In my books, the vast majority of women with Polycystic Ovarian Syndrome do not need IVF to get pregnant, as 50% of women with PCOS, if you manage to get them to ovulate just by losing weight and dieting, and they start to develop regular periods, 50% of them will get pregnant within six within when having regular intercourse with their partner, that’s as long as their partner has a good and normal sperm count, and they’re having regular unprotected intercourse. For those who are not able to have regular periods just by losing weight and dieting. For those who need to have to go into Clomiphene or Tamoxifen or Letrozole, again, 50% of those patients alone within six months will conceive and have a child if they’re having regular intercourse, and their partner has a normal sperm count. So by far, the vast majority of women with Polycystic Ovarian Syndrome do not need IVF, and even those ones who are not ovulating with the tablets, can ovulate if you use the FSH injection for one, and also laparoscopy with ovarian drilling, again, a good number will start to ovulate, will start to have regular periods and start to ovulate with those measures. And so it’s the only minority who are unable to get pregnant either because all of those other measures fail to get them to have regular periods, or they just can’t conceive naturally, because as I said, it would be less than 50% of each of those different categories, who would then proceed to require IVF. I would estimate anywhere between maybe 15 to 20% of women with Anovulatory PCOS, Polycystic Ovarian Syndrome does require IVF. Okay, so 15 to 20% Maximum.
The response to that question would be that just because they have got PCOS is not the reason that they need IVF or IVF is the first line fertility treatment modality for them. They would be assessed like anybody else. On the basis of their age, we know that their egg reserve is going to be on the higher side always, we would assess for how long they have been trying, if it is a heterosexual couple trying for natural conception or if it is a single woman then that’s a different scenario, we then look for other medical problems, we look for their tubal functions and we look for whether they are using partner sperm or donor sperm – so, all those factors would come into play in decision making. IVF would come at some point in the fertility journey but not as the only factor and the first line step just because they have got PCOS.
The majority of ladies don’t need IVF if you have PCOS, you just need to start ovulating regularly and that can be done by looking at your lifestyle, making some changes to your lifestyle. What’s really important to know is that if you’re overweight with PCOS, sadly many women are overweight with PCOS. By just losing 5 percent of your body weight, you can start to spontaneously ovulate again which is a really good thing. So you might need, if you’re not ovulating, some treatment with ovulation induction medication to help you ovulate regularly, but the majority of women don’t need IVF. However if you have been trying to conceive for a very long time and you feel like you’ve tried so many different things, you might get to the point where IVF is your next option and that is something you should discuss really carefully and in great detail with your doctor.
