the ovulation-stimulating drug clomiphene.

About three-quarters of women with PCOS who are not ovulating will ovulate on clomiphene at some dosing level, and about half will become pregnant.