polycystic ovary syndrome (PCOS) do not
ovulate regularly and often have difficulty becoming
pregnant. Although the medicine clomiphene (such as Clomid) is commonly used to
stimulate ovulation, it doesn't work for some women who have PCOS. This is because
PCOS ovulation problems are linked to an imbalance of multiple body systems.
Often other treatment measures can restore balance to the body's metabolism and
hormone system, making ovulation medicine unnecessary (or more effective if it
Before considering medicine to stimulate
ovulation, overweight women with polycystic ovary syndrome are advised to lower
body mass index (BMI) with diet and exercise. Even a
modest weight reduction may trigger ovulation in women who have PCOS.
If weight loss does not help start ovulation,
clomiphene is usually tried first.
If clomiphene does not start
ovulation, it may be combined with another medicine, such as metformin, to
start ovulation. Combining the two treatments may make it more likely that clomiphene will trigger ovulation in women who have PCOS.
Women who do
not ovulate with a combination of medicines are sometimes treated with
gonadotropins, which are similar to the hormones the body produces to start
ovulation. During this type of treatment, a woman must have daily monitoring of
egg follicle development, using blood tests and ultrasound, to prevent
ovarian hyperstimulation syndrome.
clomiphene does not work, your doctor may try a medicine called letrozole.
Letrozole is thought to harm the fetus if it is used during pregnancy. Talk to
your doctor about being sure you are not pregnant before taking this
Laparoscopic ovarian surgery such as ovarian drilling
(partial destruction of an ovary, which can trigger ovulation) or in vitro
fertilization (IVF) are sometimes used for women with PCOS who have tried
weight loss and fertility medicine, but still are not ovulating.1
For more information, see the topic Polycystic Ovary Syndrome (PCOS).
Although some people still think of fertility as a "woman's problem," a third of all cases of infertilty involve problems solely with the male partner. Infertility in a man may be the sole reason that a couple can't conceive, or it may simply add to the difficulties caused by infertility in his partner.
So it's crucial that men get tested for fertility as well as women. It's also important that men do it early. Though some guys may want to put off being tested -- possibly to avoid embarrassment...