Infertility in women: What to know about polycystic ovary syndrome

When Hajara was in her teenage years, she always wondered why her female friends and other women always had their monthly periods and she did not.  Her period comes sometimes three or six months apart, and sometimes she goes 10 months without her menses.

She also occasionally experienced heavy monthly flow that lasts weeks. She discussed it with a few older women around her who told her it was normal so long as she was menstruating once in a while. She got used to being called ‘man-woman’ or ‘wicked person’ because of her little moustache and deep voice.

However, years on when she got married, she found it difficult to have children.  It was several years later, after a lot of traumatic experiences from her husband and in-laws that she was diagnosed with polycystic ovary syndrome.

She discovered much to her dismay that some of the things she believed or was told were normal were indeed symptoms of the disease.

Polycystic ovary syndrome (PCOS) is a condition that affects how a woman’s ovaries work. It is a hormonal disorder common among women of reproductive age. Women with the disorder may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries develop a lot of small collections of fluid (follicles) and fail to regularly release eggs.

According to the Clinical director of Tunicleo Medical and Fertility centre, Abuja, Dr Tumika Akunyili, polycystic ovary syndrome is a major cause of infertility in women. She said in her close to 13 years’ experience as a fertility expert, she observed that many women in the country suffer from infertility because of the condition.

Dr Akunyili, who herself suffered from the condition, said it is usually demonstrated when a woman does not have a regular menstrual cycle, and has hormonal imbalance and hirsutism (that is male pattern hair growth in women such as on the chin, face, chest and back).

That, she said, results from the women’s high level of the male hormone called androgen which causes them to have imbalance in their hormones.

She said some sufferers have menstrual flows with lots of clots, after not having periods for three months or more.

The doctor said the condition is often diagnosed through a scan at the hospital.

“To know if a woman is polycystic, after the normal medical history, you also do a scan. The ovaries that women with polycystic ovary syndrome have is different from that of other women.

“A woman can have like six to eight follicles around the ovaries but one with polycystic ovary syndrome has a ring form with a lot of follicles around the ovaries that make it impossible for them to ovulate,” she said.

The fertility expert said polycystic ovary syndrome sufferers also tend to have a lot of miscarriages because most of the eggs that they develop are usually not of good quality, and the body has a way of removing that which is not good.

Another feature is that women who suffer the condition could also have apple shaped body. “From the side of her breasts region to the waist, she is big then she has tiny legs,” she explained.

Obesity can also cause the condition, whether you are polycystic or not, she said, adding that there are some women that being fat alone could make them suffer from infertility.

She said the disease is genetic – that is it can be inherited when one’s mother or close relative suffer from the condition.

Dr Akunyili, who is now a mother of three, said all hope is not lost for women with polycystic ovary syndrome as support and treatment can be provided for them through in vitro-Fertilisation (IVF).

She said getting married early also helps women with the condition because as they grow older to about 30 years their ovarian reserve goes down.

She cited the case of a close relation of hers with the condition who she advised to marry early. She married at 22 and has four kids. At 31 she began to notice that her period was becoming irregular. She would have started battling with infertility had she not married earlier, the clinician added.

However, she added that women and sufferers can help themselves a lot better by knowing their body very well right from early age. “The symptoms usually start from puberty. Sometimes you hear ladies say I will take postinor, I have a friend who is using postinor to prevent pregnancy, this is wrong because you don’t know if the postinor is good for you,” she advised.

She said knowledge about women/girl’s physiology and health education should be included in the curriculum in schools and that Parents Teachers Associations (PTAs) should occasionally invite mothers and their daughters to sensitization meetings to discuss about their bodies and health.

“So that when your daughter starts her period at let say 10 years and at 15 years, she said she doesn’t see her period, you won’t conclude she is pregnant,” she said.

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