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September marks Polyendocrine Metabolic Ovarian Syndrome (PMOS) Awareness Month, a time to shed light on how this condition impacts fertility and overall reproductive health. In this blog, we’ll explore the links between PMOS and fertility challenges, discuss treatment options, and highlight the importance of understanding this condition for those looking to conceive.
What is Polyendocrine Metabolic Ovarian Syndrome?
Formerly known as Polycystic Ovary Syndrome (PCOS), Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a hormonal condition affecting between 8% to 13% of all women of reproductive age. Unlike common identifiable diseases, it encompasses several problems and symptoms typically found together.
It is common for those diagnosed with PMOS to also face fertility struggles. Those who suffer from severe PMOS may not regularly release eggs or ovulate therefore people with this condition may also have a lower chance of getting pregnant. It is only natural to consider other alternatives to help with conception. Thanks to advancements made in Assisted Reproductive Technology (ART) there are a variety of fertility treatments available for PMOS patients.
How is PMOS Diagnosed?
Unfortunately, there is no one size fits all test to diagnose Polyendocrine Metabolic Ovarian Syndrome. A PMOS diagnosis involves a combination of clinical presentation, supportive blood tests, and a pelvic ultrasound.
To be diagnosed with PMOS, you must meet at least two of the following three criteria:
- Irregular menstrual cycles
- Several ovarian cysts
- Signs of abnormally higher androgen levels
Due to the variance in symptoms, oftentimes the condition goes misdiagnosed, which can be critical when it comes to family-building timelines and fertility treatment.
PMOS Symptoms
As we mentioned above, Polyendocrine Metabolic Ovarian Syndrome can affect different people differently. PMOS patients can demonstrate a combination of symptoms.
The symptoms of PMOS may include:
- Irregular menstrual cycles
- Excessive hair growth on the face chest, and back (hirsutism)
- Polycystic ovaries
- Skin changes such as acne or oily skin or skin tags
- Male-pattern baldness or thinning hair
- Weight gain and challenges loosing weight
- Infertility
Diagnosis of PMOS is important as it can shed light on a person's risk of developing a growing list of comorbidities.
Patients with PMOS have a higher risk of:
- Depression
- Sleep apnea
- Obesity
- Cardiovascular diseases
- Endometrial cancers
- Hyperglycemia or hypoglycemia
- Type 2 diabetes
- Miscarriages
- Liver disease
- Kidney disease
If you are experiencing symptoms of PMOS and are not yet diagnosed, talk with your healthcare provider and see what testing may be available to you.
Cause of PMOS
The exact cause of PMOS remains unclear, as there is no definitive medical explanation for the hormonal changes associated with the condition. Various factors, including genetic predisposition, insulin resistance, and inflammation, may contribute to the development of PMOS, but the impact among these elements is not fully understood. As research continues, it highlights the complexity of PMOS and the need for a multifaceted approach to its diagnosis and management.
PMOS Treatment
Polyendocrine Metabolic Ovarian Syndrome treatment is unique to each individual diagnosed, as there is no cure for the condition. Typically, PMOS is managed by addressing symptoms and any underlying issues, with a focus on lifestyle changes, medication, and, when necessary, fertility treatments. This personalized approach ensures that each patient receives the care best suited to their specific needs and health goals.
Lifestyle Changes
Lifestyle changes can significantly improve PMOS symptoms.
Below are lifestyle changes that may help with managing PMOS:
- Balanced diet
- Regulate insulin
- Regular physical activity
- Stress management
By making these lifestyle adjustments, individuals with PMOS may experience improved hormonal balance, better menstrual regularity, and enhanced fertility potential.
PMOS Medication
Medications for Polyendocrine Metabolic Ovarian Syndrome are aimed at managing symptoms and addressing hormonal imbalances. Hormonal contraceptives, such as birth control pills , are commonly prescribed to regulate menstrual cycles and reduce symptoms like acne and excess hair growth. Anti-androgens, like spironolactone , can help manage hirsutism by blocking the effects of male hormones. Additionally, metformin is often used to improve insulin sensitivity and support weight management in those with insulin resistance. For women seeking to conceive, fertility medications, such as clomiphene citrate , may be prescribed to stimulate ovulation. These treatments are tailored to each individual's needs.
PMOS Surgery
When other treatments prove unsuccessful, surgery becomes the next viable step. Your fertility doctor will carry out several tests and a vaginal ultrasound scan before recommending surgery. You will learn all the details about the procedure from your doctor.
Laparoscopic Ovarian Drilling (LOD) is a minimally invasive surgical procedure used primarily to treat those with PMOS who are experiencing infertility or have not responded to other treatments. During LOD, a surgeon makes small incisions in the abdomen and uses a laparoscope to visualize the ovaries. They then create small holes in the ovarian tissue, which can help reduce the production of male hormones (androgens) and promote normal ovarian function.
Getting Pregnant With PMOS
Pregnancy can be challenging with PMOS due to hormonal imbalances and irregular menstrual cycles. Elevated androgen levels often disrupt ovulation, resulting in complications when trying to conceive. Tracking ovulation is important; methods like monitoring basal body temperature or using ovulation predictor kits can help identify fertile days.
Ovulation Induction With Fertility Medications
The first PMOS infertility treatment option that your doctor will recommend is the use of fertility medication that encourages ovulation. Oral drugs such as letrozole and clomiphene citrate (Clomid) can help regulate ovulation. Injection-delivered fertility medications are the next alternative if oral drugs prove unsuccessful.
Fertility medications that are injected into patients are very effective at stimulating egg growth. However, continuous medical supervision is important since it can lead to the production of several eggs, which poses a risk of multiple births.
IVF With PMOS
In Vitro Fertilization (IVF) is an excellent option when PMOS fertility medications fail. With IVF, there are higher chances of getting pregnant with lower risks. For starters, fertility doctors can reduce the chance of multiple births by only transferring a single embryo into your uterus.
IVF With PMOS Success Rates
The success rate of IVF in PMOS is about 70% , which is excellent for patients with PMOS who want to conceive. PMOS and IVF protocol include several steps, all of which your healthcare provider or doctor will provide you with guidance. However, you can start early by looking through our website to better understand the IVF fertility treatment procedure.
PMOS Effects Pregnancy
Women with Polyendocrine Metabolic Ovarian Syndrome may face several pregnancy-related complications due to the hormonal imbalances associated with the condition. Research indicates that these women are at a higher risk for miscarriage, which can be attributed to irregular hormone levels and potential ovulatory dysfunction.
In addition, PMOS increases the likelihood of developing gestational diabetes, a condition that can impact both the mother and baby's health. Women with PMOS are also at higher risk for preeclampsia, a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems. This can lead to premature delivery and often necessitates cesarean sections.
Overall, while many women with PMOS can have healthy pregnancies, it is important to monitor and manage these risks through regular prenatal care and consultations with healthcare providers.
Fertility and PMOS Options With PFCLA
Are you a struggling with PMOS and trying to have children? Our PMOS Specialists have helped many families with this condition achieve their dreams of family. PFCLA has contributed to the birth of over 13,500 babies to families around the world through assisted reproductive technology like IVF. Contact us today to get started.
