After two unsuccessful intrauterine insemination (IUI) attempts in Japan, 34-year-old Tuyet returned to Vietnam and sought treatment at Tam Anh General Hospital - District 8. Dr. Phung Huy Tuan, from the hospital's Fertility Center, diagnosed Tuyet with polycystic ovary syndrome (PCOS), a condition characterized by irregular menstrual cycles, high androgen levels, and insulin resistance. While IUI can bring sperm closer to the egg, it's less effective if ovulation is irregular or egg quality is suboptimal.

According to Dr. Tuan, the stress and anxiety following two failed treatments likely impacted Tuyet's ability to conceive. Stress can exacerbate hormonal imbalances in women with PCOS, delaying or even preventing ovulation during an IUI cycle, even with fertility medication. It can also reduce egg quality and blood flow to the uterus.

Dr. Tuan recommended in vitro fertilization (IVF) for Tuyet and her husband to better control the ovarian stimulation, fertilization, and embryo selection process. Alongside therapy sessions with a psychologist, Tuyet received moderate ovarian stimulation to retrieve an ideal number of eggs and avoid ovarian hyperstimulation syndrome. The procedure yielded 25 oocytes, resulting in 8 day-5 embryos. A healthy embryo was transferred, leading to a successful pregnancy. Now over 10 weeks pregnant, Tuyet is no longer experiencing the same level of stress.

Dr. Tuan examines a patient. *Illustrative photo: Tam Anh General Hospital - District 8*

PCOS is a leading cause of infertility, affecting 10-15% of women of reproductive age. Symptoms include irregular periods, excessive hair growth, acne, hair loss, weight gain and obesity, melasma, and small cysts on the ovaries. Treatment often involves lifestyle changes, such as reducing refined carbohydrates, increasing fiber and lean protein intake, and regular exercise for weight loss. Dr. Tuan notes that even a 5-10% weight reduction can significantly improve menstrual cycles, ovulation, and response to other treatments.

Some patients benefit from medication to stimulate ovulation, manage insulin resistance, and lower androgen levels, regulating menstrual cycles and improving ovulation. If medication is ineffective, ovarian drilling may be considered.

While stress isn't a direct cause of infertility, it can worsen PCOS. Dr. Tuan advises women experiencing infertility and psychological distress to seek treatment at fertility centers offering multidisciplinary care for a comprehensive approach.

Dinh Lam

*The patient's name has been changed.