PCOS Expertise

As the eggs in the ovary begin to grow, they are protected by a fluid-filled sac called a follicle. The follicles are surrounded by the ‘packing material’ that carries blood vessels etc to feed the follicles. In a normal ovary, a small group of follicles grows each month and one is ‘chosen’ to become the biggest and to release its egg. The rest disappear. In a polycystic ovary there are just more of these follicles growing. They were incorrectly named cysts many years ago and hence the name poly (meaning many) cystic ovaries. When you had an ultrasound scan you may have seen these follicles as little black circles in the ovary. Polycystic ovaries also build up more of the packing material inside the ovary, so this and the extra follicles, makes them larger than normal ovaries.
An important word about the follicles/cysts in polycystic ovaries; these cysts do not get large or burst or cause pain. They are not on the ovary, but inside it, the same as in a normal ovary.

PCO just refers to the change in the ovary. If you also have one or more symptoms associated with this change then you have Polycystic Ovary Syndrome. The most common signs and symptoms are:
• an irregular or absent menstrual cycle
• effects on the skin in the form of acne and/or unwanted hair.
Other common symptoms are:
• weight gain, infertility and problems with glucose and insulin balance.

It is remarkably common! Approximately one in 5 women have polycystic ovaries and approximately 1 in 10 women have PCOS.
In addition, about one third of women who almost never have a period have PCOS. Almost all women who have irregular menstrual cycles have PCOS. Most of the women attending dermatology clinics for hirsutism and or acne have PCOS. The majority of women with Bulimia Nervosa have PCOS. Many women with gestational diabetes have PCOS. It is a very common syndrome indeed!
So why don’t we all know more about it? Good question!

PCOS affects different women in different ways. Some women struggle most with their skin, some with their irregular cycles, some with difficulty controlling their weight and some with reduced fertility. If your cycle is absent, irregular or unpredictable then clearly you are ovulating less frequently and conceiving will be harder. Ideally, all women given a diagnosis of PCOS when they are young would be given good advice at the time, but we know that this rarely happens. However, it is never too late to start to get to grips with the changes in your hormones. If you are on the fertility journey it is especially important to be well-informed about your PCOS.

As you are probably well aware, many women with PCOS gain weight very easily and unfortunately being overweight makes all aspects of the syndrome worse. We know that for some women, losing this weight has been near impossible for many women. The problem is that as you gain weight you ovulate less often and may cease ovulating entirely. It also becomes much harder to induce ovulation, with many women needing to turn to IVF. IVF can put quite a strain on the body and women with the highest BMI need very specialist care, or in some cases may need to lose a small amount of weight to make IVF safer and more successful. Many clinics are therefore reluctant to treat women with PCOS who have a high BMI, but at Concept we will support you to optimise your health before treatment or to reach a BMI at which treatment can commence safely. We can also help you to understand why you have gained weight easily and why it is so hard to lose it.

You may have been diagnosed recently, or many years ago, but are struggling to find a clinic that really understands your PCOS or you may just have a lot of questions that no one has been able to answer. We find that many women are either told ‘come back when you want a baby’ or ‘we cannot help you until you lose weight’. Neither approach is helpful. It is not surprising that women with PCOS feel unsupported and report higher levels of depression and anxiety. At Concept we offer a holistic approach to PCOS providing clinical expertise, explanation, understanding and support, whichever of the symptoms is causing you concern. Professor Mason will take the time you need to help you understand the effects of this condition on your body and work with you to achieve your aims.

Have you always had irregular cycles, struggled with your skin, have had an eating disorder, or are gaining weight easily? Perhaps your sister has been diagnosed with PCOS, or a close friend, or you have seen an article or programme about PCOS recently and thought that this may fit your symptoms. As PCOS is so common, many women put up with the symptoms and never get an accurate diagnosis, or only do so when they need fertility treatment. PCOS is diagnosed by a simple ultrasound scan and, where needed, a blood test. Receiving an accurate diagnosis from Concept is the first step towards getting to grips with your hormones and taking control. Concept can help you on your PCOS journey now and in the years to come. We recommend that you access the expertise of Professor Helen Mason so that you are armed with the most reliable and up-to-date information.

It is possible that you will not wish or need to have any treatment at this stage, but we can have a full discussion regarding this and equip you with the support and knowledge to have the best outcomes in the future, whether this includes fertility or not.

All patients requesting fertility treatment at Concept will initially have an appointment with a clinical specialist.  Depending on the information gained during the Initial Consultation, your Consultant may suggest a consultation with Professor Mason in order to further explore your PCOS or symptoms that could suggest PCOS.  Helen would then feedback her findings to your Consultant.  As state above, we feel that this can arm you with the knowledge and power to better understand your body and how it is affected by the condition, and therefore impacting on your fertility.  Helen can give you tools to improve your chances of a successful outcome.

You do not need to have the consultation, it is not obligatory, and all our doctors have experience in treating patients with PCOS. However, you should consider your whole fertility journey; all fertility treatments have a limited success rate and, whilst many patients achieve their families with a single cycle of treatment, many others need, and pay for, several rounds of treatment. More so with PCO patients. You should weigh your total cost of treatment with and without this specialist consultation and recognise that any improvement in your success rate will likely far outweigh the cost of an additional consultation. And that’s just the finances; it is physically and emotionally better for you to achieve your family with as few treatments as possible. Any further lifestyle improvements you can make through managing your PCOS are just an added bonus.