Fertility management experiences of women with polycystic ovary syndrome in Australia

Abstract

Background: Women with polycystic ovary syndrome (PCOS) are usually told that the condition is associated with fertility difficulties. However, little is known about their fertility management including contraceptive use, childbearing desires, and pregnancy outcomes.

Aim: To compare the fertility management experiences and outcomes of Australian women with and without PCOS.

Method: The 2013 Australian electoral roll was used to identify a random sample of 18- to 50-year-old women who were sent the Understanding Fertility Management in Australia survey to be completed anonymously. Factors associated with fertility management and outcomes were identified in multivariable analyses.

Results: Among the 1543 women who completed and returned the survey, 113 (7.3%) reported having PCOS. Women with PCOS reported a similar rate of current contraceptive use as women without PCOS (50.4% vs. 52.6%, p = .66). However, they were significantly younger at first pregnancy (24.9 vs. 26.8 years, p = .015), more likely to have consulted a health professional about fertility management (OR: 3.86, 95% CI: 2.50–5.96, p < .001), and perceive that it would be difficult to conceive (OR: 2.31, 95% CI: 1.41–3.79, p = .001) than women without PCOS. There were no significant differences in the number of desired children, unintended pregnancies, live births, abortions or miscarriages between women with and without PCOS.

Conclusion: These findings indicate that women with PCOS need more nuanced information about their fertility potential. While they may experience fertility difficulties because of their condition, they should also be informed that they can conceive spontaneously and need reliable contraception to avoid pregnancy when it is not wanted.

摘要

背景：患有多囊卵巢综合征（PCOS）的女性通常被告知这种情况与生育困难有关。但是, 关于他们对生育管理如避孕药物的使用、生育需求和妊娠结局等知之甚少。

目的：比较患或不患多囊卵巢综合征的澳大利亚妇女的生育管理经历和结果。

方法：采用2013年澳大利亚招募名单随机选取18-50岁女性样本, 这些女性匿名填写了澳大利亚的“了解生育管理”调查。采用多变量分析确定了与生育管理和结果相关的因素。

结果：在完成并返回调查的1543名女性中, 113（7.3%）报告患有PCOS。PCOS患者报告目前应用避孕方法的比例与未患PCOS的女性相似（50.4% vs. 52.6%, p=.66）。但是, 他们在首次怀孕时更年轻（24.9 vs. 26.8岁, p=.015）, 更有可能就生育管理咨询健康专业人士（OR: 3.86, 95% CI: 2.50–5.96, p<.001）, 并认为与无PCOS的女性相比更难以怀孕（OR: 2.31, 95% CI: 1.41–3.79, p=.001）。在希望生育孩子的数量、意外怀孕、活产、人工流产或自然流产方面, 患或不患PCOS的女性无显著差异。

结论：这些研究结果表明, PCOS患者需要更多关于其生育能力的详细信息。虽然由于他们的病情可能会出现生育困难, 但他们也应该被告知他们可以自发怀孕并需要可靠的避孕手段以避免非意愿的怀孕。

Keywords:

• Polycystic ovary syndrome
• Australia
• contraception
• childbearing
• unintended pregnancy

Acknowledgements

The researchers thank all the respondents for their generous participation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by an Australian Research Council Linkage Project Grant (LP100200432) with funding and in-kind contributions from Family Planning Victoria, Melbourne IVF, The Royal Women’s Hospital, and the Victorian Department of Health and Human Services. JF is supported by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship.