Q: Good evening Dr. Ketch. please can women with PCOS who can only menstruate, ovulate by taking medication, conceive and put to birth without miscarriage?

A: Ovaries are small bean-shaped organs on either side of your womb. Every month, your ovaries develop sacs called follicles from where eggs are released monthly and female sex hormones produced. After the egg is released every month, the sac disintegrates. But sometimes, the egg is not released and the sac remains or the egg is released and the sac does not disintegrate. This follicle becomes the fluid-filled cyst sac. Usually this is not a problem as it could form during every menstrual cycle and usually resolves on its own. These cysts are called the functional cysts. However, these cysts could get very big and in some instances become twisted or they could rupture causing problems. This latter type is called pathological cyst.

Examples of pathological cysts occur in PolyCystic Ovarian Syndrome (PCOS) and endometriosis. In the former, small cysts appear all over the surface of the ovary and is also associated with irregular menstruation and high hormonal levels. In endometriosis, the tissues of the uterus (womb) are found outside of the uterus. These two pathological cysts are associated with fertility problems. Functional cysts are hardly associated with fertility issues except they become extremely large.

So, is it possible to become pregnant with PCOS? It is not impossible. To help improve your chances, maintain a healthy weight, eat healthy, exercise, monitor your ovulation and time sexual intercourse to coincide with this time.

Treatment depends on your particular situation. Your doctor could order serial scans to continually observe the size of the cysts and see if they reduce in size. Another treatment option is the use of birth control pills to prevent the development of more cysts in future menstrual cycles. The final option is surgery.

Risks associated with pregnancy in a patient with PCOS include miscarriage, high blood pressure, premature birth and diabetes mellitus. The risk of these can be reduced by monitoring PCOS symptoms and taking extra care during pregnancy. Your doctor will advise on the best course of action based on your history.

All the best!