So following on from our last post about how acupuncture can support the IVF process, we’ll be discussing PCOS, how this affects an IVF cycle and how acupuncture may help to counteract some of the side effects.
So what is Polycystic Ovarian Syndrome?
PCOS is associated with high levels of androgens, which cause the ovaries to produce multiple follicles each month. However these follicles tend to not mature fully so rather than releasing lots of eggs they accumulate in the ovaries. Therefore PCOS can mean that you may not be ovulating or have an irregular cycle. Unfortunately once you are diagnosed PCOS there is no cure, however some evidence shows that a low sugar (Low GI) and high fibre diet can have a positive effect on PCOS.
How does having PCOS affect your fertility?
Obviously it can be very tricky to conceive if you have an irregular cycle. Unless you are tracking your basal body temperature or have want to use ovulation sticks every day throughout your cycle then it’s hard to know when or even if you have ovulated. Many women are offered Clomid to try and guarantee ovulation which can help. Due to increased risks to PCOS sufferers undergoing IVF this is normally the first step in fertility treatment.
How does PCOS affect an IVF or ICSI cycle?
During an IVF cycle the primary goal is to stimulate your ovaries to produce more than one follicle and hopefully eggs, it’s a number’s game, the more eggs that can be collected the higher your chances of getting some that fertilise. Take a PCOS patient who already has multiple immature follicles and stimulate her ovaries further then you can imagine the excessive response that occurs! The slow and steady approach is normally taken during stimulation and drugs such as metformin or cetrotide are given to help reduce the chances of early ovulation.
What are the main Risks?
Ovarian Hyperstimulation Syndrome (OHSS) is a risk with any IVF cycle, however this risk is increased for women with PCOS. The many unripe follicles can all suddenly develop and overstimulated ovaries can fill with fluid which can leak into the abdominal cavity or collect in the lungs, it is a serious condition which needs to be addressed early. Clinics will monitor high risk patients more than others and Kate has been well managed and monitored daily by her consultant through this current cycle. This has meant that the chance of her developing complications as a result of her PCOS have been minimised.
How can Acupuncture help?
When treating most IVF patients our main aim is to support the stimulation phase by increasing blood flow to the uterus (see our last blog post!), however when supporting women with PCOS it’s definitely more of a balancing act. We need to address the ‘damp’ which has accumulated, clear any resulting heat from the extra medications aswell as increase the blood flow to help the follicles mature, it’s a fine line. OHSS can still occur post egg collection so still needs to be monitored.
It’s important to look out for any signs of OHSS that the patient may display and to advise them to contact their clinic immediately, acupuncture should not be substituted for western medicine as OHSS may require medication!