Polycystic Ovary Syndrome (PCOS) is a metabolic disorder and is the most common cause of anovulatory infertility, affecting as many as 5 million women in the US. This syndrome may also include obesity (50% of women with PCOS are obese), various hormonal problems and high levels of blood insulin.

Infertility is present in the majority of women with this syndrome, and they have a higher risk of miscarriage. Their reproductive organs are normal, but their hormonal balance is disrupted. The condition is diagnosed by symptoms that can vary (such as irregular menstrual cycles, obesity, acne and facial hair) and a blood test.

Higher than normal levels of insulin are believed to stimulate the ovary to produce excess testosterone, thereby altering the level of other hormones and impairing ovulation. The body tries to ovulate monthly, creating growing numbers of immature follicles on the ovary - the basis for the name "polycystic ovary".

PCOS Diagnosis at Boston IVF

Boston IVF is one of the few fertility centers in the Northeast with the experience and technology to treat Polycystic Ovary Syndrome (PCOS, treating more than 200 cases per year. Our specialists (reproductive endocrinologists, OB/GYN's, nutritionists, acupuncturists, and counselors) all work together to develop the best possible treatment plan for each patient. Our evaluations typically take just a few days and treatment to control its symptoms begin immediately.  

The first step towards confronting PCOS is to schedule an appointment with a Boston IVF physician -- who will conduct a wide-ranging history and examination that focuses on the patient's hormonal and metabolic abnomalities. At this consultation, a treatment plan will be implemented and the decision may be made for the patient to undergo further testing depending upon their symptoms.

PCOS Treatment at Boston IVF

Once diagnosed with PCOS, many women are grateful to hear that there's a reason for their fertility woes or general discomfort. However, they may also feel overwhelmed by the steps needed to control the condition. Boston IVF has extensive experience in treating the disease and will taylor a medical plan for each individual based on their specific symptoms. Along with several ovulation-inducing medications designed to regulate the menstrual cycle and hormone levels -- the primary treatment of PCOS is to manage insulin resistance -- which typically requires significant diet and lifestyle changes. 

Nutritional Counseling For PCOS Patients at Boston IVF 

With obesity affecting about 50% to 60% of women with PCOS, one of the best ways to treat the disease is to focus on losing weight through exercise and changing one's diet -- as exercise does naturally what some of the medications used do treat the disease do chemically.

All PCOS patients at Boston IVF are strongly advised to meet with Hillary Wright, MEd, RD, LDN -- the Director of Nutritional Counseling at Boston IVF/Domar Center for Mind/Body Health and author of The PCOS Diet Plan: A Natural Approach to Health for Women with Polycystic Ovary Syndrome.

A registered and licensed dietician with a Masters degree in Health education from Boston University -- Hillary has over 18 years experience counseling clients on diet and lifestyle change in relation to PCOS.   

          Hillary's PCOS Health Tips

• Eat fewer carbohydrates. Because bloog sugar and insulin go hand in hand -- the more sugar that''s in the blood, the more insulin you secrete -- the main dietary treatment is to lessen insulin secretion by eating smaller portions of carbohydrates. Try adjusting your carb ratio to about 25% to 30% of your plate (as opposed to the usual 50% or more), and choosing better quality, less-processed food options (such as whole fruits instead of juice and whole grains over white flour).
  
  
• Eat smaller meals and snacks spread out over the day. This not only blunts the insulin response but helps you avoid feeling "overhungry" -- which generally leads to overeating. Studies show that for many people, eating smaller amounts of food spread over the course of a day is an effective way to lose weight.
  
  
• Focus on fiber. Opt for at least 3 daily servings of unrefined grains (such as whole grain breads and cereals, borwn rice and whole wheat pasta. ) that have not been stripped of their dietary  fiber. Because fiber is not digestable, it slows the digestion process, which then slows the release of sugar into the blood. High-fiber diets are also strongly linked to weight loss.
  
  
• Partner your carbs with protein. Pairing smaller amounts of unprocessed carbs with lean protein and a little fat (think whole-grain crackers with light cheese) helps increase satiety and holds blood sugars steady -- and helps avoid "dips" that can result in carb cravings. Choose heart-healthy fats such as olive and canola oils, nuts, seeds and avocados. These "good" fats benefit both cholesterol levels and insulin sensitivity.
  
  
• Allow time for daily activity. Exercising helps to cleat sugars out of the blood naturally and is absolutely necessary for lasting weight loss.

ABOUT PCOS

Who Has PCOS? PCOS may affect as many as five million women in the United States. That means that one in ten women of childbearing age may have PCOS. It can occure is girls as young as 11 years old and for adults -- it is the most common cause of female infertility.

How Do I Know If I Have PCOS? Not all women with PCOS share the same symptoms, which is why so many cases will go undiagnosed. These are some of the symptoms of PCOS:

• infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
• infertility (not able to get pregnant because of not ovulating
• increased hair growth on the face, chest, stomach, back, thumbs or toes
• ovarian cysts
• acne, oily skin, or dandruff
• insulin resistance or type 2 diabetes
• high cholesterol
• high blood pressure
• male-pattern baldness or thinning hair
• patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs.
• skin tags, or tiny excess flaps of skin in the armpits or neck area
• pelvic pain
• anxiety or depression due to appearance and/or infertility
• sleep apnea (excessive snoring and times where breathing stops while asleep 

What Causes PCOS? The exact causes of PCOS are still not fully understood but many cases are believed to be related to insulin resistance -- or the body's inability to efficiently utilize insulin.

Insulin is a hormone secreted into the blood by the pancreas in response to the arrival of glucose (sugar) in the blood after the digestion of carbohydrates -- foods like grains, fruits, milk, yogurt, sweets, and starchy vegetables like potatoes, sweet potatoes, squash, yams, corn, peas and legumes.

Once released, insulin roams the blood system, "unlocking" muscle, fat and liver cells so that glucose can pass into the cells -- where it is then either burned as fuel of stored as an energy reserve.

In most people, insulin activity works very efficiently. But with insulin resistance, the cells are not as sensitive to insulin, stimulating the pancreas to secrete extra insulin in an attempt to keep blood sugars normal. (In some, this need to work in "overdrive" may, over time, exhaust the pancreas and ultimately lead to diabetes.) It's this excess circulating insulin that is thought to trigger many of the hormonal changes seen in PCOS.

Research also shows that  an overabundance of abdominal fat further aggrevates insulin resistance -- and worstens the symptoms of PCOS. This hormonal imbalance can also disrupt reproductive hormones enough that ut inhibits ovulation.

Additional PCOS Web Links

PCOS Frequently Asked Questions (FAQ)

SoulCysters.com (online PCOS community/message boards)

PCOS Guide For Teens