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She’s having a baby…finally
Tywona Walker of Detroit is in the early stages of her first pregnancy. She and her husband, Diago, are thrilled – and a little surprised. Just a few months ago they feared they would never have a child of their own.
“We didn’t know if we’d ever get pregnant,” Tywona said. “We even started talking about adoption.”
In 1999, a gynecologist told Tywona she had all the symptoms of Polycystic Ovarian Syndrome (PCOS), a mysterious condition that can cause fertility problems in women. (See the related story on page XX).
At first, the newlyweds weren’t concerned. But, four years and five doctors later, they were still unable to conceive. They even participated in a clinical study of a new treatment for PCOS, but nothing helped.
Then, at 29, Tywona met Frank Yelian, M.D., Ph.D., an associate professor of reproductive endocrinology and infertility at Wayne State University School of Medicine and Hutzel Women’s Hospital.
“Meeting him, it’s been a real blessing to us,” she said. “None of the other doctors were able to help us and he was just so positive, so hopeful for us.”
After taking Tywona’s medical history, examining her and conducting a variety of tests on both Tywona and Diago, Dr. Yelian felt confident he could help them. “He said he didn’t want to give us false hopes, but he didn’t see any reason why we couldn’t be pregnant by my 30th birthday,” Tywona said.
An Unknown Cause
The cause of PCOS is unknown, but physicians know it can result in abnormal ovulation – making it difficult for women to get pregnant. If left untreated, PCOS can cause other, more serious health problems.
“I had irregular periods,” Tywona said. “I would not ovulate every month. I could miss my period for 90 days and when I’d have one, it could last for as long as 14 days.”
Tywona also had other symptoms of the syndrome – elevated androgen (a male hormone) levels and multiple, small cysts on her ovaries.
An Expert Treatment
Dr. Yelian and other Hutzel physicians treat dozens of women with PCOS. After treatment, many of them are able to get pregnant. Some – like Tywona – are able to conceive without fertility drugs or artificial insemination.
While Tywona’s previous physicians knew about her PCOS symptoms, only Dr. Yelian was able to develop an effective treatment plan. Tywona’s treatment included exercise, eating right and taking Metaformin, a common medication for Type II diabetes.
“It’s very typical for women with PCOS to have insulin resistance,” Dr. Yelian said. “They may have elevated fasting glucose and/or insulin levels. They don’t have diabetes necessarily, but they have a significantly increased chance of developing diabetes. And if they do get pregnant, they have an increased chance of developing gestational diabetes.”
In patients with diabetes, Metaformin is known to stabilize glucose levels by increasing the body’s sensitivity to insulin. In women with PCOS, the medication not only stabilizes glucose and insulin, it often enables women to get pregnant by increasing the chance of ovulation.
Still Mysterious
Even though Dr. Yelian and other physicians at Hutzel Women’s Hospital are often able to treat PCOS, the disease remains a mystery.
“We still do not know what causes Polycystic Ovarian Syndrome,” Dr. Yelian said. “Approximately 5 to 10 percent of reproductive age women have this illness. There are probably multiple factors causing it. There certainly is a genetic component.”
Studies have shown that the sisters of women with PCOS have an increased chance of developing the syndrome.
Dr. Yelian and Michael Diamond, M.D. – another physician at Hutzel Women’s Hospital – are currently studying various medical therapies for PCOS. While they are learning about the syndrome, Tywona and Diago will be learning about pregnancy and how to care for a newborn.
“We’ve been going through this infertility problem for at least 5 years,” Tywona said. “It’s just so exciting to be pregnant now. We are so pleased with Dr. Yelian. He’s been the most caring and thorough doctor that we’ve ever come across.”
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