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Apr24
Pcos-Infertility- Treatment With Medicines Only
How PCOS is related to the infertility?
Women with PCOS have good number of eggs inside the follicles but they cannot be released (Ovulation). As a result, sperms cannot meet the eggs, leading to infertility. Additionally, obesity, diabetes, high testosterone and insulin level all can be risk factors for infertility.

How PCOS is treated?
Unfortunately, there is no cure for PCOS. However, it can be kept under control. You should aim to keep your weight to a level that is normal. Losing only a small portion of weight will improve regularity of your periods, ovulation and also the chance of pregnancy.

Some women are prescribed “Insulin sensitizers” like inositol and metformin.

Treatment of fertility depends on your age, duration of infertility and other fertility factors. Usually the first line of treatment is OI (Ovulation Induction).

What is "Ovulation Induction" (OI)?
OI means taking medicines to help the follicles (fluid filled sacs in the ovaries, containing the eggs) grow and ovulate (rupture, releasing the eggs), to improve the chance of pregnancy. The medicines may be in the form of tablets or injections.

What tests should be done before OI?
The condition of your tubes (HSG), Ovaries (AMH, TVS) and husband's sperms (Semen Analysis) should be checked. In addition, blood group, Thalassemia screening and Rubella testing should be done to ensure that your baby should not have any problem during and after pregnancy. Do not conceal from your doctor, if you received any OI before.

How OI is done?
Oral tablets are usually started from day 2/ 3/ 4 of the period for 5 days. TVS Follicular Study is done from day 8/9, once in every 2-3 days (until day 14-16) to confirm that the medicine is working.

Is it necessary to undergo TVS Follicular Study while doing OI?
It is important to know whether the medicine given for OI is acting for you (ovaries are responding and ovulation is happening). If medicine is not working, then taking the same for several months, is the waste of time, money and energy. If the medicine is working in the first month, as confirmed by TVS, you can take the medicine for next few months without need of further TVS.

What's the success rate of OI?
If OI is done with oral medicine, the success rate is 15% per cycle. That means, out of 100 women taking the tablet, having regular intercourse and undergoing TVS Follicular Study, 15 will conceive at the end of one month.

When OI should NOT be done?
1. If you already tried OI for more than 6-9 months. Here OI in unlikely to succeed.

2. If both of your Fallopian Tubes are blocked. Here OI will not help.

3. If the husband has very low or absent sperm count / motility/ morphology. Here OI will not help.

How long OI can be done?
How long you can take OI, depends on your age and the duration of infertility.It is useless to take the medicines for OI years after years. Pregnancy should happen within 6-9 cycles of OI.

If oral tablets has been tried for 4-6 months, it's better to add injections for next 3-4 months.

If still pregnancy cannot happen, it's better to consider IUI or IVF.

Conclusion-
Most of the women with PCOS can conceive with simple OI only.


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