Polycystic Ovarian Syndrome (PCOS) Awareness Month: September

What is PCOS?

The name ‘polycystic ovarian syndrome’ is very frightening to hear, because it sounds as if it refers to cysts, which is misleading. PCOS fortunately does NOT mean there are cysts on the ovaries.

In simple terms, PCOS affects the little follicles in the ovaries in which potential eggs await the right hormonal signals to grow, after which they are released during ovulation. With PCOS, the little follicles are not stimulated to grow and to release every month.

PCOS is actually an endocrine (hormone) disease of the ovaries. It is a genetic disease and runs in families, and it is also a chronic medical condition for which there is no known cure. However, like other chronic medical problems such as asthma or diabetes, it can be well managed over the long term.

What are the symptoms of PCOS?

It is important to note that PCOS can affect different women in different ways.

However, below are listed some of the most experienced symptoms of PCOS.

* Problems with ovulation
* No menstruation or irregular menstruation
* Prolonged, heavy menstruation
* Recurrent miscarriages
* Infertility
* Skin problems
* Acne
* Unwanted and abnormal hair growth
* Excess weight, rapid weight gain and difficulty in losing weight
* Health problems associated weight issues
* Problems with sugar metabolism and insulin levels
* Cholesterol
* High blood pressure.
* Obstructive sleep apnea

Ovarian Cancer and Fertility

According to the National Cancer Institute in the US, because gynaecological cancers such as ovarian cancer may not cause early signs or symptoms, and it is difficult to screen for the diseases, these cancers often go undetected until they’ve reached advanced stages. Because of this, the survival rate is low, with a five-year survival rate of less than 50% percent.

The American Association for Cancer Research (AACR) explains that there are three types of ovarian cancer in adults. Ovarian epithelial cancer begins in the tissue covering the ovary, lining the fallopian tube, or the peritoneum. Ovarian germ cell tumors start in the egg or germ cells. Ovarian low malignant potential tumors begin in the tissue covering the ovary, and are characterized by abnormal cells that may become cancer, but usually do not.

The risk factors for developing ovarian cancer include a family history and the presence of inherited gene mutations. There are tests that can detect mutations in the BRCA1 and BRCA2 genes, which increase the risk of female breast and ovarian cancers and some additional types of cancer.

Ovarian cancer treatment and your fertility

Having ovarian cancer and the resulting treatment can affect your fertility.

The American Society of Clinical Oncology (ASCO) recommends that all women with cancer discuss the risk of infertility and fertility preservation options with their doctors as soon as possible – and before cancer treatment begins.

IVF vs ICSI

What is IVF?

In vitro fertilization – or IVF as it is often called – refers to a medical process that has helped millions of couples around the world to experience the joy of having their own babies.

It is a type of assisted reproductive technology (ART) that is used to treat fertility or genetic problems to help couples to conceive a child. Parents of babies born following in vitro fertilization often describe their babies as “miracles” and “dreams come true”.

Practiced for more than three decades across the world, IVF is a safe and trusted medical treatment, and its success rate is impressive.

Very simply stated, during in vitro fertilization the female partner’s eggs (ovum) are collected and fertilized with sperm in a laboratory. The embryo is then implanted into the uterus.

While the process sounds relatively simple, IVF is not a single medical procedure or event, but a series of procedures completed over several weeks. From the first day of the cycle to the pregnancy test completed 14 days after the egg retrieval, the entire IVF process spans around 28 days.

Treatment usually commences on the first two to three days of the female partner’s cycle. The first step is taking medications to stimulate the growth of the eggs, and to suppress ovulation until egg collection. Patients are carefully monitored using blood tests and ultrasound scans, usually starting on the eighth day of the cycle.

Artificial Insemination Cost In Cape Town

What artificial insemination treatment entails

Artificial insemination refers to a process in which semen is placed in a woman’s vagina or cervix by a means other than sexual intercourse. It is a widely-used form of assisted reproductive technology (ART) that has proven over time to be both safe and effective.

Artificial insemination is a non-invasive procedure, and because it entails very little medical risk for the women undergoing the treatment, it is very safe. It is also a relatively quick and easy procedure, compared to other fertility treatments such as in vitro fertilisation (IVF).

In addition, it offers a good success rate and it is not as expensive as other fertility treatments.

What the cost of a cycle of artificial insemination treatment is

PCOS Treatments When Trying to Get Pregnant

If you have PCOS and are taking medications to improve your chances of falling pregnant, it is crucial to rely on the expertise and experience of a qualified fertility specialist, who can monitor closely the effect of the tablets and/or injections. This is because women respond differently to the medications and injections.

Some women may not respond to a certain medication at all, or may just take longer to respond. Others may respond immediately and grow a healthy egg or two in the same cycle, ready to ovulate. Some women may over-respond, ovulating multiple follicles that could result in a multiple pregnancy. The aim is to ovulate one follicle, although two and maybe even three follicles might be accepted. There is also a risk of hyperstimulation, when the ovaries make too many follicles.

As a result, if you are taking meds or injections for ovulation, you should be monitored closely to ensure there is an adequate response and that this response is safe. If you’re not getting a good response from the medication, a different type of medication can be tried. If you’re getting an excessive response, and are at risk of having multiple pregnancies, a different treatment plan may be required. This is because a multiple pregnancy is very high-risk, with a much higher possibility of miscarriage and preterm babies.

Medications for ovulation

A Step By Step Overview of the In Vitro Fertilisation (IVF) Process

The Steps in the IVF Process

In short, we can summarise the steps during IVF treatment as follows:

* The first step is a course of fertility medications to stimulate egg growth, followed by careful monitoring.

* Next, the eggs are surgically removed from the ovary.

* In the lab, the eggs are mixed with sperm to be fertilized.

* Three to five days later, the fertilized eggs, called embryos, are transferred into the women’s uterus.

* The last step is a blood test to establish if a pregnancy has been achieved.

* Below is a full overview of the steps involved in a typical IVF treatment cycle at Cape Fertility and provides a realistic picture of the steps in the IVF process.

Step 1 – Fertility medications

The first step in IVF treatment is taking fertility medications to stimulate egg growth within the first two to three days of your cycle. These medications may include tablets or fertility injections containing FSH (Follicle Stimulating Hormone), which you can easily administer yourself.

During this time, you will also take medication to suppress normal pituitary function and prevent the eggs from being ovulated before it is time for egg collection.

Treatment Options for PCOS

The reason is simple: excess weight not only contributes to metabolic syndrome, it also adversely affects other crucial health factors, such as cholesterol, insulin levels and blood pressure. Furthermore, PCOS can also interfere with ovulation.

It is crucial to lose some weight to improve all these adverse health conditions associated with PCOS.

One way to know where you are at right now in terms of a healthy weight is the body mass index or BMI. The formula is BMI = kg/m2 where kg is your weight in kilograms and m2 is their height in metres squared. You can use an online calculator to work out your BMI.

A BMI between 18 and 25 is considered normal. A BMI above 25 is considered overweight while a BMI over 30 is considered obese, and above 35 – morbidly obese. The objective of knowing your BMI is to provide a starting point from which to improve over the long term.

At Cape Fertility, we usually aim for an initial target of losing 5% of your body weight and to reach a healthy BMI. So, if for example you weigh 100kgs, you might start off with an initial target of losing 5% of your body weight, or 5kgs.

Fertility Awareness Month: FAQs for Parents-To-Be

Infertility often creates one of the most distressing life crises that a couple has ever experienced together. For this reason, it is important to spread awareness that there are options available for treatment.

For this Fertility Awareness Month, our team would like to share the answers to some of the frequently asked questions from parents-to-be who are struggling with infertility.

Are many people affected by infertility?

Normally, three out of five couples conceive within six months of trying; one in four take between six months and a year. For the rest, conception takes more than a year, which means that there may be a problem.

When a couple has not conceived after 12 months of regular unprotected sexual intercourse, they may be regarded as infertile. According to SASREG, “infertility” is the term used when a couple cannot get or stay pregnant after trying for at least a year, and the female partner is younger than 35.

The World Health Organisation (WHO) has recognised infertility as a public health issue worldwide, with many couples needing to seek medical treatment to help resolve underlying fertility problems.

Worldwide about 1 in 6 couples of reproductive age have a fertility problem, while in developing countries the number is as high as one in every four couples. Infertility doesn’t discriminate either, and can be an issue regardless of gender, race, religion or economic status.

Are men affected by infertility?

What is ICSI Infertility Treatment?

What does ICSI entail?

ICSI is one of the procedures completed during the IVF treatment process, which spans around 28 days. To illustrate where ICSI fits into the process, here is a brief description of the IVF process.

Very simply stated, during IVF treatment the female partner’s eggs (ovum) are collected and fertilized with sperm in a laboratory. The resulting embryo is then implanted into the uterus.

During conventional IVF treatment, the fertilisation of the eggs is achieved in an advanced laboratory by mixing the eggs ‘in vitro’ (in glass) with tens of thousands of washed sperm, allowing the sperm direct access to fertilise the eggs retrieved from the female partner or a donor.

This process is replaced by ICSI. Instead of the eggs and sperm being mixed and left to fertilise as with traditional IVF treatment, during ICSI, one sperm is injected into the egg using a micromanipulation microscope.

The embryologist will choose a single sperm cell – the best and strongest available – and inject it directly into the egg. This circumvents any possible problems with the sperm penetrating the egg.

At Cape Fertility, our laboratory is equipped with the newest high-magnification ICSI microscope. This helps the embryologist in selecting the best spermatozoa. High-magnification ICSI can also improve clinical outcomes in couples with previous repeated conventional ICSI failures.

This is just one of the procedures during IVF treatment, however.

PCOS: How is it diagnosed?

What are the symptoms of PCOS?

PCOS is a leading cause of infertility, but it also produces with a range of other possible symptoms.

There are two reasons why PCOS affects fertility. The first is that one of the most common symptoms of PCOS is problems with ovulation. These problems range from no menstruation at all to irregular menstruation or very prolonged and heavy menstruation. The second reason is that PCOS could also cause recurrent miscarriages.

Further symptoms of PCOS includes skin problems, weight issues and associated health problems.

PCOS can cause problems with elevated levels of male hormones in a woman’s body, resulting in oily skin, acne and unwanted and abnormal hair growth. Women with PCOS could also have weight problems such as being overweight, gaining weight rapidly and difficulty to lose weight.

There are also possible associated health problems, especially problems with sugar metabolism and insulin levels, cholesterol and high blood pressure.

Another condition that has been associated with PCOS is obstructive sleep apnea. Some clues that you have this include your family or your partner complaining about excessive snoring or if you wake up in the mornings feeling exhausted.