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PCOS Treatment for Pregnancy - Fertility Success Rates

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What is the treatment for PCOS and infertility?

Polycystic ovarian syndrome is a common cause of female infertility. The ovaries in these women contain multiple small cystic structures, or antral follicles, that are 2-9 mm in diameter.

  • The ovaries have a characteristic "polycystic" (many cysts) appearance on ultrasound

PCOS ovary ultrasound image
Ultrasound image of PCOS ovary at "PCO"
Bowel at "B"

For a more detailed general explanation of PCOS, see: Polycystic Ovarian Syndrome, PCOS

  • Women with PCOS syndrome do not ovulate (release eggs) regularly and therefore have irregular menstrual cycles
  • Therefore, treatment for infertility caused by PCOS is directed at getting the woman to ovulate
  • Doctors call this "induction of ovulation"

What is induction of ovulation?

Ovulation induction involves the use of medication to stimulate development of one or more mature follicles (where eggs develop) in the ovaries of women who have ovulation problems and infertility.


PCOS Fertility Treatment - Inducing Ovulation

Treatment Options

There are several possible ways to attempt ovulation induction in women with polycystic ovaries, including:


PCOS Pregnancy Statistics

Pregnancy success rates with induction of ovulation vary considerably and depend on:

  1. The age of the woman
  2. The type of PCOS meds used
  3. Whether the medication used is effective at stimulating ovulation in that woman
  4. Whether there are other infertility factors present in the couple

In general, successful treatment resulting in pregnancy is more likely to occur in the first 3 to 4 months of treatment. After that, the monthly success rate drops off considerably.

The approximate average monthly pregnancy success rate (female age under 35, normal sperm) for the major types of treatment used for PCOS are:

Treatment for PCOS Expected "Monthly" Success Rate
Metformin alone About 1-2%
Clomid 15% - if ovulating
Femara 15% - if ovulating
Injectable gonadotropins 20%
IVF, In vitro fertilization 60% - at our IVF clinic

A brief overview of each PCOS treatment option is below
For details see the pages that discuss each treatment option

Clomid

  • The least complicated method is the use of Clomid tablets, also called Serophene, or clomiphene citrate
  • Many will be able to get pregnant using clomiphene to induce ovulation
  • Clomiphene is usually the first line of treatment

Details about Clomid for treatment of polycystic ovarian disease and infertility


Femara (Letrozole)

Femara (generic name is letrozole) is an oral drug which can be effective in stimulating ovulation in some women with polycystic ovaries and anovulation.

Some women that do not respond and ovulate with Clomid will respond well to letrozole. Other women that do ovulate with Clomid may never get pregnant on it, and could do better with letrozole.

Details about Femara (letrozole) for PCOS treatment


Injectable Gonadotropins (FSH Hormones)

For women that do not ovulate with clomiphene, the "traditional" next step has been to use injectable gonadotropins. The woman takes daily shots of FSH hormone for about 7 to 15 days in order to stimulate mature follicle development.

Risks and Side Effects

  • The injectable medications are expensive
  • Beware of multiple birth risks with this treatment option - there are risks for triplets and higher order multiple pregnancies
  • There are risks of ovarian hyperstimulation syndrome
  • The daily injections and multiple trips to the office for monitoring are inconvenient

Injectables for PCOS treatment


IVF - In Vitro Fertilization

The large majority of women with PCOS that have not gotten pregnant with other treatments will be able to have success with IVF if they are under 40 years of age and have their IVF performed at a high quality clinic.

IVF clinics are not all the same - learn more about IVF pregnancy success rates

Success Rates

We specialize in treating women with PCOS and have many IVF PCOS success stories

Details about IVF treatment for PCOS


Metformin

Oral medications such as metformin (brand name Glucophage) can be used to try to stimulate ovulation with PCOS. It can be used with or without Clomid.

  • Metformin is an "insulin sensitizing agent" primarily used to control diabetes.

Success Rates

Not many couples will get pregnant using metformin alone. However, some women will respond to metformin and clomiphene when they are used in combination.

Some will not ovulate even with the combination therapy and will need either injectable FSH medications, or IVF to have a baby.

Side Effects

Metformin has unpleasant gastrointestinal side effects such as diarrhea in about 25% of patients.

Metformin for PCOS and fertility treatment


Cost for Induction of Ovulation and PCOS Treatments

The costs associated with induction of ovulation depend on:

  1. The type and dose of medication required.
  2. The number of ultrasound and blood tests required to properly monitor the cycle.
  3. Sometimes artificial insemination will be recommended, which increases the chances for a pregnancy, as well as the cost.
  • A Clomid cycle usually costs between $100 and about $1200, depending on what is done.
  • A cycle with injectable gonadotropins usually costs between $1500 and $6000, depending on what is done and the doses of injectables needed to stimulate follicles to grow.

Details about costs of various fertility treatments


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