For women with PCOS who are trying to conceive, treatment varies and may include:
- Ovulation drugs. Medications that stimulate ovulation. The main fertility issue that affects women with PCOS is the lack of ovulation. Therefore, ovulation medications are the first line of treatment for women with PCOS who wish to become pregnant. For women with PCOS, the ovulation drug most commonly used is clomiphene citrate. A second, more aggressive therapy may be used, involving injectable drugs called gonadotropins. These drugs trigger ovulation in almost all women with PCOS and can lead to pregnancy in most cases. Potential side effects of gonadotropins may include hot flashes, vaginal dryness and loss of bone density, among others. In addition, all ovulation drugs may put PCOS patients at an increased risk for multiple births.
- Antidiabetic agents. Medications that increase the body’s sensitivity to insulin normally used in the treatment of type 2 diabetes. Several studies have shown insulin–sensitizing agents, such as metformin, to be very effective in stimulating ovulation in women with PCOS. This type of treatment is usually prescribed if clomiphene therapy does not result in pregnancy when prescribed alone.
- Laparoscopic ovarian drilling. An outpatient surgery that involves the use of electrical or laser energy to burn holes in enlarged follicles on the surface of the ovaries. This type of surgery stimulates ovulation, regulates the menstrual cycle and increases a patient’s chances of becoming pregnant. However, the procedure is only used if other, less invasive methods fail because it increases the risk of pelvic adhesions, which can cause chronic pelvic pain. For women who smoke, this type of surgery may not be successful.
- In vitro fertilization (IVF). Another option for women with PCOS who are trying to conceive is IVF. This procedure involves retrieving mature eggs from a woman, fertilizing them with a man's sperm in a laboratory and implanting the embryos in the uterus three to five days after fertilization. IVF is sometimes recommended by physicians to reduce the chance of having multiple births, which is higher when using ovulation drugs.
