ภาวะ PCOS หรือมีถุงน้ำรังไข่หลายใบ เสี่ยงมีบุตรยากจริงไหม?

Women who want to conceive are often advised by doctors to maintain their body weight within the standard range. Why do doctors recommend this? Today, we will learn about one of the common conditions that increase the risk of infertility found in overweight individuals, which is related to PCOS.
<h2>What is PCOS? 
</h2>
PCOS (Polycystic ovary syndrome) often causes abnormal ovarian function. When there are no eggs to be released to fertilize with sperm, no embryos form, and pregnancy does not occur. Therefore, it can be said that PCOS definitely affects infertility.
<h2>How to know if you have PCOS? 
</h2>
Normally, we consider a patient likely to have PCOS when 2 out of the following 3 symptoms are present:
<ol>
<li>Irregular menstruation, with cycles longer than 35 days or no menstruation at all</li>
<li>Elevated male hormones, which may be observed through external signs such as severe acne, excessively oily skin, abnormal hair growth, significant hair loss, or male-pattern baldness. If these signs are present, blood tests should be conducted for confirmation.</li>
<li>Ultrasound of the ovaries showing many small follicles in the ovaries, which is typical in PCOS</li>
</ol>
<h2>How does PCOS affect infertility? 
</h2>
Regarding fertility, PCOS affects ovulation, causing poor quality eggs or no ovulation at all. Without eggs, pregnancy cannot occur. In cases where pregnancy is possible but PCOS persists, the body’s elevated male hormones may interfere with other hormones that support pregnancy, increasing the risk of miscarriage or complications such as gestational diabetes, preeclampsia, and preterm birth. It may also cause other chronic symptoms in the future. Therefore, it is best to treat PCOS before attempting to conceive.
<h2>Other risks associated with PCOS 
</h2>
Currently, the exact cause of PCOS is not conclusively known, so treatment focuses on managing symptoms. Most people with this condition experience higher than normal insulin resistance. Insulin is a hormone that helps transport sugar from the blood into cells. When insulin resistance occurs, blood sugar levels rise continuously, which can eventually lead to diabetes and increased male hormone levels in the ovaries. This causes the ovaries to not develop properly and results in “anovulation”.
Additionally, as male hormones accumulate, they further increase insulin resistance, creating a vicious cycle. To resolve this, the cycle must be broken.
This disorder not only raises blood sugar but also causes lipid abnormalities, such as obesity or sleep apnea. These conditions are collectively called Metabolic Syndrome, characterized by high blood sugar, high blood pressure, and high cholesterol, which may lead to heart disease and increased mortality risk in the future.
It is clear that PCOS affects not only infertility but also many other aspects of health. Therefore, if these problems occur, treatment should be sought to improve overall health.
<h2>Treatment approaches for infertility</h2>
<ul>
<li>Initial self-care before seeing a doctor</li>
</ul>
<ol>
<li style="list-style-type: none;">
<ol>
<li>Reduce weight to a normal range to help restore hormonal balance, regulate menstruation, and prevent abnormalities and various risks.</li>
<li>Strengthen the body by eating nutritious food or taking supplements such as vitamin C, fish oil, folic acid (vitamin B9) to support pregnancy.</li>
</ol>
</li>
</ol>
<ul>
<li>Visit a doctor</li>
</ul>
<ol>
<li style="list-style-type: none;">
<ol>
<li>Take medical history and perform physical examination, including blood tests to check hormone levels affecting pregnancy.</li>
<li>Treat PCOS with diabetes medications that improve insulin function to lower blood sugar levels, combined with weight loss and dietary control.</li>
</ol>
</li>
</ol>
<h2>ICSI and PCOS 
</h2>
For those with PCOS undergoing in vitro fertilization or ICSI, the quality of eggs retrieved is clearly visible. Doctors can select good quality eggs for fertilization. In untreated PCOS patients, about half of the eggs are usually poor quality, while the rest may be good or not. However, after 1-2 months of treatment, the quality of eggs retrieved during stimulation is noticeably better.
<h2>If you want to have a child sooner 
</h2>
The main problem for those with PCOS is “lack of ovulation”. Therefore, treatment focuses on inducing ovulation and ensuring the eggs are of sufficient quality for use, through methods such as IUI or IVF, depending on the suitability of each couple and the individual’s overall health.
&nbsp;
Dr. Teerayut Jongwutiwes 
Fertility Specialist 
Infertility Treatment Center, Phyathai 2 Hospital

Those who wish to have children are often advised to maintain their body weight within the standard range. Why is that? How is being overweight related to infertility?

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