Ovulation and PCOS

I've decided to try and explain why ovulation is so hard to detect for women who have PCOS and use ovulation predictor kits to determine ovulation. I have gotten some questions about my testing habits and I do want to say that I normally only test once a day, but I had purchased a month supply of OPKs that needed to be used within 30 days, so I tested a couple times a day for a while. Typically I test once, in the afternoon, with several different brands. I only do that because I am obsessed and I don't trust any one brand.

Anyway, PCOS and OPKs; here's a short break down:

PCOS, or Polycystic Ovarian Syndrome, is one of the leading causes of infertility in women. Approximately 5%-10% of women of childbearing age have PCOS. Most women with PCOS don’t even know that they have it. In fact, less than 50% of women with PCOS have actually been diagnosed. 85% of women who suffer from PCOS suffer from infertility as well. Most women do not get a diagnosis until they begin trying to get pregnant. Some of the symptoms of PCOS may be overlooked until a woman starts trying to conceive a baby. Symptoms include, but are not limited to: unwated hair growth, fine or thin scalp hair, obesity, skin tags and missing periods.

PCOS is a medical condition that affects women’s menstrual cycles, fertility, hormone levels, and physical appearance. Women with PCOS produce high levels of insulin and higher levels of male hormones or androgens.

During the first half of a normal menstrual cycle, several follicles will develop. Each follicle contains an egg. As the menstrual cycle continues, only one follicle will remain. This follicle will produce the egg during ovulation. Once the egg has matured, LH levels will surge causing the egg to burst from the follicle. This is when ovulation occurs. However, the excess male hormones produced with PCOS affect the production of female hormones necessary for ovulation. A woman with PCOS does not produce enough hormones to cause any of the follicles to mature. They may grow and collect fluid but none become large enough for ovulation. If ovulation does not occur, progesterone will not rise.

 

Because hormone levels are affected with PCOS, predicting ovulation can be difficult. Some women with PCOS; including myself, usually have an anovulatory BBT chart. If we do ovulate, it may be very difficult to interpret the BBT chart. PCOS may also affect the results of ovulation prediction kits. OPKs work by detecting LH surges. Some women with PCOS have elevated LH hormones making it difficult to use an ovulation prediction kit. OPKs actually warn consumers on the box that the reliability of the test my be compromised if you suffer from PCOS, or use fertility medications.