One of the most common causes of “unexplained infertility” is polycystic ovarian syndrome or PCOS, which affects more than six million women in the United States and is the most common cause of missed periods. Although doctors tend to be aware of the more common symptoms—being overweight, and having excess hair and acne—many don’t realize that thin patients and others without these symptoms can have PCOS as well—especially those with mild PCOS, whose symptoms are still subtle.
If you have missed periods or there is any evidence that you’re not ovulating, request an evaluation for PCOS. This syndrome is characterized by high testosterone production (that’s what causes the acne and hair growth), irregular ovulation and multiple cysts on the ovary called polycystic ovaries. These small cysts are partially developed follicles that have stopped maturing because of the inhibitory effects of the high testosterone levels. To be diagnosed, you need to have two of the following three factors:
Excess testosterone. If you have acne or excess hair growth, then you do not need a blood test to confirm high testosterone. If you don’t have these symptoms, request the blood test for total and free testosterone. High insulin levels, caused by insulin resistance, are the most common reason women have high testosterone.
Anovulation. If you have infrequent, irregular periods or you menstruate without ovulating, it’s called anovulation. Use an at home ovulation prediction kit, like Clearblue Easy Fertility Monitor, for three to four months to monitor your ovulation.
Polycystic Ovaries. Cysts can only be detected with an ultrasound or other imaging test, but testing is not necessary to confirm PCOS if you have two other factors. If you’re already having an ultrasound for another reason, then your doctor should examine your ovaries. If your ovaries are larger than 10 cc or have more than 12 antral follicles early in your cycle, you have polycystic ovaries.
PCOS can range from mild to severe, and it goes without saying that the more severe it is, the more it can affect your fertility. But on the other hand, those with mild PCOS are more likely to be overlooked and diagnosed with unexplained infertility—and not treated for it.
For treatment recommendations, check out our book, Perfect Hormone Balance for Fertility or ask a question on my co-author Dr. Robert Greene's discussion board, haveababy.com .
Laurie
Tarkan is the co-author of Perfect Hormone Balance for Fertility
and Perfect Hormone Balance for
Pregnancy. She writes for the New York Times and national magazines and is
also the author of My Mother's Breast: Daughters Face Their Mothers' Cancer.
Check out Laurie's recent post on the Huffington Post.
Toxic Wombs
and infertility related articles:
Lowering Odds of Multiple Births
and
Are Men Overlooked at Fertility Centers
[photo credit: Getty Images]
