Getting Pregnant When Syndrome O Gets in Your Way by Robert F. Feinberg, MD, Ph.D

Millions of women struggle every day with infertility, miscarriage, weight problems, and menstrual cycle irregularities. These troubling issues are often directly related to metabolic and hormone disruptions disruptions that wreak havoc on women's bodies and their self-esteem. Although many of these problems are blamed, simplistically, on polycystic ovaries, a much more significant condition is frequently overlooked: Syndrome O, a reproductive problem that is unique to women of our time. It is the World War III of hormones, causing women's metabolism to unravel the normal sequence of hormone changes during an otherwise fertile menstrual cycle and pregnancy. The types and quantities of foods you choose to eat, along with other vital life choices, may literally be preventing you from becoming the woman you could be.

The basic hallmarks of Syndrome O are best defined as: 1) Overnourishment: a chronic mismatch in how calories are taken in and burned, leading to insulin overproduction and a tendency toward obesity; 2) Ovarian imbalance: causing improper levels of male and female hormones within the ovaries; and 3) Ovulation disruption: blocking the development and release of healthy eggs.

As two of many vital organs involved, women's ovaries are supposed to produce uniquely female hormones - estrogen and progesterone - in a pattern as predictable as the phases of the moon. When overnourished and bombarded with inappropriate levels of insulin hormones, the ovaries become confused, producing some estrogen, a bit too much androgen like testosterone (male hormone), and too little progesterone. This problem now affects millions of women, even if they appear to be ovulating regularly!

The Syndrome O phenomenon has a close common link with Syndrome X, a problem many medical experts have come to understand as a high-insulin metabolic state. This is also called the "metabolic syndrome," and commonly promotes too much weight gain, obesity, diabetes, hypertension, and coronary artery disease in women and men. It is estimated that as many as 50% of Americans are affected by the metabolic syndrome. For young women, their reproductive system and destiny are profoundly affected.

Recent research has shown that women with Syndrome O are faced with tough challenges everyday, including some necessary and overdue lifestyle adjustments and real health concerns. Although not so true in the past, infertility and miscarriage are now viewed by our society as truly significant health concerns. Often, women with Syndrome O feel overwhelmed and don't know where to turn for help. "I need to be pointed in the right direction" is a common plea.

The Syndrome O Survival (SOS) Strategies provide a blueprint to give Syndrome O women a fighting chance for enhancing their fertility and health. "You will accomplish that which is important to you" is the philosophy that forms the foundation of the SOS Strategies, a framework for living, which complements and enhances the necessary medical evaluation and treatment for Syndrome O.

In order to overcome the challenges of Syndrome O, it is recommended to: 1) Organize your goals and desires, your time, and your approach to health evaluation and treatment; 2) Optimize your life activities, your nutrition, and your fitness; and 3) Offer attention to loved ones and to yourself, offer time and expertise outside the house, and offer your assistance to others in the Syndrome O community. Many individuals seek quick and easy answers, whether the latest diet craze or fitness fad, or the desire to just take a pill. There are no quick fixes for people affected by Syndrome O, or by the metabolic syndrome in general. It is obviously necessary to "eat right" and "get some exercise" but those concepts will mean different things for different people.

There is no substitute for a careful and caring evaluation by a trusted physician. However, one must seek the right specialist. For fertility concerns, it is often wise to seek out evaluation and treatment by a board-certified, fellowship trained reproductive endocrinologist (RE). As a subspecialty of obstetrics and gynecology, most RE doctors are up-to-date on the issues, challenges, and treatments for Syndrome O and polycystic ovaries. Good luck in your quest to be healthy and fertile.

Ronald F. Feinberg MD, PhD, a board-certified reproductive endocrinologist at Reproductive Associates of Delaware, is the author of "Healing Syndrome O: A Strategic Guide to Fertility, Polycystic Ovaries, and Insulin Imbalance" (Avery; 2004). He has been a women's health clinician, educator, and researcher for over 20 years. For a support group on Syndrome O, visit