Polycystic Ovary Syndrome

WEBVTT 00:00:05.800 --> 00:00:10.400 PCOS or polycystic ovary syndrome, is a tricky diagnosis that unfortunately 00:00:10.425 --> 00:00:12.580 affects a lot of our patients. 00:00:12.605 --> 00:00:15.920 Somewhere between 6 to 10% of the reproductive age population may 00:00:15.945 --> 00:00:18.140 be impacted by this condition. 00:00:18.165 --> 00:00:20.580 And its name is a bit of a misnomer. 00:00:20.605 --> 00:00:25.360 The word cyst or cystic often alludes to a problem within the ovaries. 00:00:25.385 --> 00:00:30.360 But in fact the word cyst simply means a fluid filled sac, and we know that part of 00:00:30.385 --> 00:00:33.580 this condition is having a really high egg number. 00:00:33.605 --> 00:00:37.040 That is in part how it gets its name because women with polycystic ovary 00:00:37.065 --> 00:00:41.720 syndrome typically have a lot higher egg count or quantity of 00:00:41.745 --> 00:00:44.380 eggs than other women their same age. 00:00:44.405 --> 00:00:49.000 But PCOS is interesting in that we don't yet understand completely how or why 00:00:49.025 --> 00:00:52.500 it occurs or who it impacts directly. 00:00:52.525 --> 00:00:55.735 And then similarly, we don't have a single test to diagnose it. 00:00:55.760 --> 00:00:58.880 This is different from other conditions in medicine where you can take a single blood 00:00:58.905 --> 00:01:02.920 test and know if you do or do not have the condition. 00:01:03.040 --> 00:01:06.320 Unfortunately, this is also why polycystic ovary syndrome is really difficult to 00:01:06.345 --> 00:01:09.655 diagnose, and it's often a delayed finding for many patients, 00:01:09.680 --> 00:01:12.160 and they've sadly had to see many providers sometimes before 00:01:12.185 --> 00:01:14.020 this diagnosis is aborted. 00:01:14.045 --> 00:01:17.620 You have to meet two out of three conditions in order to quote 00:01:17.645 --> 00:01:19.340 be diagnosed with this. 00:01:19.365 --> 00:01:24.175 Those conditions are in most terms high ovarian reserve or egg count that 00:01:24.200 --> 00:01:25.380 is above what we would expect. 00:01:25.405 --> 00:01:29.740 Additionally, the cornerstone to this diagnosis and probably the one that most 00:01:29.765 --> 00:01:33.340 people identify with when they are seeking treatment for this is 00:01:33.365 --> 00:01:35.100 irregular ovulations. 00:01:35.125 --> 00:01:40.735 For some women is an extension of their regular period by five to ten days beyond 00:01:40.760 --> 00:01:42.120 what their normal cycle length would be. 00:01:42.145 --> 00:01:46.100 Other women may skip periods for almost an entire year. 00:01:46.125 --> 00:01:50.200 The third criterion is evidence of excess testosterone production or androgens. 00:01:50.225 --> 00:01:54.290 This can be in laboratory form, or it can be in clinical signs. 00:01:54.320 --> 00:01:57.490 Some of those could include extra hair growth more than you would expect, 00:01:57.520 --> 00:02:01.900 chin, upper lip, inner thigh are common locations for women affected by this, or 00:02:01.925 --> 00:02:05.620 even male pattern baldness, hair thinning on the top of the head. 00:02:05.645 --> 00:02:10.280 Or also commonly reported some symptoms are acne or significant issues with 00:02:10.305 --> 00:02:12.580 weight gain or inability to lose. 00:02:12.605 --> 00:02:17.400 Although polycystic ovary syndrome is poorly understood as to why it happens, we 00:02:17.425 --> 00:02:22.340 know there may be, some in way genetic relation but also potentially 00:02:22.365 --> 00:02:26.060 autoimmune conditions that may, have some overlap. 00:02:26.085 --> 00:02:30.495 We really do not know at the core why this in particular occurs. 00:02:30.520 --> 00:02:33.450 That all being said, specialists here at Heartland Center For Reproductive Medicine 00:02:33.480 --> 00:02:37.450 are all trained in diagnosing and treating this condition. 00:02:37.480 --> 00:02:42.820 We are experts in helping you identify if this is a condition you're impacted by. 00:02:42.845 --> 00:02:46.500 Important treatment cornerstones are protecting the lining of your uterus. 00:02:46.525 --> 00:02:51.880 If you are not currently seeking pregnancy or more suffering infertility but just 00:02:51.905 --> 00:02:56.140 simply have irregular periods, long term that can put you at increased risk 00:02:56.165 --> 00:02:58.255 of conditions related to your uterus. 00:02:58.280 --> 00:03:01.610 And therefore it's really important to be meeting with a physician who can help you 00:03:01.640 --> 00:03:05.135 either experience regular periods or ensure that you're protecting the lining 00:03:05.160 --> 00:03:06.460 of your uterus through medication. 00:03:06.485 --> 00:03:12.760 Up to about 85% of patients impacted by PCOS will respond, and by respond I mean 00:03:12.785 --> 00:03:19.220 have an ovulation form, in response to an oral medication that we use very commonly. 00:03:19.245 --> 00:03:23.880 The first line treatment recommendation for this condition is actually a letrozole 00:03:23.905 --> 00:03:27.295 or Femara, which like I mentioned is an oral medication. 00:03:27.320 --> 00:03:30.440 Unfortunately, many patients assume that all treatments through an infertility 00:03:30.465 --> 00:03:33.660 office are gonna involve injections, or it would be incredibly costly. 00:03:33.685 --> 00:03:37.140 But this condition in particular is one that often has a 00:03:37.165 --> 00:03:39.260 much simpler treatment to start. 00:03:39.285 --> 00:03:43.680 However, there are still a significant number of patients that may not respond 00:03:43.705 --> 00:03:46.980 or ovulate after taking those medications. 00:03:47.005 --> 00:03:50.940 And for those patients, we often are talking about stronger therapies like 00:03:50.965 --> 00:03:53.640 injection medications or even in vitro fertilization.