Polycystic Ovarian Syndrome (PCOS): What is it and what are its symptoms?

Polycystic Ovarian Syndrome (PCOS) is a condition that affects woman’s menstrual cycle, fertility and hormones. Women develop PCOS when they have high levels of androgens, sometimes called male hormones. This hormone makes ovulation rare or irregular.

Symptoms of PCOS include:

• Infrequent, irregular, or absent menstrual cycles

• Infertility due to irregular or absent ovulation

• Increased hair growth on face, neck, stomach, back, hands, and feet

• Acne or oily skin

• Dandruff

• Pelvic pain

• Weight gain

• High cholesterol

• High blood pressure

• Thinning hair

• Skin tags

• Dark or thick skin located on the neck, arms, thighs, and/or breasts

• Increased hair growth on face, stomach, back, hands or feet

• Sleep Apnea

Usually women with PCOS are likely to have a relative with PCOS as well, leading researchers to believe there may be a genetic factor. Many women with PCOS also struggle with weight issues. The main culprit is insulin -.  Excess insulin in a women’s body causes a production increase of androgen, causing irregular ovulation.

Normally a woman ovulates when an egg-containing follicle develops and releases a mature egg. Polycystic Ovarian Syndrome keeps those follicles from growing; the follicles build up in the ovaries and form small cysts that release estrogen and excess androgens. The combination of estrogen and androgens disrupts the production of other hormones that help ovulation to occur.  

The primary fertility problem with PCOS is the lack of ovulation or late ovulation. If a woman struggles with weight issues, losing weight will improve ovulation, and a low carbohydrate diet is key such as our own Dr Sharara’s app “The Infertility Diet” which will be available in the App Store on February 3rd. Prescribing insulin-sensitizing drugs such as Metformin helps many PCOS women ovulate on their own or respond better to drug treatment. Fertility drugs like Clomiphene and Gonadotropins may be prescribed to help ovulation occur if Metformin and life style changes are not enough to achieve ovulation. Multiple pregnancy remains a major concern for women using Gonadotropins.

Another fertility option for woman with PCOS is in vitro fertilization (IVF). IVF creates the best opportunity of getting pregnant during a menstrual cycle because it gives doctors better control and allows for the transfer of a single embryo.

Dr. Sharara at the Virginia Center for Reproduction Medicine will evaluate a woman’s symptoms, review their medical records and conduct a physical exam and blood test to evaluate hormone levels to assist women with PCOS get pregnant. For more information, please visit http://www.vcrmed.com/fertility-reston-va/pcos/

Trying to conceive after being on birth control

A common question we are asked at the Virginia Center for Reproductive Medicine is “How long does it take birth control to wear off?”

Some women take birth control to prevent a pregnancy, while others take it to regulate their periods.

Once a woman decides to stop taking birth control to conceive, it only takes about a week for the hormones to leave your system. Your body will then begin to function on its own and produce follicles again, leading you to ovulate.

Each woman’s body is different, it may take a couple of week to ovulate and for others it may take several months. On average, it takes two to three months for your body to regulate. Whether you have been on birth control for a few months or several years, your body should go back to ovulating fairly quickly, regardless of the time period. However, if you had problems with ovulation before starting the pill, the same issues may still be there. If Dr. Sharara deems it necessary, medication to induce ovulation may be prescribed.

There are no known issues involved with getting pregnant after stopping birth control. It is recommended to wait at least one period cycle before trying to conceive. This will help Dr. Sharara determine your time of ovulation and better calculate your birth due date. 

When you are ready to conceive, you can contact Dr. Sharara at 703-437-7722 or request an appointment by visiting: http://www.vcrmed.com/

Endometriosis: What is it and how does it affect fertility?

Endometriosis, also referred to as ‘endo’ occurs when endometrial tissue is found outside the uterus, usually on the ovaries, fallopian tubes or ligaments that support the uterus. The condition affects at least 5 million women in the United States.

Endometriosis is more common in women who:

·      Are between 30-40 years old

·      Have not had any children

·      Have periods lasting longer than 7 days

·      Have cycles shorter than 28 days

·      Have another family member with the condition

If Dr. Sharara suspects a woman may have endometriosis he will perform a pelvic exam to check the ovaries, uterus and cervix for any abnormalities.  An exam may reveal a cyst or internal scarring due to endometriosis. In some cases an ultrasound, or MRI will be used to help with diagnosis. A Laparoscopy is the only sure way to determine if a patient has endometriosis. The procedure consists of inflating the abdomen with gas through a small incision in the naval. Dr. Sharara will take small pieces of tissue for a biopsy.

The symptoms of Endometriosis are:

·      Above average pain before and during a menstrual cycle

·      Pain while having intercourse

·      Infertility

·      Fatigue

·      Painful urination and bowel movements during a menstrual cycle

·      Gastrointestinal issues like diarrhea, constipation, and nausea

Women can live their whole lives with endometriosis and not be aware they have the condition until they have difficulty getting pregnant. Infertility affects about 1/3 of women with endometriosis but the reasoning is not completely understood. Luckily there are medical treatments available to overcome fertility and pregnancy can even relieve some of the symptoms of endometriosis. Because hormones cause endometriosis, hormone treatments like birth control pills, or GnRH agonists are effective at treating the symptoms of endometriosis. For women trying to conceive, a laparoscopy may be performed to remove or vaporize the tissue as a way to improve fertility in women. However, in most cases a laparoscopy can be avoided and treatments such as ovulation induction/IUI or IVF are recommended instead.

Virginia Center For Reproductive Medicine (VCRM) is a world renowned fertility clinic led by Dr. Sharara - a highly regarded, published and awarded specialist. To learn more about VCRM, please visit www.vcrmed.com. 

If you have specific questions, please contact Contact VCRMED at info@vcrmed.com or call 703-437-7722 to schedule a personalized consultation. Dr. Sharara will gladly answer any questions you may have.

What is FET?

FET, also known as Frozen Embryo Transfer is a process in which frozen embryos from a previous fresh IVF cycle are thawed and transferred into the woman’s uterus. Healthy embryos produced from an IVF cycle but not transferred to the patient can be frozen and stored. FET is the most effective way for women to preserve their fertility.

Women consider FET as an option to avoid the risks, costs and inconvenience of fertility drugs and undergoing egg collection multiple times. Patients who had an unsuccessful cycle or ready to expand their family again will have the FET option waiting for them.

When a couple decides they want to proceed with the FET cycle, an ultra sound is performed and medications will be given to optimize the lining of the woman’s uterus for implantation. Estrogen and progesterone injections will be given for 2-3 weeks and Dr. Sharara will check the uterine lining before beginning the implantation. Embryo thawing only takes an hour or so and the quality of the embryos is thoroughly checked for a positive transfer outcome. Patients will find that going thru the FET process is easier and less intense than an IVF cycle.

The success rate of an FET cycle is about the same as a fresh IVF cycle, the fundamental factor for success is the maternal age at the time of the embryo freezing. Many of our patients wait several years before going thru the FET process. Rest assured, no matter the amount of time between embryo freezing and thawing patients can rely on the same embryo quality because frozen embryos are suspended in time and do not age.

The Virginia Center for Reproductive Medicine Frozen Embryo Success Rate results for January 1, 2014-June 30, 2014 can be seen here:

The complete Frozen Embryo Transfer Results for 2013 are shown here:

 We are happy to offer guidance or answer any questions you may have. Please click here to Schedule a Consultation: http://www.vcrmed.com/