Dr Abri de Bruin

Welcome! Please see this website as an educational reference for patients. My practice strives to offer comprehensive and individualized care in minimal access surgery, endometriosis and infertility.

What is PCOS?

  • A condition where the ovaries contain a large number of small cysts at the periphery of the ovary
  • This is usually but not always, associated with irregular periods, weight problems and acne.  Any combination of the symptoms below can be present in a patient
  • Patients do not need to be overweight to have PCOS

What are the symptoms?

  1. irregular cycles
  2. no cycles
  3. infertility
  4. weight gain
  5. abnormal hair growth, typically on the nipples, face and up to the belly button
  6. acne
  7. any combination of the above

What tests should be done?

  1. ultrasound to look at the ovaries and measure the volume of the ovaries
  2. fasting insulin and glucose levels
  3. day 2 of your cycle LH levels
  4. testosterone and sex hormone binding globulins
  5. BMI determination

Can the cysts be removed?


How long has this been there?

  • You have always had this and you will always have this
  • It is a chronic medical condition and needs to be managed like one manages other chronic conditions like high blood pressure

What is actually wrong?

  • you do not ovulate.
  • you produce and excess of male hormones
  • the follicles do not mature and when stimulated not all follicles will contain eggs

What are the treatment options?

  • this depends on the patient's wish and is usually one of a few:
  • young girl with irregular cycles only - the oral contraceptive pill
  • acne - tablets to decrease the excess male hormones
  • insulin resistance - insulin lowering drugs
  • weight problems - dietary advice and insulin lowering drugs if insulin levels are high
  • infertility - ovulation induction using either tablets or injections or a combination
  • ovarian drilling - a last resort in patients that do not respond to ovulation induction using standard protocols

any combination of the above treatments may be necessary.

ovarian drilling (4 holes only on one ovary)

Can I actually get pregnant if I have PCOS?

  • You have a very good chance of conceiving, especially if PCOS is the only reason why you are not conceiving
  • Yes you most probably can, depending on other factors as well like your state of your tubes and your husband's semen analysis
  • However, patients with PCOS are difficult to stimulate and it will not always work the first time and different protocols might be used
  • Usually stimulation is started with only tablets and later injections are added if necessary
  • One of the problems is the possibility of over stimulating due to the number of eggs that you have in your ovaries
  • Your LH hormone will be checked at the beginning of the treatment cycle during your period - the reason for this is that if your LH level is raised, you have a poor chance of actually stimulating and an increased chance of having a miscarriage