Polycystic Ovarian Syndrome (PCOS) Program

Polycystic ovary syndrome (PCOS) is one of the most commonly misdiagnosed conditions associated with female infertility. It is a prevalent yet intricate endocrine disorder marked by an imbalance of female reproductive hormones. Common symptoms include irregular menstrual periods, acne, and excessive facial or body hair growth. PCOS is often linked with obesity.

In addition to fertility issues, women with PCOS face an increased lifetime risk of conditions such as diabetes, uterine lining pre-cancer, cholesterol abnormalities, high blood pressure, sleep apnea, and depression. Effective PCOS management typically requires a multidisciplinary approach involving primary care physicians (for general health, weight loss, diabetes risk, high blood pressure, and depression), gynecologists (for gynecological health and uterine lining protection), endocrinologists (for hormonal issues, including hair excess and acne, obesity, diabetes, and elevated cholesterol), and reproductive endocrinology and infertility specialists (for pregnancy goals). Maternal-fetal medicine specialists may also be involved for fertility-seeking women at risk of gestational diabetes or pregnancy-related blood pressure problems. Mental health providers and nutritionists can also provide valuable support for improving overall well-being.

Our aim is to optimize the family-building goals of women with PCOS while prioritizing the overall well-being of both mothers and babies.

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Our Approach

For overweight or obese women with PCOS, lifestyle modifications focusing on diet and exercise can lead to significant improvements in menstrual cycles, acne, and mood. Metformin, commonly prescribed for diabetes, may also benefit overweight or obese women with PCOS, as well as some undergoing fertility treatment.

Treatment options for PCOS should be tailored to reduce symptoms (such as abnormal menstruation, acne, and excessive hair growth), address individual goals (such as fertility), and mitigate lifetime risks (such as diabetes, depression, heart disease, and uterine cancer). Treatment may include birth control pills with or without anti-androgens for acne and hair growth, as well as medications like metformin.

Our team is dedicated to helping patients with PCOS achieve their fertility goals through personalized treatment plans. Our approach begins with a comprehensive evaluation, including hormonal and metabolic profiling and an assessment of uterine and fallopian tube health. For couples in heterosexual relationships, semen analysis is a critical step. Endometrial biopsy may be recommended for women with irregular menstruation. Preconception consultations with high-risk obstetricians may also be advisable for those at higher risk of pregnancy complications.

For women with PCOS-related infertility, various treatment options are available, such as ovulation induction with medications like letrozole. Metformin may be added if the ovaries are unresponsive to these medications. Injectable hormones are less commonly used.

In cases where simpler treatments fail, assisted reproductive technologies like in vitro fertilization (IVF) may be recommended, particularly when there are concerns regarding tubal health or sperm quality.

Our multidisciplinary PCOS program aims to address the physical and reproductive issues that commonly arise when patients have this condition.