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What Is the Connection Between PCOS and Infertility and Overall Health?
Dr. Rashmi Kudesia, RMA of New York: The most sort of stereotypical PCOS picture really revolves around the idea of the insulin resistance. So, it’s easier for these women to put on weight, harder for them to lose it and so their sort of this component of coming in and trying to figure out how to get very healthy first and then get pregnant.
So, there’s sort of two different dynamics that we generally see with our PCOS population.
Being overweight or obese is associated with, obviously, difficulty in getting pregnant in the first place, but then also worse outcomes during actual pregnancy.
Having PCOS, being insulin resistant, puts you at a higher rate of having problems during pregnancy like gestational diabetes, cesarean section, all these other complications that we try to avoid.
So, for women that are coming in that are all ready overweight or obese, trying to lose weight, trying to establish that healthy diet and exercise regimen before getting pregnant, before having a toddler or baby running around, is really important.
A key part of what I talk to all my POCS patients when they come in the door: Where is their BMI? What is their glucose control? Are they already pre-diabetic and do we need to talk about losing weight before pursuing any fertility treatment?
Particularly with the younger women, where I feel that there is a little bit of time, there’s not a huge crunch on “we have to get pregnant right now!” I try to say, “OK, let’s take three months to maybe work on getting healthy.”
I refer them to our nutritionist we have. We’re lucky to have a nutritionist on our staff. So, that’s really important. And I sit there and I’m very honest about, you know, the challenges that we all face and try to incorporate exercise into a healthy lifestyle.
It’s important for women to remember as they go through the process of fertility treatment, you know, as reproductive endocrinologists making that diagnosis of PCOS is really important to me.
But it’s important for women to remember that that’s something they should be mentioning to their general OB/GYN and their internal medicine doctor, if they have one or if they get one down the road, because we know that that diagnosis does predispose women to having cardiac and metabolic issues in the future. And I think if I was a cardiologist seeing, you know, 45-year-old women, knowing that she had a PCOS history, might make me feel a little bit more differently about how I’m screening her for heart disease and diabetes and all of these things.
And so I think that’s an important piece of the puzzle when they come in for fertility reasons to make sure that no matter who their doctor is that they’re understanding the full breadth of ramifications of the diagnosis, not just “OK, I’m not ovulating. I can fix that problem and then forget about it.” It’s kind of an important thing to remember; the lifelong consequences.
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