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Session on Enhancing Fertility in PCOS with Dr. Mala Raj

- 5 min read
written by Shield Connect

An issue of great concern is enhancing fertility in PCOS patients. This article talks about fertility in PCOS patients based on the session
with Dr Mala Raj, the current managing director of the FIRM hospital, Chennai. Here, the doctor talks about the natural improvement of fertility in PCOS during the lockdown. Other possible ways to improve fertility are discussed below.

Classification of PCOS
The attempts to classify PCOS are numerous, starting with the National Institute of Health (NIH) criteria in 1990. In 2006, the diagnosis of PCOS was suggested based on clinical biochemical hyperandrogenism in combination with other factors. In 2012, the NIH proposed the phenotype approach of PCOS.

The NIH consensus panel classified the PCOS based on four phenotype categories. When it comes to infertility, the PCOS affects women at different rates. It starts from ovulation to fertilization, implantation, fetal viability, and then a healthy live-born child.

Factors affecting fertility in PCOS
Various factors contribute to infertility in PCOS patients. The main factor in PCOS is anovulation, an ovulatory dysfunction. Another factor that affects PCOS is hyperandrogenemia and hyperinsulinemia. In obese women, the clinical pregnancy rates are low in both natural and assisted conceptions.

The pregnancy outcomes in women with PCOS, when compared with a control group, showed differences. They are at more risk of developing PIH, perinatal mortality, gestational DM leading to fetal macrosomia, and so on.

Management of fertility

Clinical management of fertility in women with PCOS is the first step. It is done through the introduction of mono ovulatory cycles, a step-wise approach. The approach involves a change in lifestyle and diet, oral medication, amongst others. Physical activity is crucial in the management of fertility.

Observations show that when obese women reduce some of their body weight, they present higher ovulation rates. They are advised to undergo at least 30 minutes of physical activity in a week. They also make some lifestyle modifications which includes nutrition.

Enhancing fertility
Asides from the above method of managing fertility, another way is through bariatric surgery. Studies show that the chances of fertility are boosted after bariatric surgery. Another procedure which gained attention is IVM also known as In Vitro Maturation.

Laparoscopic ovarian drilling is a form of fertility management as well. There is a lot of controversy around this procedure, but the recommended number of punctures per ovary is between 4 to 5. The size of the ovary also matters when determining the amount of energy source exposure required.

In conclusion, PCOS is treatable with lifestyle changes, medication, and proper diagnosis. Clinicians are to familiarise themselves with the several phenotypes of PCOS for an accurate diagnosis. The implications of PCOS affects women’s metabolic and psychological systems before, during, and after reproductive years.

To find out more in-depth knowledge about fertility in PCOS and the detailed process of managing fertility, you can watch the entire session with Dr Mala Raj.

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