Dubai: Starting a family is one of life’s biggest milestones, but for sufferers of polycystic ovarian syndrome (PCOS), pregnancy can be illusive or present itself with unforeseen complications.
Patients with PCOS can, however, look forward to starting a family, if their condition is properly managed. This was the message driven home at the latest Gulf News webinar, ‘PCOS and Pregnancy — How to ensure a positive outcome’. Three top experts from Fakeeh University Hospital in Dubai offered advice on pathways to pregnancy for women with the syndrome.
PCOS is a hormonal disorder common among women of reproductive age with around 20-25 per cent in the Gulf Cooperation Council (GCC) suffering from the condition. Women who have PCOS often have trouble conceiving due to the high levels of male hormone androgen produced as a result of the disease, interfering with the process of ovulation.
Dr Ahmed Hassoun, clinical professor and consultant endocrinologist, confirmed that PCOS was in fact the most common female endocrine disease and the most common cause of infertility.
Treatment for infertility
Dr Alaa Younus Mohammed, specialist obstetrician and gynaecologist, urged women with PCOS to look at it as a life-long metabolic disorder with long-term implications if not managed properly. Treatment for infertility always begins and ends with a healthy lifestyle, whether a patient is overweight or not, she said. She warned that women who are obese are more likely to struggle to conceive, as well as having a higher risk of miscarriage, gestational diabetes and pre-eclempsia.
Symptoms of PCOS can vary according to age and can be difficult to diagnose early on. Often patients with PCOS will present with some of the following symptoms: Missed or irregular periods, ovaries that are large or have many cysts, excessive body hair, weight gain, acne or oily skin, baldness, and infertility, explained Dr Jayacy Chandrassery Jayankar, specialist obstetrician and gynaecologist. She also emphasised that there are different types of polycystic ovaries, but not all will be diagnosed as polycystic ovarian syndrome.
Dr Hassoun discussed the need to treat insulin resistance for PCOS patients, or else it could lead to complications like type 2 diabetes, high blood pressure, infertility, as well as problems with the heart.
Keeping insulin in check
Dr Jayankar confirmed that patients are more likely to miscarry in the first trimester if insulin is not kept in check. Controlling insulin is also necessary to ensure that the baby’s weight is within the healthy range, allowing for a normal delivery rather than C-section.
All the doctors emphasised the importance of lifestyle modification as the first course of action for women with the diagnosis. For those who are overweight or obese, a healthy low-carb diet as well as regular exercise can go a long way to rebalancing weight and hormones and creating the ideal environment for conception and a healthy pregnancy.
But Dr Hassoun emphasised that patients should not expect exercise alone to bring about significant changes. Rather, 80 per cent of weight reduction relies on following a proper diet and only 20 per cent relies on exercise. While there are several diets that can assist in weight reduction, he recommended that patients follow a diet suitable for them that would be sustainable over the long term.
Reproductive treatments
When it comes to starting a family, beyond lifestyle modification, the doctors also discussed the range of the reproductive treatments and technologies available to women, including ovulation induction and IVF, underscoring that each case is different and will require a unique course of treatment.
Dr Alaa said that PCOS is hereditary and has a genetic component and that patients cannot control whether they have it or not. They should, however, feel empowered by the fact that they can manage it and in most cases will be able to experience a successful pregnancy and delivery.
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Dr Alaa and Dr Jayacy further spoke of the need for patients to be screened for anxiety and depression as PCOS symptoms can negatively impact a woman’s self-esteem and mental wellbeing.
Watch the full webinar on Gulf News’ agnc3 YouTube channel.
— In association with Fakeeh Hospital.