PCOS, short for polycystic ovarian syndrome, is a familiar term. It is a common condition in reproductive-aged women. Hormonal imbalances, metabolic abnormalities and insulin resistance are a common occurrence in women with PCOS. Most women who are diagnosed with PCOS have just one question in mind –will getting pregnant be a challenge? While PCOS is a leading cause of infertility, it does not mean that women with PCOS cannot get pregnant. Since fertility can vary quite a bit from one woman to another, not everyone with the condition is infertile. Knowing the signs of infertility with PCOS can make it easier for women to seek treatment.
How PCOS impacts Fertility?
PCOS negatively impacts fertility. This is mainly because women who are diagnosed with this condition do not ovulate or release a healthy egg at the end of their menstrual cycle. In PCOS, the body overproduces androgens (male hormones) as well as insulin. This hormonal imbalance results in ovulation not occurring regularly.When you have PCOS, your ovaries tend to be larger than normal. In these big ovaries, many tiny cysts that have immature eggs develop. They are usually 2-9mm in diameter(1).
As a result of this, periods become irregular, weight gain is common, and egg quality is affected. Although women with PCOS take longer to get pregnant than other women, the good news is that they too can have as many children as women who are not diagnosed with this condition.
Research suggests that PCOS affects 5-13 percent of women of reproductive age (15-44 years)(2).While some women voluntarily visit a doctor to get themselves diagnosed for PCOS, there are others who learn they have PCOS when they visit a doctor since they’re trying to get pregnant without success. Despite this figure, women with PCOS can still get pregnant.
Signs of Infertility with PCOS
Having PCOS is one thing, being infertile is another! Recognising these warning signs will help you manage the condition better. Some of them include:
- Irregular, less frequent periods
- Severe weight gain
- High levels of male hormones – androgens
- Formation of tiny, painless, fluid-filled cysts in the ovaries
- Increased level of insulin in the blood
- Thickening of the outer shell of the ovaries
When a woman with PCOS is suffering from the above-mentioned symptoms, she can further put herself at the risk of developing type 2 diabetes, cardiovascular diseases, gestational diabetes, first-trimester spontaneous abortion and other infertility problems. Although a lot of women seek fertility treatment, there are several others who lose hope completely. They tend to feel dejected, experience body dissatisfaction, and are at an increased risk of anxiety and eating disorders (3.1, 3.2).
Gynaecologists recommend women with PCOS to get pregnant before the age of 35. The sooner the planning for a baby starts the better. According to them, fertility rates, and success rates of fertility treatments and therapies tend to decline after that.
Treating PCOS for Pregnancy
Don’t think of PCOS as a roadblock to conceiving. There are several routes you can take to help your chances of getting pregnant if you have PCOS. Start by seeing a doctor and getting a confirmed diagnosis. Other tips to increase fertility include:
- Weight Control
If you’re a woman suffering from PCOS, start by modifying your lifestyle. A healthy diet and exercise is imperative. Losing weight can also make your menstrual cycle more regular and improve your fertility. If you are trying to conceive, your diet should include lower carbohydrates and a reduced glycaemic load. Avoid eating foods that can spike your blood sugar levels. Also, try to exercise for a minimum of 30 minutes per day. You can also get a personalised health plan on MyAva. Seeking professional advice can help you stay in the healthy weight range.
- Manage Stress
Prolonged or long-term stress can affect your hormones. It is said to increase the levels of cortisol in the body, which results in higher insulin production. Heightened levels of stress can cause an imbalance in female sex hormones and cause infertility. You can manage stress by getting regular exercise, eating nutrient-rich foods, maintaining a work-life balance and by sleeping for eight hours.
While lifestyle modifications such as a better diet, no smoking and less stress can improve your chances of fertility with PCOS, there are other medical and pharma routes you can take too(4).
- Medicine
A lot of doctors even prescribe medicine to help a woman ovulate. The most common drug prescribed is Clomid (clomiphene). It is an anti-oestrogen drug that is supposed to be taken at the beginning of your cycle. Other popular medicines include metformin and femara. No matter which medicine you take, nothing is a sure-shot path to pregnancy. It all depends on your body. Research even shows that Clomid might lead to multiple pregnancies but in the bargain has several side-effects such as mood changes and hot flashes. In a study conducted in 2015, researchers pointed out that with Clomid, there are 49 percent chances of ovulation and 30 percent chances of pregnancy and a 23 percent live birth rate (5).
- Surgery
If your body hasn’t responded to medication, there is still hope by way of surgery. There is a procedure called laparoscopic ovarian drilling. The doctor makes tiny holes in the surface of your ovary using lasers. This usually restores pregnancy, however, only for six to eight months.
With so many options available for treatment, the good news is that there is hope. Always remember that if a woman has PCOS, it doesn’t mean she also has infertility. Recognising the warning signs and seeking professional advice always helps.
