PCOS treatment in Goa: what PCOS is, and how it's managed

What PCOS actually is

PCOS is a hormonal imbalance that affects how the ovaries release eggs. Instead of one egg maturing and being released each month in a regular cycle, the ovaries may contain many small, immature follicles that do not mature and release on a predictable schedule. "Polycystic" refers to how the ovaries can look on an ultrasound scan — not that the ovaries contain harmful cysts. The exact cause is not fully understood, but insulin resistance and hormonal factors both play a part, and PCOS often runs in families.

Typical symptoms

Symptoms vary a lot from one woman to another, and not everyone has all of them. The more common ones are:

• Irregular periods, infrequent periods, or periods that stop altogether
• Difficulty conceiving, due to irregular or absent ovulation
• Weight gain, or difficulty losing weight
• Acne, particularly along the jawline and chin
• Excess hair growth on the face or body, and sometimes thinning hair on the scalp

None of these on their own confirms PCOS — plenty of other conditions can cause similar symptoms, which is why a proper diagnosis matters rather than assuming based on symptoms alone.

How PCOS is diagnosed

Diagnosis is usually based on a combination of your history, a physical examination, blood tests, and an ultrasound scan.

Managing PCOS

PCOS cannot be cured, but it can be managed well, and management is tailored to what matters most to you at the time — whether that is regulating periods, managing symptoms like acne or hair growth, or conceiving.

PCOS and fertility

PCOS is one of the more common causes of female infertility, mainly because irregular ovulation makes it harder to predict, or sometimes achieve, a fertile cycle without help. This does not mean pregnancy is unlikely — many women with PCOS conceive with lifestyle changes and medication alone, and those who need more support move on to IUI or IVF in a stepwise way, rather than starting with the most involved treatment first.

Tests at the first visit, and what each one shows

• Internal ultrasound scan: looks at the womb and both ovaries. It can show the many small follicles typical of PCOS, a cyst, a fibroid or a polyp.
• Day 2 or 3 hormones: hormones such as FSH and LH show how the ovaries and the brain's signals to them are working.
• AMH: a blood test of egg reserve that can be done on any day. A high AMH is common in PCOS, where the ovaries hold many small follicles, so the result is read differently; see what AMH means.
• Thyroid and prolactin: either one out of balance can upset ovulation, and both are usually straightforward to treat.
• Blood sugar: checked because PCOS is closely linked to how the body responds to insulin.
• The husband's semen analysis: a sperm problem can exist alongside PCOS and would change the plan; see male infertility treatment in Goa.
• A tube test: before IUI, at least one fallopian tube must be open; see the HSG test in Goa.

The PCOS fertility treatment ladder

Treatment for conceiving with PCOS starts with the gentlest step and moves up only when it is needed:

1. Lifestyle. Even a modest, gradual weight loss, where relevant, with regular movement and a balanced diet, can help ovulation return on its own. Crash diets are not needed.
2. Ovulation tablets. Simple tablets, taken for a few days early in the cycle, encourage the ovary to release an egg. Scans follow the growing follicle and show when ovulation is near. They are usually tried for about three or four months; if no egg has been released by then, there is little point in carrying on.
3. Injections, sometimes with IUI. Hormone injections called gonadotropins give the ovary a stronger, carefully controlled signal. Because ovaries with PCOS can respond more strongly than usual, they are given under close supervision, and scans make sure that not too many eggs grow at once. When the egg is ready, a trigger injection releases it at a planned time, and IUI with washed sperm can be done that day; see follicle scans explained and IUI in PCOS when tablets do not work.
4. IVF. If two or three well-done IUI attempts have not worked, or other factors mean there is less time to spare, IVF is the next step, with ICSI when the husband's sperm count is low; see ICSI treatment in Goa. PCOS often responds well to IVF because the eggs are usually there.

What happens at our hospital, step by step

1. Consultation. By appointment. Bring every earlier scan and blood report you have.
2. Tests in one cycle. The hormone tests are timed for day 2 or 3 of the period, the tube test for the days after bleeding stops, and the rest can be done on any day.
3. The plan. The doctor explains the results and the first step on the ladder that suits you, and the point at which you would move up is agreed in advance.
4. Monitored cycles. During treatment, scans follow the growing follicle, so the timing of intercourse or IUI becomes clear.
5. After an IUI. Hormone support with progesterone, as tablets and sometimes as injections, is often prescribed to support the lining of the womb. Your doctor tells you what to take and for how long.

The scans, the laboratory work and the procedures are done at Pai Hospital at Vaddem, Vasco-da-Gama, which has its own IVF laboratory and operating theatre.

How long each step takes

Most of the first tests fit into a single menstrual cycle, and once the results have been reviewed, treatment can often begin with the next period. Ovulation tablets are usually tried for about three or four months. Our doctor recommends two or three well-done IUI attempts before IVF; read how many IUI cycles before IVF. An IVF cycle, from the start of the injections to the pregnancy test, usually takes about a month when the embryo is transferred fresh.

When to come sooner

Do not wait if your periods stop for two or three months at a time, if you have been trying for a while with irregular periods, or if tablets have been taken for three or four months without an egg being released. As a general guide, a couple should be checked together after about a year of trying, or after six months if the woman is over thirty-five.

Getting started: when to see a PCOD specialist

If your periods are irregular, infrequent, or absent, or if you are trying to conceive and are concerned PCOS may be involved, call or WhatsApp us to arrange an assessment. Bring any previous scan or blood test reports you have — they often shorten the path to a plan.

Read next: infertility specialist in Goa · IVF cost in Goa.

Video guide in Konkani

Our doctor explains the causes of PCOS and shows what a PCOS ovary looks like on ultrasound, in Konkani: PCOS: what causes it, and what the ultrasound shows.

Or call +91 95185 02773

This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.