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Polycystic Ovaries (PCOS) & Fertility
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Dr Nupur Gupta High Risk Obstetrician
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PCOS affects fertility by disturbance of ovulation and excess of male hormones or insulin
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Polycystic Ovaries (PCOS) & Fertility
1.
1Copyright © 2014
Well Woman Clinic. All rights reserved. Polycystic Ovaries & Fertility Log on www.facebook.com/pcosclinic YouTube: BETTER HEALTH FOR WOMEN: WELL WOMAN CLINIC RADIO AN ONLINE EDUCATION INITIATIVE OF PCOS CLINIC • Does PCOS affect fertility & how? • What are the home remedies I can do to manage PCOS? • Medical Treatment options – insulin sensitizers, OVI • Surgical Treatment options – ovarian drilling • Will I be needing IVF for conception? Dr Anju Yadav Dr Nupur Gupta Fertility Consultant Gynecologis t 9818077238
2.
2Copyright © 2014
Well Woman Clinic. All rights reserved. The Mother of all Lifestyle Disorders in Women Polycystic Ovarian Syndrome/ PCOS Dr Nupur Gupta MBBS, MS, MICOG (Ex AIIMS) DIRECTOR, Dept of Obstetrics & Gynecology Fortis Memorial Research Institute, Gurgaon
3.
3Copyright © 2014
Well Woman Clinic. All rights reserved. DIFFICULT DIAGNOSIS Collection of signs and symptoms May be difficult to diagnose - Heterogeneous presentation - Features change with age No single test or feature is diagnostic of PCOS
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4Copyright © 2014
Well Woman Clinic. All rights reserved. INCIDENCE Affects 10 to 20% of females 20 to 30% have ultrasound appearance Most common hormonal disorder in women of reproductive age
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5Copyright © 2014
Well Woman Clinic. All rights reserved. WHAT IS PCOS? A health problem that can affect a woman’s Menstrual cycle, Ability to have children Hormones Heart Blood Vessels & Appearance
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6Copyright © 2014
Well Woman Clinic. All rights reserved. AGE GROUP Adolescent age (pubertal) Reproductive age
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7Copyright © 2014
Well Woman Clinic. All rights reserved. Clinical Presentation
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8Copyright © 2014
Well Woman Clinic. All rights reserved. SYMPTOMS Vary from woman to woman Irregular menstrual cycles (amenorrhoea 25%, oligomenorrhoea 85%, hypomenorrhoea) Difficulty in conception 50% Weight gain 40% Unwanted hair growth Acne
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9Copyright © 2014
Well Woman Clinic. All rights reserved. PCOD & INSULIN RESISTANCE High insulin levels – high androgens Hyperinsulinemia Insulin resistance IR (body cells do not respond normally to insulin)
10.
10Copyright © 2014
Well Woman Clinic. All rights reserved. DIAGNOSIS CLINICAL ULTRASOUND – multiple tiny ovarian cysts (STRING OF PEARLS) BIOCHEMICAL (blood tests) – hormones (LH FSH, Testosterone, DHEAS, Glucose tolerance test) ASSOCIATED TESTS - thyroid, prolactin, lipid profile
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11Copyright © 2014
Well Woman Clinic. All rights reserved. PCOD & WEIGHT GAIN Increase in abdominal fat as in males Apple figure (waist hip ratio) Rise in BMI
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12Copyright © 2014
Well Woman Clinic. All rights reserved. ANOVULATION Prevents release of eggs from the ovaries
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13Copyright © 2014
Well Woman Clinic. All rights reserved. LIFESTYLE MANAGEMENT: First Line Weight control Healthy Diet Regular exercise & physical activity
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14Copyright © 2014
Well Woman Clinic. All rights reserved. WEIGHT LOSS & MENSTRUAL CYCLES If 7% weight loss & 30 to 60 min of moderate physical activity Spontaneous menses Free androgen Free insulin Free testosterone SHBG
15.
15Copyright © 2014
Well Woman Clinic. All rights reserved. WEIGHT LOSS & FERTILITY In overweight anovulatory women Weight loss 6 Kg Resumption of ovulation 92% Pregnancy rate 65% Decrease in insulin & testosterone levels
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16Copyright © 2014
Well Woman Clinic. All rights reserved. MEDICAL TREATMENT Metformin - metabolic/glycemic abnormalities & menstrual irregularities Clomiphene, Letrazole, HMG - infertility IUI
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17Copyright © 2014
Well Woman Clinic. All rights reserved. SURICAL TREATMENT LAPAROSCOPIC OVARIAN DRILLING ADHESIOLYSIS ENDMETRIOSIS
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18Copyright © 2014
Well Woman Clinic. All rights reserved. HOW TO COPE WITH EMOTIONAL ASPECTS OF PCOS? Don’t feel embarrassed Don’t be depressed
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19Copyright © 2014
Well Woman Clinic. All rights reserved. Early diagnosis & treatment helps prevent long-term complications, such as infertility, metabolic syndrome, obesity, diabetes & heart disease Lifestyle management (weight loss & exercise) Metformin IS THERE A CURE FOR PCOS? CAN IT BE PREVENTED?
20.
20Copyright © 2014
Well Woman Clinic. All rights reserved. Thanks NEVER LOSE HOPE WE ARE THERE FOR YOU www.facebook.com/pcosclinic
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