Infertility and PCOS

Ovulation disturbance is the most likely cause of infertility in women with PCOS who do not ovulate regularly, although other factors may contribute to fertility problems in some couples. The Yale PCOS Program provides state-of-the-art management of PCOS-related infertility. With one of the highest success rates in the region, our experts offer individualized management strategies to maximize success while minimizing the risks of ovarian hyperstimulation and multiple pregnancy in patients with PCOS.

Treatment begins with a basic infertility workup:
• Pelvic ultrasound
• Prenatal lab tests
• HSG (hysterosalpingogram) – X-ray of the uterus and fallopian tubes
• SHG (sonohysterogram) – saline ultrasound to determine uterine abnormalities
• Semen analysis
• Complete health assessment, including a risk profile for diabetes, heart disease and other diseases associated with PCOS
After reviewing these test results, we meet with
you to determine the best course of action.

Options include:
• Ovulation induction – A number of medications are available to induce ovulation in women with PCOS; dose and treatment duration are individualized:
– Clomid – orally administered fertility medication
– Gonadotropins – injectable fertility medications for those who do not respond to simpler treatments; more expensive with greater chance of multiple pregnancy
– Aromatase inhibitors – trigger ovulation in women; safer and less expensive than some alternatives
• Insulin sensitizing agents – Metformin has been shown to restore normal ovulation in some women with PCOS, may improve response to other fertility drugs, and has little or no risk of multiple pregnancies.
• In vitro fertilization (IVF) – removing eggs from your body, fertilizing them with your partner’s sperm, and implanting a fertilized egg into your womb. We utilize minimal stimulation and blastocyst culture and transfer strategies to reduce risks for such problems as ovarian hyperstimulation syndrome and multiple pregnancy.
• Lifestyle modifications – Because being overweight or obese may reduce a woman’s fertility, weight loss is highly recommended to improve fertility and pregnancy outcome. We provide a comprehensive lifestyle management program that includes weight management counseling.
• Optimizing Vitamin D status – Our ongoing research indicates lower pregnancy rates following IVF in women with low blood levels of Vitamin D. Vitamin D levels are assessed for all women attending the Yale PCOS Program and treatment provided to achieve normal levels.