What Cause PCOD ?
Many experts believe that as the symptoms and signs are diverse, there may be more than contributing and causing factors. One of the major biochemical features of polycystic ovary syndrome is insulin resistance accompanied by compensatory hyperinsulinemia (elevated fasting blood insulin levels). There is increasing data that hyperinsulinemia produces the hyperandrogenism of polycystic ovary syndrome by increasing ovarian androgen production, particularly androstenedione and testosterone, and by decreasing the serum sex hormone binding globulin concentration. The high levels of androgenic hormones interfere with the pituitary ovarian axis, leading to increased LH levels, anovulation (absence of proper ovulation process), amenorrhea (absence of menses), recurrent pregnancy loss, and infertility. Hyperinsulinemia has also been associated high blood pressure and increased clot formation and appears to be a major risk factor for the development of heart disease, stroke and type II diabetes..
Insulin & PCOD
In many cases insulin resistance is the root cause for PCOD. In these cases a hormonal imbalance linked to the way the body processes insulin after it has been produced by the pancreas to regulate blood sugar (glucose), and this imbalance is known as insulin resistance. The underlying cause of PCOS, Insulin Resistance, has many factors that contribute to its presence in the body. In essence, our environment and lifestyles have evolved too rapidly for our bodies to keep pace. We are still genetically built to consume nutrient-rich foods, a diet low in carbohydrates and a kind of life style that sustains greater levels of movement and exercise. Some people may also have a genetic predisposition to Insulin Resistance, while others develop the condition through high stress and unhealthy lifestyles.
TREATMENT
Treatment of PCOD varies according to case requirement; menses regulation, cosmetic, weight reduction, or infertility. PCOD should be treated even if the case does not want fertility treatment to prevent long term consequences.
Infertility treatments include weight loss diets, insulin sensitizing agents, ovulation medications (clomiphene, Letrozole, gonadotrophins), ovarian drilling surgery and IVF/ICSI. There are many factors that would determine any of these should be started;
* Criteria used for the diagnosis! * Age of the wife * Duration of subfertility * Any other contributing factors to subfertility * Any previously taken medications and duration * has insulin sensitizers been given and how effective? * Other factors
At Ganin Fertility Center we believe that cases of PCOD should be looked at global attitude, which simply is: that goals have to be achieved through strong commitment from all of those who are involved in the treatment. The right diagnosis has to depend on specific criteria and confirmed with the sensitive investigations, treatment has to be followed addressing the couple need, and following up the response. All these steps have to be accomplished in a well defined time frame.
Prognosis:
With proper diagnosis and treatment, most PCOD symptoms can be adequately controlled or eliminated. Infertility can be corrected and pregnancy achieved in most patients.