A pregnancy breakthrough

When her pregnancy test showed up positive, Ines Acevedo did not believe she was pregnant. After years of trying to conceive, she had recently learned that at the root of her problems - the disappearance of regular menstrual cycles, the weight gain and hair growth - lay an endocrine disorder that rendered it near-impossible for her to conceive.

But her new doctor had started her on a drug previously reserved for diabetics, and it had ameliorated many of her symptoms - most importantly, restoring her menstrual cycles. Now, against all odds, the dipstick's pink color assured her that her dream had become reality.

She repeated the test just to be sure: "Magenta pink."

Acevedo and her husband, who live in Pembroke Pines, were delighted. "We had already sat down and had that big conversation: What if we're not parents? He walked around the house in shock," she recalls. In June 2000, Janelle Marie Gutierrez was born.

A decade ago Acevedo might never have successfully borne a daughter. She might never have even received a diagnosis for the constellation of symptoms that had plagued her.

The past five years have brought a surge of medical and patient interest in Acevedo's condition, Polycystic Ovarian Syndrome. As doctors learn more about this disorder, they have started treating it with insulin-sensitizing drugs, the same substances that prompt a diabetic to decrease sugar production.

These drugs appear to work wonders in some patients, like Acevedo, who have difficulty conceiving. Hollywood physician Kenneth Gelman, who devotes about half his practice to PCOS, sees about one to two pregnancies a week in patients recently placed on the drug.

PCOS occurs when a woman overproduces insulin. The increased insulin leads to abnormally high levels of male sex hormones, or androgens, such as testosterone. The excessive androgens give the body the go-ahead to put on weight, develop acne and cease menstrual cycling.

This mix can morph the ovaries from their normal rounded shape to football-shaped organs dotted with follicular cysts, hence the syndrome's name. The cysts arise from stunted follicles that do not develop into eggs because of the out-of-whack hormones in the body.

In the past, doctors had few tools to fight PCOS. Their best bet was to prescribe birth control pills that would take over the work of hormonal regulation for the woman, ease those side effects, and "restore" cycles.

Except, of course, that prevented conception.

MASKING PROBLEM

"Birth control pills are just masking the problem. They're not treating it specifically," says Dr. Neil Goodman, a clinical professor at the University of Miami School of Medicine and endocrinologist in private practice in Miami. The insulin-sensitizing drugs, however, halt the runaway hormonal process in its tracks. While the jury's still out on how exactly these drugs work, they appear to reduce the need for the body to overproduce insulin. Lower insulin levels translate into lower androgen levels, allowing the woman to menstruate normally and opening the door for conception.