Realising there may be difficulties while trying to conceive a baby can be a devastating blow for many women.
“While fifteen to twenty percent of South African women may experience infertility, it is still possible for many of them to become mothers,” says Dr Jackson Ndhlovu, an obstetrician and gynaecologist specialising in reproductive medicine who practises at Netcare Pholoso Hospital in Polokwane.
“A major cause of infertility is a condition known as polycystic ovary syndrome, commonly referred to as PCOS. The good news is that this cause of infertility can often be managed to a point, making pregnancy possible.”
Polycystic ovary syndrome (PCOS) is a complex hormonal condition that affects ovulation, when the ovary releases an egg at around two weeks before the next menstrual period. “This can cause irregular or absent periods, which do not follow a regular cycle of between 25 and 35 days. Tests will usually show those affected have higher levels of male hormones, like testosterone.”
Dr Ndhlovu explains that the ovaries of those with PCOS are dotted with many little cysts, which cause their hormonal imbalance. “This makes it difficult for women to monitor their fertile window, which is when they should be able to fall pregnant.”
Signs to look out for
The signs of PCOS often emerge during adolescence, says Dr Ndhlovu. “As well as irregular or absent periods, patients may notice some weight gain. They may develop acne and have more body hair than other girls.”
He is quick to point out that PCOS doesn’t always follow the same pattern of symptoms for all women. “Even if your periods are regular and your weight is within normal parameters, you may still find it difficult to become pregnant because of PCOS.”
How can the effects of PCOS be managed?
While a PCOS diagnosis may feel like a lot to deal with, Dr Ndhlovu assures that there are ways to manage its effects.
“Up to three quarters of women with PCOS carry too much weight, but losing five to ten percent of their body mass results in a far greater chance of them ovulating, up to 80% of the time. Exercise is paramount, as is eating a healthy diet.”
He advises those who smoke to quit and those who drink alcohol to limit their intake.
PCOS can affect patients’ mental health too. “This can manifest in distressing things like low self-esteem, anxiety and depression. Some women may develop sleeping or eating disorders, so we would refer patients for counselling where necessary. There’s no need to go through this alone.”
He says some patients risk developing metabolic syndrome, which is a cluster of conditions which increase the risk of high cholesterol, diabetes and hypertension. Others may notice the appearance of dark, velvety patches on their skin known as acanthosis nigricans. “Sharing everything that you’re experiencing, both physically and mentally, with your medical practitioner will enable them to get you on the right path to manage the effects of PCOS,” says Dr Ndhlovu.
Dr Ndhlovu urges women aged under 35 who aren’t able to conceive after a year to seek help by consulting a medical practitioner. “But women who are older than that should see their medical practitioner as soon as they become concerned, because time is of the essence in that age bracket.”
If lifestyle changes don’t help, then their medical practitioner may prescribe medication or injections to induce ovulation. “These must always be administered under close medical supervision due to their potency and possible side effects,” cautions Dr Ndhlovu.
However, if these measures are also unsuccessful after six months, all hope is not lost. “There are still other options to be considered, like in vitro fertilisation (IVF). We would conduct other routine medical checks and likely check the partner’s semen to ensure it is within the parameters needed for pregnancy to occur.”
Dr Ndhlovu advises women aged 44 and over to consider egg donation as the chances of them having a healthy, full term pregnancy can diminish to less than five percent per cycle.
“We strongly recommend counselling to ensure the patient is able to manage their expectations of IVF.”
Addressing misconceptions
He stresses that IVF cannot guarantee a pregnancy. “There are many factors which come into play, like the age of the woman and the semen being used, which can influence the outcome.”
Dr Ndhlovu says it is also incorrect to assume that IVF will result in multiple births. “We believe it is better to have a single embryo transplanted at a time to lessen the risks associated with multiple pregnancies.”
Dr Ndhlovu has a final, important word of advice to women who are struggling with PCOS or infertility. “Find an understanding medical practitioner with the right experience, and don’t be shy to open up to them. Tell them everything you’re going through, so they can make informed decisions to guide you along a treatment plan tailored to your specific needs. It really can make all the difference.”
References and further reading
Ends.
Notes to editors
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For media enquiries, please contact MNA at the contact details listed below:
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Issued by:
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MNA on behalf of Netcare Pholoso Hospital
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For media enquiries contact:
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Martina Nicholson, Meggan Saville, Estene Lotriet-Vorster,
Clementine Forsthofer or Natasha Burger
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Telephone:
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011 469 3016
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Email:
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[email protected]
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