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Top 5 PCOS Questions and Answers: IVF Cycle

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Q: If I have PCOS and I am doing IVF, are there aspects of my IVF cycle that will be different due to my diagnosis of PCOS?

A: In general, two of the main risks of doing IVF are multiple births and hyperstimulation . The issue of multiple births can be minimized by the number of embryos being transferred. If you are under 38 years old, you may be a candidate for transferring only one embryo. By transferring only one embryo, you give yourself the best chance for being pregnant with a singleton pregnancy, the safest type of pregnancy. Many IVF centers have very high pregnancy rates with low numbers of embryos being transferred. You should talk with your doctor to see if you are a candidate for a single blastocyst embryo transfer.

The second risk of hyperstimulation needs to be taken very seriously in a woman with PCOS. Ovarian hyperstimulation is when the ovaries become very large and fluid can build up in a woman’s belly. In its mild form, a woman may feel bloated with some discomfort in her belly. In its more severe form, it can put a woman at significant health risk. Women with PCOS have many small follicles ready to be stimulated by the IVF injection medications. Therefore, the risk of ovarian hyperstimulation is higher in women with PCOS. There are a few modifications that can be made to an IVF cycle in women with PCOS. First, Metformin has been shown to potentially decrease the risk of hyperstimulation in IVF. So ask your doctor if you should start Metformin as you are preparing for your IVF cycle. Second, your doctor can put you on lower doses of gonadotropin injections. This will still allow a group of eggs to grow to maturity, but will not cause too many eggs to grow. Third, your doctor can consider triggering with a medication called Lupron instead of HCG. This will help your ovaries return to their normal size much more quickly and will decrease your symptoms of bloating. Third, your doctor can consider freezing all of your embryos in your fresh cycle and then doing a frozen embryo transfer with your next period. This will dramatically decrease your risk of hyperstimulation and will likely make your first trimester of pregnancy much more comfortable.

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