Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disorder affecting 10-13% of women of reproductive age. This condition leads to increased male hormones and insulin resistance. It causes ovaries to develop numerous small follicles that often struggle to mature, resulting in irregular ovulation. Consequently, natural conception is often difficult, even though eggs are present.

Intrauterine insemination (IUI) is a method where washed sperm is directly placed into the uterus. For women with PCOS, doctors typically combine IUI with mild ovarian stimulation medication to produce one or two mature eggs. Doctors then monitor follicle development via ultrasound. Once the follicles mature, sperm is inseminated around the time of ovulation. This method is less invasive and costs less than in vitro fertilization (IVF), making it a suitable initial option.

In vitro fertilization (IVF) is considered after multiple IUI failures, or in cases of low ovarian reserve, fallopian tube issues, uterine problems, or if genetic screening is required. For PCOS patients under 35, IVF offers a higher success rate, approximately 60-70% per cycle. However, these patients face an elevated risk of ovarian hyperstimulation syndrome, necessitating individualized stimulation protocols with precise medication dosages and close monitoring.

Dr. Do consults a woman. Illustration: Tam Anh Cau Giay General Clinic.

Before deciding between IUI and IVF, a comprehensive fertility assessment is necessary. This includes evaluating ovarian reserve, counting follicles via ultrasound, conducting a hysterosalpingography, a semen analysis for the husband, and checking blood sugar and insulin levels. If overweight, reducing body weight by 5-10% can improve ovulation. A diet low in refined carbohydrates, rich in vegetables, fruits, and protein, combined with regular exercise, is also crucial.

You may try IUI first. Many women with PCOS successfully conceive using this method, especially given your age of 30 and your husband's normal sperm count. An IUI cycle typically lasts two to three weeks. Strict adherence to ultrasound appointments, timely medication, and avoiding unauthorized ovarian stimulation drugs is crucial to prevent multiple pregnancies or hyperstimulation.

Dr. Le Quang Do

Fertility Support Unit

Tam Anh Cau Giay General Clinic