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PCOS and Fertility
Dr. Daniel Griffin discusses what PCOS, or Polycystic Ovarian Syndrome, is and the possible impact it has on fertility.
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Learn more about Daniel Griffin, MD
Daniel Griffin, MD
Daniel Griffin, MD specialties include Reproductive Endocrinology.Learn more about Daniel Griffin, MD
Transcription:
Deborah Howell: Welcome. We all perhaps know a little bit about the hormonal disorder, polycystic ovary syndrome or PCOS, but can it affect fertility? I'm Deborah Howell and our guest today is Dr. Daniel Griffin, reproductive endocrinologist at The Women's Hospital. Welcome, Dr. Griffin.
Daniel Griffin: Thank you very much for having me, Deborah.
Deborah Howell: So glad that we're going to be talking about PCOS. So let's jump right in. What is PCOS?
Daniel Griffin: PCOS, it stands for polycystic ovarian syndrome and it's a condition that affects a lot of the patients that I see. It's one of the more common conditions that affects fertility. And it can cause different symptoms, irregular periods, it can also cause issues with unwanted hair growth and acne. But it has also been associated with other health problems that can impact cardiovascular disease and diabetes. And so it's not only important from a fertility standpoint but also is important just from a general health standpoint.
Deborah Howell: Now, how does PCOS impact fertility?
Daniel Griffin: The common way PCOS impacts fertility is it affects ovulation or release of the egg from the ovary. And if a patient doesn't ovulate or release an egg in a given month, well, the chances that they would get pregnant in that month are zero. And it can totally eliminate the chances of somebody ovulating or they ovulate very sporadically, which makes trying to time intercourse and things more difficult to do.
Deborah Howell: Sure, I can understand that. Now, is it possible to get pregnant with PCOS?
Daniel Griffin: Absolutely. You know, like I mentioned before, women that have PCOS at least, you know, sometimes have the capability to just ovulate on their own and could conceive spontaneously that way. There are also many other fertility treatments that patients could use to conceive whether that be with induction using pills such as Clomid or letrozole. There are also treatments that involve using a diabetes medicine called metformin. And then there are other fertility treatments as well if those treatments would not work that a person that had PCOS could use to become pregnant.
Deborah Howell: Okay. That's fair. And what's the first step to fertility treatment with PCOS?
Daniel Griffin: I think the first step for any patient who's having difficulties getting pregnant whether it be PCOS or any other diagnosis is to seek out an evaluation. And that can be done by a primary care provider. It can be done by a general obstetrician gynecologists or it could also be done by reproductive endocrinologists like myself.
But I would recommend somebody go see their physician and have, you know, hormonal testing done as well as just a, you know, basic fertility workup. And then depending upon what that workup would show, then we would gear that treatment for whatever we thought was best for that patient.
Deborah Howell: You mentioned hormonal workup. Could you describe that a little bit more?
Daniel Griffin: So polycystic ovarian syndrome is a diagnosis of exclusion. And so to make the diagnosis of PCOS, you have to exclude other hormonal causes. So you would want a patient to have their thyroid checked, have this hormone called prolactin checked, which if it's elevated can affect observation. And then we would also do some tests to look at male hormones in the blood, like the testosterone level, which if they're elevated may also impact ovulation.
Because if any of those things were abnormal, that would change the treatment that you would do for that patient. And so that's why, you know, it's so important before they just would start on treatment to have a formal evaluation done.
Deborah Howell: Now is there any way to prevent problems from PCOS during pregnancy?
Daniel Griffin: There is. I think one of the biggest things, and you see this with fertility treatment, is to try to lower the risk of having a multiple pregnancy. And there are treatments that are very effective that have a pretty low chance of having a multiple pregnancy, but certainly if you get pregnant with a singleton pregnancy that's going to make the pregnancy overall safer.
In terms of lifestyle things with polycystic ovarian syndrome, as I mentioned earlier, women that have polycystic ovarian syndrome are at higher risk for hypertension, high cholesterol, diabetes. A lot of times women that have polycystic ovarian syndrome are overweight. And so things that they could do even pre-conceptually that will lower their risks once they would become pregnant would be to have a healthy diet, exercise. Try to lose weight if that is something that is indicated for them. If they are having issues with their blood pressure or diabetes, to make sure that those things are under good control prior to becoming pregnant.
Deborah Howell: Do you have any success stories with your patients that you might want to share?
Daniel Griffin: Many success stories. You know, one of the things that I try to stress to patients when I see them is just how common PCOS is. If you look at the patients that I see on a daily basis, I would say probably close to a handful a day have some form of polycystic ovarian syndrome.
And in most cases, especially as it pertains to getting pregnant, it's a pretty easy thing to treat. You know, I've had many patients that are successful with just something as simple as ovulation induction with a medicine called Clomid or letrozole, which are pills, they're not shots. They're pretty inexpensive. They're tolerated pretty well. But even in those patients that have more resistant cases, you know, where we're unable to get them to ovulate or conceive a pregnancy with those medicines, we've had a lot of success in treating patients, whether it be with other like injectable fertility medicines or even IVF.
Deborah Howell: I know we covered this a little bit, but what again are the signs and symptoms of PCOS?
Daniel Griffin: The most common symptoms of PCOS are either absent or irregular menstrual periods plus or minus unwanted hair growth, like on the face, chin, chest, abdomen, and acne. Those are the most common symptoms that people would have. Sometimes patients, again, may have other symptoms that they may not even realize in terms of hypertension, diabetes. But in terms of physical symptoms, those would be the most common symptoms that we see with PCOS.
Deborah Howell: Okay. So that's what to watch out for. Well, this is some really good information, Dr. Griffin. Thank you so much for all of it around PCOS and fertility and for being with us today.
Daniel Griffin: Thank you very much.
Deborah Howell: And that wraps up this episode of the podcast series from Deaconess The Women's Hospital, a place for all your life. To learn more about The Women's Hospital and PCOS head on over to deaconess.com/BIVF or call (812) 842 -4530. And for more health tips and updates, follow us on your social channels. We thank you for that. I'm Deborah Howell. Thanks for listening. Have yourself a great day.
Deborah Howell: Welcome. We all perhaps know a little bit about the hormonal disorder, polycystic ovary syndrome or PCOS, but can it affect fertility? I'm Deborah Howell and our guest today is Dr. Daniel Griffin, reproductive endocrinologist at The Women's Hospital. Welcome, Dr. Griffin.
Daniel Griffin: Thank you very much for having me, Deborah.
Deborah Howell: So glad that we're going to be talking about PCOS. So let's jump right in. What is PCOS?
Daniel Griffin: PCOS, it stands for polycystic ovarian syndrome and it's a condition that affects a lot of the patients that I see. It's one of the more common conditions that affects fertility. And it can cause different symptoms, irregular periods, it can also cause issues with unwanted hair growth and acne. But it has also been associated with other health problems that can impact cardiovascular disease and diabetes. And so it's not only important from a fertility standpoint but also is important just from a general health standpoint.
Deborah Howell: Now, how does PCOS impact fertility?
Daniel Griffin: The common way PCOS impacts fertility is it affects ovulation or release of the egg from the ovary. And if a patient doesn't ovulate or release an egg in a given month, well, the chances that they would get pregnant in that month are zero. And it can totally eliminate the chances of somebody ovulating or they ovulate very sporadically, which makes trying to time intercourse and things more difficult to do.
Deborah Howell: Sure, I can understand that. Now, is it possible to get pregnant with PCOS?
Daniel Griffin: Absolutely. You know, like I mentioned before, women that have PCOS at least, you know, sometimes have the capability to just ovulate on their own and could conceive spontaneously that way. There are also many other fertility treatments that patients could use to conceive whether that be with induction using pills such as Clomid or letrozole. There are also treatments that involve using a diabetes medicine called metformin. And then there are other fertility treatments as well if those treatments would not work that a person that had PCOS could use to become pregnant.
Deborah Howell: Okay. That's fair. And what's the first step to fertility treatment with PCOS?
Daniel Griffin: I think the first step for any patient who's having difficulties getting pregnant whether it be PCOS or any other diagnosis is to seek out an evaluation. And that can be done by a primary care provider. It can be done by a general obstetrician gynecologists or it could also be done by reproductive endocrinologists like myself.
But I would recommend somebody go see their physician and have, you know, hormonal testing done as well as just a, you know, basic fertility workup. And then depending upon what that workup would show, then we would gear that treatment for whatever we thought was best for that patient.
Deborah Howell: You mentioned hormonal workup. Could you describe that a little bit more?
Daniel Griffin: So polycystic ovarian syndrome is a diagnosis of exclusion. And so to make the diagnosis of PCOS, you have to exclude other hormonal causes. So you would want a patient to have their thyroid checked, have this hormone called prolactin checked, which if it's elevated can affect observation. And then we would also do some tests to look at male hormones in the blood, like the testosterone level, which if they're elevated may also impact ovulation.
Because if any of those things were abnormal, that would change the treatment that you would do for that patient. And so that's why, you know, it's so important before they just would start on treatment to have a formal evaluation done.
Deborah Howell: Now is there any way to prevent problems from PCOS during pregnancy?
Daniel Griffin: There is. I think one of the biggest things, and you see this with fertility treatment, is to try to lower the risk of having a multiple pregnancy. And there are treatments that are very effective that have a pretty low chance of having a multiple pregnancy, but certainly if you get pregnant with a singleton pregnancy that's going to make the pregnancy overall safer.
In terms of lifestyle things with polycystic ovarian syndrome, as I mentioned earlier, women that have polycystic ovarian syndrome are at higher risk for hypertension, high cholesterol, diabetes. A lot of times women that have polycystic ovarian syndrome are overweight. And so things that they could do even pre-conceptually that will lower their risks once they would become pregnant would be to have a healthy diet, exercise. Try to lose weight if that is something that is indicated for them. If they are having issues with their blood pressure or diabetes, to make sure that those things are under good control prior to becoming pregnant.
Deborah Howell: Do you have any success stories with your patients that you might want to share?
Daniel Griffin: Many success stories. You know, one of the things that I try to stress to patients when I see them is just how common PCOS is. If you look at the patients that I see on a daily basis, I would say probably close to a handful a day have some form of polycystic ovarian syndrome.
And in most cases, especially as it pertains to getting pregnant, it's a pretty easy thing to treat. You know, I've had many patients that are successful with just something as simple as ovulation induction with a medicine called Clomid or letrozole, which are pills, they're not shots. They're pretty inexpensive. They're tolerated pretty well. But even in those patients that have more resistant cases, you know, where we're unable to get them to ovulate or conceive a pregnancy with those medicines, we've had a lot of success in treating patients, whether it be with other like injectable fertility medicines or even IVF.
Deborah Howell: I know we covered this a little bit, but what again are the signs and symptoms of PCOS?
Daniel Griffin: The most common symptoms of PCOS are either absent or irregular menstrual periods plus or minus unwanted hair growth, like on the face, chin, chest, abdomen, and acne. Those are the most common symptoms that people would have. Sometimes patients, again, may have other symptoms that they may not even realize in terms of hypertension, diabetes. But in terms of physical symptoms, those would be the most common symptoms that we see with PCOS.
Deborah Howell: Okay. So that's what to watch out for. Well, this is some really good information, Dr. Griffin. Thank you so much for all of it around PCOS and fertility and for being with us today.
Daniel Griffin: Thank you very much.
Deborah Howell: And that wraps up this episode of the podcast series from Deaconess The Women's Hospital, a place for all your life. To learn more about The Women's Hospital and PCOS head on over to deaconess.com/BIVF or call (812) 842 -4530. And for more health tips and updates, follow us on your social channels. We thank you for that. I'm Deborah Howell. Thanks for listening. Have yourself a great day.