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Apr24
IVF in PCOS- When it is needed
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. 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.

Is IVF ONLY treatment for PCOS?
Treatment of PCOS-Infertility depends on your age, duration of infertility and other fertility factors. Usually the first line of treatment is OI (Ovulation Induction). If patient fails to conceive with OI, then IUI is offered. If IUI also fails, then ONLY IVF is usually advised. Therefore, majority of the women with PCOS conceive without IVF; especially if they are young (age less than 35 years), infertility duration is short, husband;s sperm condition is OK and Fallopian tubes are alright.

When IVF is suggested for PCOS?
If your age is on the higher side (age more than 35), infertility duration is of longer time, husband's sperm reports are not good or your fallopian tubes are blocked then you should consider IVF. Moreover, if you tried OI several cycles (4-6 cycles) with oral tablets and injections and also tried IUI 3-4 cycles, the chance of pregnancy is low, without IVF. Therefore in that case, you should seriously consider IVF.

What should you do before IVF?
First of all please remember, the success rate of IVF is only 40-50%. That means out of 100 couples undergoing IVF, 40-50 can conceive after the first cycle. Some may need additional cycles. Keep your weight normal. reducing weight helps to improve success rate of IVF.

How IVF is done?
You will be given some injection (gonadotrophin) to promote growth of the follicles (fluid filled sacs in the ovaries containing eggs). Injections are NOT painful and are needed to be taken under the skin. You have to come to TVS (ultrasound by putting probe in the vagina) follicular study regularly to see if the follicles are growing. Usually, injections are needed for 10-12 days. After that, under anaesthesia, eggs are collected from your body by inserting small needle. The eggs are then fertilized with the sperm to produce the embryos. The embryos are then frozen and are transferred after 2-3 months.

Why embryos are not transferred in the same cycle and are frozen?
In PCOS, there is a risk called, OHSS (Ovarian Hyperstimulation Syndrome), where excessive number of focllicles can develop, leading to fluid accumulation in tummy and chest. It may turn serious, sometimes. Therefore, if we freeze the embryo, the OHSS severity decreases. At the same time, during IVF, we give some medicines to reduce the risk of OHSS, ask to come for regular monitoring and request the women to take protein rich diet and plenty of water.

Overall, the success rate is higher in PCOS, after IVF, compared to other causes of infertility.


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