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Sameh K. Toma, MD Medical Director North Carolina Center for Reproductive Medicine www.NCCRM.com 1 Thursday, March 29, 12

Polycystic Ovary Syndome (PCOS) and Fertility

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Medical Director of the North Carolina Center for Reproductive Medicine explains how Polycystic Ovary Syndrome (PCOS) affects fertility and how to diagnose and treat it.

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Page 1: Polycystic Ovary Syndome (PCOS) and Fertility

Sameh K. Toma, MDMedical Director

North Carolina Center for Reproductive Medicine

www.NCCRM.com

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Thursday, March 29, 12

Page 2: Polycystic Ovary Syndome (PCOS) and Fertility

Polycystic Ovarian Syndrome (PCOS)

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Page 3: Polycystic Ovary Syndome (PCOS) and Fertility

What is PCOS?Polycystic ovarian syndrome is a condition that impacts a woman’s endocrine system and can cause infertility. It affects 10 - 15% of women.

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Page 4: Polycystic Ovary Syndome (PCOS) and Fertility

What is PCOS?

Several names for PCOS:• Polycystic Ovarian Syndrome• Polycystic Ovary Disease• Polycystic Ovaries• Stein-Leventhal Syndrome• Polyfolicular Ovarian Disease

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Page 5: Polycystic Ovary Syndome (PCOS) and Fertility

What is PCOS?

Women with PCOS have:• Normal uterus• Normal fallopian tubes• Ovaries that contain many small follicles or cysts• Eggs in the ovaries don’t grow normally• Very abnormal ovulation• Difficulty conceiving without reproductive assistance

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Page 6: Polycystic Ovary Syndome (PCOS) and Fertility

Who does PCOS affect?

• Most common hormonal disorder among women of reproductive age• One of the leading causes of fertility problems• As many as 5 million women have PCOS in the United States• Can occur in girls as young as 11 years old• Common for women to have irregular or missed periods

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Page 7: Polycystic Ovary Syndome (PCOS) and Fertility

Symptoms of PCOS• Irregular or missed periods• Obesity• Extra hair on face and body• Thinning hair on the scalp• Fertility problems• Cause of miscarriage• Heart disease• Hypertension• Diabetes• Depression

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Page 8: Polycystic Ovary Syndome (PCOS) and Fertility

What causes PCOS?• Glucose intolerance due to defective insulin or insulin receptor• Carbohydrate digestion results in elevated insulin levels• Due to the connection between elevated insulin and testosterone in the body results in elevated testosterone levels• Elevation in testosterone levels causes most of the symptoms of PCOS

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Page 9: Polycystic Ovary Syndome (PCOS) and Fertility

How is PCOS diagnosed?• Ask questions about past health, symptoms and menstrual cycles• Do a physical exam to look for signs of PCOS, such as extra body hair and high blood pressure

• Check your height and weight to assess BMI (Body Mass Index)

• Do lab tests to check blood sugar, insulin and other hormone levels to rule out thyroid problems• Do a pelvic ultrasound to look for cysts in the ovaries

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Page 10: Polycystic Ovary Syndome (PCOS) and Fertility

How do we fix this?• Glucophage (Metformin) is a prescribed medicine that helps with digestion of sugar•Combination of low carbohydrate diet and Glucophage can improve symptoms• Results in decreases in insulin and therefore a decrease in testosterone• Once testosterone decreases, the symptoms of PCOS decrease• Ovulation improves• Easy to treat with Clomid• Continue Glucophage during pregnancy through 12 weeks to reduce risk of miscarriage

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Page 11: Polycystic Ovary Syndome (PCOS) and Fertility

How do we fix this?

Ovarian Drilling

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Page 12: Polycystic Ovary Syndome (PCOS) and Fertility

PCOS

• Q & A• www.PayItForwardFertility.org

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