Women's Health

Treating PCOS With Progestin Decreases the Chances of Pregnancy

Treating PCOS With Progestin Decreases the Chances of Pregnancy

PCOS is one of the common problems or medical condition faced by women. PCOS is usually caused due to the imbalance of the reproductive hormones. This imbalance in the hormones can lead to problems in the ovaries. In the normal healthy state, the ovaries would make the egg and release it every month as part of the healthy menstrual cycle however for those with PCOS, the eggs may not completely develop as it should have or in some cases it does not get released during the ovulation process. Women suffering from PCOS have multiple cysts on their ovaries hence the name Polycystic Ovary Syndrome. These cysts are usually not considered to be harmful but it can lead to an imbalance in the hormones.

PCOS is characterized by the enlargement of ovaries. These enlarged ovaries would contain collection of fluids in small amounts which are called as follicles. These are located in each of the ovary as can be seen while performing an ultrasound. For those women suffering from PCOS would experience an irregular menstrual period or a missed period and due to irregularity in periods it can lead to inability to get pregnant or infertility and cysts development in the body.

Symptoms –

The symptoms in PCOS are usually mild in the initial phase and gradually tend to worsen if not diagnosed or treated on a timely manner. Also the woman would not experience all of the symptoms at first, initially there would be just few of the symptoms. The common symptoms a woman would experience are:

  • Hair thinning on the scalp. This is quite a common instance but can also lead to other medical conditions hence proper diagnosis is very much required. This pattern of thinning is also related to male pattern baldness.
  • Increase in weight
  • Increase in acne on the face, chest and upper back region.
  • Delay in menstrual period or irregular periods wherein there can be less than nine periods in a given year. In some cases, the woman would have periods alternately once in three months and in some cases they would not have periods at all. In certain other woman they would experience heavy menstrual bleeding.
  • Due to the persisting symptoms and imbalance in hormone the woman would undergo mental changes which could lead to depression.
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  • Issues relating to fertility wherein woman who are diagnosed with PCOS have trouble getting pregnant or if they are pregnant then it can lead to complications which needs to be properly dealt with.
  • Excess growth of hair on the face and other parts of the body. Similar to men, women would get thicker and darker hair on the face such as below the chin and sides of the cheek. There would also be thicker hair on the belly, back and chest. This problem is also medically termed as hirsutism and it tends to affect at least seventy percent of
  • Skin turning dark and pale mostly the creases around the neck, underneath the breast and the groin.
  • There would be excess formation of flaps of skin in the area around the armpits or the neck region.

According to a study conducted by the National Institutes of Health research network, infertility treatment of polycystic ovarian syndrome (PCOS) with hormone progestin decreases the chances of conception and giving birth. PCOS is a disorder in which the ovaries, and sometimes the adrenal glands, produce excess amounts of androgens. PCOS is characterized by menstrual irregularities and women with this condition often have difficulty in conceiving.

In order to induce a period and to also regulate the menstrual cycle in women, those suffering from PCOS were given progestin. Progestin is a chemical which imitates or mimics the action of the body hormone called progesterone. Progestin or synthetic progestin was developed during the time the birth control pill was started. The natural progesterone’s half-life was very short and the researchers were looking out for an agent to be induced in the body which would increase the life and make it longer half-life and still copy the same effects as the actual hormone progesterone. Note that progestin and progesterone are not one and the same. Progestin is ten to 100 times more potent and also have a longer life in the body as compared to the hormone progesterone. Progestin was chosen along with the synthetic form of estrogen for use in birth control pills. The common progestin is Provera, Amen, Curretab, Cycrin and Aygestin.

In certain women suffering from PCOS the estrogen levels are not sufficient for the progestin to have its effect hence in order for the synthetic progestin to be effective the uterus should be first primed with estrogen. If the progestin alone cannot help inducing bleeding, then a program first using estrogen to cause the endometrial lining of the uterus so as to proliferate after which it would give the progestin to mature the lining may be attempted. In certain other women, this estrogen procedure would not be required since in their case the body would already be estrogen dominant.

In certain cases, the progestin can be used to suppress partially the ovary and also regulate the bleeding before the use of fertility medicines.

As per the scientific study made in the National Institutes of Health research network. It is found that the issue of infertility treatment of polycystic ovarian syndrome (PCOS) with hormone progestin could decreases the chances of pregnancy. It does reduce the chances of conception and possibilities of giving birth. PCOS is a disorder is one which relates to the ovaries and also relates to the adrenal glands which produce excess amounts of androgens. PCOS. It is characterized by menstrual irregularities and women with such difficulties, often found it difficult even in conceiving.

The method induction of ovulation is most common and can be used in treating the problems with infertility disorder. Before getting the process of ovulation induction, the course of progestin should be administered. It helps thickening of the uterine lining which gets sloughed off during the beginning of a monthly menstrual cycle.

Induction of ovulation is the most common method for treating infertility associated with this disorder. Before ovulation induction, a single course of progestin is often administered. This helps in the thickening of the uterine lining. As progestin is not continued, the uterine lining is sloughed off as in the beginning of a monthly menstrual cycle.

According to the new study, women who did not have progestin before receiving the fertility treatment had four times more chances of getting pregnant when compared to those women who had progestin treatment. The results showed that 20% of the women who did not have progestin treatment gave birth, when compared to 5% of the women who received the progestin treatment.

Esther Eisenberg, MD, of the Reproductive Sciences Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), one of the study authors, commented that the results clearly show progestin treatment is counterproductive in helping women with PCOS to conceive. The study published in the journal Obstetrics and Gynecology, was conducted by Michael P. Diamond, MD, of Wayne State University in Detroit, Richard S. Legro, MD, of the Penn State College of Medicine in Hershey, and researchers at 16 institutions in the NICHD Cooperative Reproductive Medicine Network (RMN).

In this study, data was analyzed from a 2007 RMN study in which two fertility treatments for women with PCOS were compared — the standard drug therapy clomiphene, which stimulates ovulation, and the diabetes treatment drug metformin. PCOS often results in insulin resistance, a condition in which the body is unable to use insulin properly. Studies have shown that drugs like metformin, which makes the body more sensitive to insulin, can increase ovulation rates in women with PCOS. The 2007 study showed that women who took metformin had lower chances of getting pregnant when compared to women who took clomiphene or a combination of clomiphene and metformin.

The present data analysis compared the effectiveness of ovulation induction with that of ovulation induction combined with advance progestin treatment. The study results showed that about 5% of the women with spontaneous ovulation were able to conceive. Many women who took the fertility treatment failed to ovulate the following month. Nearly 30% of the women who received a dose of progestin treatment, followed by ovulation induction, ovulated. Out of this, 7% of the women conceived. 

Fertility treatment and progestin

The medical study shows that the women who did not have progestin before the fertility treatment had more chances of getting pregnant than the women who had progestin treatment.  According to the survey, 20% of the women who without having progestin treatment had given birth to a child successfully. And only 5% of the women have delivered a baby after having the progestin treatment.

According to the experts of the Reproductive Sciences Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), clearly show that progestin treatment is not suitable for the women to get PCOS to conceive. The results published in the journal Obstetrics and Gynecology were based on the survey conducted in the Wayne State University in Detroit with the help of Penn State College of Medicine in Hershey, and many researchers from different institutions under NICHD Cooperative Reproductive Medicine Network (RMN).

Standard medicinal therapy

The study shows results after analysing the data present from 2007 and it was found out that when the two fertility treatments given to the women with PCOS. But when compared the results, it was clear that the standard medicinal therapy clomiphene can stimulates ovulation and offers diabetes treatment drug metformin. PCOS results in insulin resistance which is a condition in which the body is unable to use insulin properly. The studies also show further about have shown that medicines such as metformin, makes the body sensitive to insulin. It increases ovulation rates in women with PCOS. According to the study conducted in 2007 which shows that women having taken metformin have less chances of getting pregnant while the women who took clomiphene or a combination of clomiphene and metformin have more chances of getting pregnant.

The data analysis available shows that the effectiveness of ovulation induction along with the ovulation induction combines advance progestin treatment. The results show that about 5% of the women having spontaneous ovulation were successfully conceived. The women who have failed in the test took the fertility treatment again in the following month. The result shows about 30% of the women who received a dose of progestin treatment and it was combined with ovulation induction, the result displayed showing about 7% of women were conceived.

Are the women more likely to get pregnant, or not?

According to the research the Polycystic ovary syndrome (PCOS) is one of the most common reasons which causes infertility among women. As many as 10 percent of women experience this disorder. PCOS is a hormonal problem which causes women to have a variety of symptoms, including irregular or no menstrual periods, acne, obesity and excess hair growth. Symptoms may start to appear in your teenage years as menstrual irregularity, or you may not notice anything until you start trying to get pregnant, and can’t.

Most women with the condition have small cysts in their ovaries, which is where the name for the syndrome comes from. Women with PCOS suffer from an excess of androgen, the male hormone, and often have difficulty ovulating and conceiving. They’re also at a higher risk of obesity, high blood pressure and diabetes. Fertility treatment for PCOS involves lifestyle changes as well as medication to stimulate ovulation, while recent research has shed new light on the use of progestin.

Fertility Treatment for PCOS

The first line for treating PCOS is often weight loss. It’s not clear if obesity causes PCOS or if PCOS causes obesity, but a weight loss of as little as five percent of your body weight may affect the symptoms.

Treatment for the lack of ovulation associated with PCOS often involves taking clomiphene to stimulate your ovaries to produce and release eggs. Many physicians will prescribe a course of progestin first, before starting clomiphene. Progestin causes the lining of your uterus to thicken, the way it normally does before your period starts. When the progestin is stopped, your uterus sloughs off the lining, simulating a normal menstrual period. Then clomiphene is taken to induce ovulation.

However, there are recent findings that using progestin appears to decrease your chance of getting pregnant and giving birth. A study from a National Institutes of Health research network in 2012 examined data from a 2007 Reproductive Medicine Network study comparing women who received progestin to women who did not receive it.

Below are certain drug treatments which can be carried out to treat infertility issues in woman suffering from PCOS.

Metformin: The doctor can prescribe Metformin to reduce the high levels of insulin in blood and also to bring stability in the hormones. Once the individual is started on this medicine the ovulation cycles would become more regular.

Clomid: With or without taking in metformin the doctor can also prescribe a fertility drug treatment called clomid. However, it has been seen that a combination drug of clomid and metformin would help the woman suffering from PCOS to get pregnant quickly than by just taking metformin alone. In certain cases, few women would need higher doses of clomid so as to restore the fertility. This high dose sometimes can also lead to unpleasant side effects.

Gonadotropins: These hormones are naturally occurring hormones which help to stimulate the ovaries so as to release on or more eggs. If a woman is not ovulating on a regular basis, then this medicine would be really helpful in speeding up the ovulating process. Also those women with PCOS whose body does not respond to Clomid treatment can also benefit from this fertility drug called as Gonadotropins.

What precautions you should take?

If you have PCOS and you have infertility issues, you may want to consult a reproductive endocrinologist who treats PCOS. It’s likely this specialist will be familiar with the latest research, and will be able to bring the most expertise to bear on your desire to have a family. Depending on your age, the fertility center team may advise you to have IVF treatment in order to have the best chance of getting pregnant and of controlling the risk of multiple order pregnancy.

Need help finding treatment?

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