Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies, or hormonal problems, in women of reproductive age, affecting between 5 and 10 percent of women.

Most professionals use the Rotterdam criteria to make the diagnosis of PCOS, with 2 out of 3 criteria required for the diagnosis. These criteria include:

Clinical or biochemical of hyperandrogenism – blood test results showing excess androgens. For example, unwanted hair growth and acne.
Less frequent or absent ovulation - leading to infrequent and irregular menstrual cycles.
Polycystic morphology of the ovaries on ultrasound.

In clinical practice the picture is a bit more complex with different women manifesting the syndrome in different ways. In addition to reproductive abnormalities and hyperandrogenism, clinical manifestations may include metabolic issues, such as obesity and type 2 diabetes, psychosocial issues, such as mood disorders and eating disorders, and more.

How does the diagnosis of PCOS affect fertility preservation?

Ovarian reserve is defined as the number of eggs remaining in the ovary. Women with PCOS tend to have a higher ovarian reserve than age matched women without PCOS. This may mislead some to think that freezing their eggs is not necessary. However, it is important to remember that with age, egg quality also declines. As such, it is recommended that decisions regarding egg freezing be based on the woman’s goals regarding her desired family size, her career, her relationships and more.

Having a high ovarian reserve, like in PCOS, does mean that there is a higher likelihood of having a successful stimulation cycle that will result in a higher number of frozen eggs. This means that a woman with PCOS will likely need less stimulation cycles to achieve the desired number of frozen eggs. Additionally, thanks to new protocols used by most reproductive endocrinologists, the risk of ovarian hyperstimulation syndrome is almost negligent.

In summary, fertility preservation with egg freezing is a good option for women with PCOS who would like to delay starting their family. As always, it is important to remember that egg freezing is all about giving yourself options and choices.

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Dr. Ido Feferkorn is a reproductive endocrinologist at Reproductive Medicine Group in Tampa. He specializes in treating patients with infertility, PCOS, endometriosis and recurrent pregnancy loss. He also has a special interest in fertility preservation. Dr. Feferkorn’s research has been presented in international conferences such as the American Society for Reproductive Medicine (ASRM) and European Society for Human Reproduction and Embryology (ESHRE). Dr. Feferkorn loves spending his free time with his wife and three kids. He chose REI because of the magic in seeing life created and accompanying the journey to parenthood.