Medical Treatments
If you are trying to conceive it is imperative that you start to ovulate. One of the most common drugs used to trigger ovulation is clomiphene citrate. Clomiphene is an anti-oestrogen that tricks the brain into thinking that there is no oestrogen in the blood. Because the oestrogen is blocked, the pituitary gland gets the message to increase the supply of follicle stimulating hormone (FSH).The FSH reaches the ovaries and egg production is stimulated. If the clomiphene is suddenly stopped, the brain recognizes that there is a massive amount of oestrogen and this results in an LH surge that releases the egg from the ovary.
Clomiphene is an effective drug for artificially inducing ovulation but, ironically, it may also increase the chances of a miscarriage by somewhere in the region of 20-30 per cent. It is thought that the clomiphene interferes with the womb lining, preventing the fertilised egg from implanting. Other treatments used to induce ovulation, like gonadotrophin treatment, can also increase the miscarriage rate.
Natural Treatment
Losing weight has been shown to be very effective in treating PCOS and restoring fertility. One study showed that overweight women with PCOS had more fertility problems than lean women with PCOS. However, even though the link between PCOS and excess weight (and between losing weight and reduced symptoms) is well-established, the reasons for it are unclear.
When these women went on a diet and lost weight their SHBG levels rose, their testosterone levels fell and their PCOS symptoms diminished.
Along with the weight loss, came a remarkable change in ovarian function: 82 per cent of the women who were not previously ovulating showed improvements, with a number of successful pregnancies occurring during the study, even though these women had a long-standing history of infertility.
One reason may be that weight loss lowers insulin levels, which reduces the ovaries’ production of testosterone. No one really knows why PCOS responds to weight loss but it must be linked with the fact that overweight women (without PCOS) can dramatically increase their fertility by losing weight.
One study found that 11 out of 12 women who had been overweight and not ovulating conceived naturally after reducing weight.
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