IVF and PCOS
There are a number of fertility treatment options for women with PCOS: lifestyle changes, oral ovulation medications (Clomid), injectable medications and ovarian drilling surgery. Although many times these treatments are successful, women who are still unable to conceive through these methods may choose in vitro fertilization (IVF).
IVF Ovarian Stimulation Protocols for Women with PCOS
Your reproductive endocrinologist will choose the appropriate medication, dosage and stimulation protocol for IVF. Patients are closely followed with medication dosage increased or decreased as necessary. The goal is to produce a number of high quality eggs for retrieval, while avoiding overstimulation of the ovaries.
Women with PCOS are at a high risk of developing ovarian hyperstimulation syndrome (OHSS) when gonadotropin stimulation is used for IVF. Gonadotropin-releasing hormone (GnRH) agonists and antagonists may be used to reduce the risk of OHSS.
- Gonadotropin-releasing hormone agonist long stimulation protocol
To prevent hyperstimulation, a GnRH agonist (Lupron) is given in place of the HCG shot often administered prior to egg retrieval in IVF. When a GnRH agonist is used, estrogen and progesterone may be given after egg retrieval to reduce the risk of miscarriage.
- Short, or Flare, protocol
Lupron is given on day 2 of the cycle and FSH injections are started the following day. Both medications are continued until HCG is administered. Some fertility specialists recommend this protocol for women who are low responders.
- Gonadotropin-releasing hormone antagonist protocol
GnRH antagonist drugs such as, Ganirelix and Cetrotide, are given along with FSH (follicle stimulating hormone) and HCG. These medications are given subcutaneously beginning on day six of the FSH stimulation and continued daily until the day of the HCG injection.
Injectable gonadotropins are linked to a high risk of multiple pregnancy. This risk is greatly reduced by selecting only a limited number of the highest quality embryos for transfer. Our fertility specialists typically recommend placing only one or two embryos back into the uterus.
The fertility specialist at Dallas-Fort Worth Fertility Associates are experts in fertility treatments for women with polycystic ovarian syndrome (PCOS). Our physicians care for patients in Southlake, Keller, Grapevine, Colleyville, Denton and their surrounding areas.