About: R F

 

What is PCOS?

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects roughly 10% of women of reproductive age. Women with PCOS may have infrequent menstrual periods (anovulation) and may exhibit an increase in male hormone (androgen) levels resulting in excessive hair growth. Women with PCOS can demonstrate numerous small sacs of fluid in their ovaries (ovarian cysts) on ultrasound examinations due to the failure of releasing eggs regularly. PCOS is frequently correlated with infertility in women.

 

Symptoms:

• Irregular Ovulation/Menstrual Cycles: Women with PCOS typically have fewer periods, heavier periods or no periods at all as compared to women without PCOS. Irregular menstrual cycles is the most common symptom of PCOS as women with PCOS do not ovulate on a regular monthly schedule.
• Excessive Body Hair (Hirsutism): Hirsutism is the excessive growth of dark facial or body hair on women. Hirsutism may appear on the chest, arms, legs, face, chest, back or abdomen.
• Weight Gain: Women with PCOS may have higher levels of male hormones and demonstrate less sensitivity to insulin, commonly referred to as being "insulin-resistant." Many women with PCOS may be overweight or obese. Increased body weight with PCOS is correlated with insulin resistance which makes it difficult for their body to use the hormone insulin. Insulin normally helps convert starches and sugars from the foods we eat into energy.
• Thinning Head Hair: Thinning hair due to the effects of male hormones (androgens) is called androgenic alopecia and can be seen in women with PCOS.
• Acne: Excessive androgen production can increase sebum production resulting in acne in PCOS women.

Do You Have PCOS?

If you are concerned that you have PCOS and are having difficulty with trying to become pregnant, it may be time to have an evaluation with a fertility specialist. While there is no one test to definitively diagnose PCOS, a fertility specialist is likely to evaluate your medical history, including your menstrual cycles and weight fluctuations. A physical exam will include checking for signs of acne, excess hair growth and insulin resistance. In addition, your doctor will likely perform a transvaginal ultrasound to inspect the ovaries and the thickness of the uterine lining and/or blood work to measure hormone levels and other potential markers.

Your first step to help figure out why you may be having challenges becoming pregnant is to schedule a New Patient Appointment ​here​.

 

Many cases of female infertility are due to problems with ovulation. Without ovulation, fertilization cannot occur. Signs that a woman may not be ovulating normally include irregular or absent menstrual periods.

 

Ovulation problems may be caused by one or more of the following:

• Polycystic ovarian syndrome (PCOS)
• An imbalance of hormones
• Thyroid issues
• Shortened menstrual cycles
• A cyst or tumor in the reproductive system
• Eating disorders such as bulimia or anorexia
• Excessive alcohol or drug use
• Excess weight/obesity
• A significant loss of body fat due to intense exercise
• High levels of stress

Trouble conceiving can be caused by a blockage or damage to one or both fallopian tubes. In order for an egg to be fertilized, sperm must travel through the fallopian tubes to meet the egg. If the sperm and egg cannot meet, fertilization can not occur.

 

Reasons fallopian tubes may be damaged, blocked or cause infertility:

• STIs- Sexually transmitted infections (STIs) such as chlamydia and gonorrhea have been known to cause damage and scar tissue to form in the fallopian tubes and could be a contributor to infertility. PID (Pelvic Inflammatory Disease) is most commonly caused by the progression of chlamydia or gonorrhea and can cause damage to other reproductive organs as well.
• Ectopic pregnancy- An ectopic pregnancy occurs when a fertilized egg (embryo) implants in the fallopian tube (most common) or other abnormal areas such as ovary or cervix instead of the uterus. An ectopic pregnancy, if caught early enough, can be treated medically with Methotrexate to successfully cause dissolution, or if recognized later, may need to be surgically removed from the fallopian tube before tubal rupture occurs. If one or both fallopian tubes have been removed due to a previous ectopic pregnancy, assisted reproductive technology can still help to become pregnant.
  
• Tubal Irregularities- Abnormalities in fallopian tubes can be the result of birth defects, previous pelvic surgeries, scar tissue, inflammation, endometriosis, and other less common issues. All of these tubal irregularities potentially can hinder conception.

At your fertility evaluation appointment, we will discuss if you are at risk for tubal issues and discuss next steps to help you conceive. Click here to schedule your appointment.

 

 

Fertility in the Aging Female

 

Generally speaking, a woman’s fertility peaks in her early to mid-twenties, with the average woman’s fertility peaking around age 24. Fertility then starts to gradually decline at about age 27 and drops off dramatically after age 35. The age-related loss of female fertility is related to both the decline in quality and quantity of eggs that exist over time. As fertility begins to decline, miscarriage rates increase due to the larger proportion of chromosomally abnormal eggs remaining as women age or aneuploidy. Aneuploidy is the presence of an abnormal number of chromosomes in a cell, for example a human cell having 45 or 47 chromosomes instead of the usual 46.

 

 

Fertility In Your 20s

A woman has her best chance of successfully conceiving in her early 20s. Women under age 25 have a 96 percent chance of conceiving within a year if they are attempting conception each month with a fertile partner, or roughly a 25% chance of getting pregnant each month that she tries. That means that for every 100 fertile under-25-year-old women attempting pregnancy in 1 cycle, 25 will be successful and the other 75 will have to try again.

If you’re in your 20s and are having trouble becoming pregnant after 12 months of trying, please click here to schedule a fertility consultation appointment with Dr. Davies. Always know that if you ever feel anxious or concerned about your fertility, Dr. Davies is more than happy to meet with you and answer any questions that you may have.

If you’re in your 20s or early 30s and want to become pregnant someday, but are not ready at this time, consider learning more about egg freezing to see if this option is the right choice for you.

 

Fertility In Your 30s

Fertility begins to gradually decline around age 27 and into the 30s, then drastically decreases after age 35. A healthy, fertile 30-year-old woman has a 20% chance of getting pregnant each month that she tries to conceive with a fertile partner. Overall, for every 100 fertile 30-year-old women trying to become pregnant in 1 cycle, 20 will be successful and the other 80 will have to try again. Roughly 30 percent of women at age 35 may take a year or more to conceive.

If you’re under 35 and have been trying unsuccessfully to become pregnant for 12 months or more, or age 35 or older and have been unsuccessful conceiving in 6 months or more, please click here to schedule an appointment for a fertility consultation with Dr. Davies. No matter your question or concern, she is always willing to meet with you.

If you’re in your 20s or early 30s and want to become pregnant someday, but are not ready at this time, consider learning more about egg freezing to see if this option is the right choice for you.

 

Fertility In Your 40s and Beyond

By age 40, a woman’s chance of conception is 5% or less per cycle. This decrease in conception rates is largely correlated to the higher rate of chromosomally abnormal eggs that remain as we age. The average age for menopause is 51, but most women become unable to have a successful pregnancy sometime in their mid-40s. These percentages are true for natural conceptions as well as conceptions achieved using fertility treatments, including in vitro fertilization (IVF), but of course there are always rare outlying exceptions. The use of donor oocytes (eggs) is an option for women whose fertility has declined yet they still desire to carry a pregnancy.

If you are in your 40s and attempting to conceive, you may want a consultation and evaluation with Dr. Davies sooner. Please click here to schedule a consultation appointment to discuss your fertility options with Dr. Davies. We will thoroughly guide you through all treatment options to help you decide what is the best way to help you achieve your dream of having a child.

Some women may choose to explore using donor eggs. To find out more about when and why some women choose to use donor eggs, click here.