PCOS and Fertility: What You Need to Understand

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions affecting women of reproductive age. But beyond irregular periods and acne, PCOS has a significant impact on fertility, and that’s what many women don’t fully understand. In this blog, we cover the connection between PCOS and fertility, how it affects your health, and the treatment options that can help you get pregnant.

What is PCOS?

PCOS, or polycystic ovarian syndrome, is a very common hormonal disorder in women, which involves excessive production of male hormones, or androgens. Women normally produce androgens in small amounts, but excessive androgens can interfere with the body’s hormone balance.

Ovulation is a phase of your menstrual cycle during which a single follicle, or fluid-filled egg sac, grows and bursts every month, releasing a mature egg. In PCOS, these follicles do not burst but rather collect in the ovaries. They look like clusters of cysts on an ultrasound scan, hence the name ‘polycystic ovarian syndrome.’

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How are PCOS and Fertility Linked?

PCOS is caused by hormonal imbalances, which cause an increase in male hormones (androgens). These hormones harm female reproductive potential by interfering with the reproductive processes of menstruation and ovulation.

Let’s understand how this happens. In PCOS, you may have irregular periods with infrequent or no ovulation. In this situation, your ovaries don’t release eggs, which means that even if you have sex, pregnancy cannot happen.

Women who don’t ovulate regularly are not ‘fertile’ as often as those without it. They need to carefully track when they ovulate and have timed intercourse during their fertility window to even have a chance of getting pregnant.

PCOS and Infertility: Does PCOS Cause Infertility?

PCOS is considered one of the leading causes of subfertility in the world. It’s important to note that PCOS causes subfertility, not infertility. It’s still possible for PCOS patients to become pregnant with lifestyle changes, ovulation-tracking tools, and medical support.

Most PCOS patients experience difficulties getting pregnant due to irregular or no ovulation. This problem can be resolved through diet and lifestyle changes. Your gynecologist can also prescribe you medicines that induce ovulation or regulate your menstrual cycle.

Once you’re able to ovulate regularly, you can time intercourse to align with your fertility window. This boosts your chances of natural conception. In fact, many women with PCOS conceive naturally this way!

PCOS and Fertility: Getting Pregnant With PCOS

Depending on your overall reproductive health, your gynecologist may first recommend trying to get pregnant naturally. If that doesn’t work out for you, the next step is moving on to infertility treatment for PCOS.

Birth Control

You may be taken aback if your fertility specialist recommends birth control pills as a treatment for PCOS. They actually have a good reason for doing so: birth control pills have been shown to regulate hormonal imbalances caused by PCOS.

What does this mean for you? Birth control pills can help you restore hormonal balance so that you have better chances of conceiving with fertility treatments in the future. Note that your doctor will only prescribe birth control if you’re not actively trying to conceive at the moment.

IUI (Intrauterine Insemination)

Intrauterine insemination is a minimally invasive fertility treatment that can help you conceive. In this treatment, washed semen is transported directly to the uterus.

IUI helps increase the chances of fertilization because it stimulates ovulation and places sperm directly in the uterus.

In Vitro Fertilization (IVF)

If IUI and other treatments don’t work, your fertility specialist may recommend going the IVF route. In vitro fertilization is a highly successful type of fertility treatment that involves retrieving the eggs from the patient and fertilizing them with sperm in a laboratory.

IVF helps women with PCOS conceive, as it becomes possible to test egg quality and monitor embryo development outside the uterus.

Insulin-Sensitizing Agents

PCOS can cause insulin resistance, which is often directly or indirectly the reason for most of its symptoms.

Metformin, which is usually prescribed to treat diabetes, is sometimes given to PCOS patients to increase their sensitivity to insulin. This helps them lose weight easily and reduces the severity of other PCOS symptoms too.

Ovarian Stimulation Medication

No, you don’t need to go through IUI or IVF to receive ovarian stimulation medication. Your fertility specialist can recommend medication like clomiphene citrate or letrozole, which stimulates your ovaries to produce and release eggs during ovulation. If these don’t work, your doctor may recommend gonadotrophins instead.

Laparoscopic Ovarian Drilling (LOD)

Laparoscopic ovarian drilling is a surgical procedure in which the tissue on your ovaries that produces androgens is removed. This surgery is not common anymore thanks to the advancements in PCOS treatments and medication in recent years.

Lifestyle Changes To Deal With PCOS and Fertility

Most women with PCOS are told to make lifestyle changes to ease the effects of PCOS symptoms. In the long run, these changes can be more effective than medical treatment.

Weight Loss

According to a famous study published in Fertility and Sterility, losing just 5% of your body weight can help restore regular reproductive functions such as ovulation. Most women are advised to lose weight through a combination of healthy eating and exercise.

Diet

Since most PCOS patients can gain weight quickly, making positive changes to your diet can make a huge impact on your overall health.  Fiber, protein, and healthy fats are your best friends.

We recommend foods that have a low glycemic index and cutting out processed sugars from your diet.

Exercise

Regular exercise helps you lose weight, which can gradually improve your body’s sensitivity to insulin and manage your blood sugar levels. Exercise doesn’t have to be at the gym; it can be biking, swimming, running, or strength training.

PCOS and Pregnancy Complications

PCOS can increase your risk of pregnancy complications like pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, cardiovascular disease (CVD), and preterm birth. 

While there’s a very real risk, top IVF clinics like Bloom IVF carefully monitor your condition by understanding your unique symptoms and providing personalized fertility treatment options.

Mental Health and PCOS

Getting diagnosed with PCOS can come as a shock, especially if you didn’t expect it. The symptoms of PCOS can be very difficult to deal with, and it can feel isolating when your friends and family don’t know what it is like to live with this condition.

Dealing with infertility can cause feelings of sadness and guilt to surface. Often, women who deal with PCOS struggle with other symptoms like excessive weight gain and hirsutism, which can take a huge toll on confidence and mental health.

At Bloom IVF, we understand the emotional weight of a PCOS diagnosis. With PCOS treatment, you can efficiently manage your symptoms and become pregnant. We also offer high-quality medical treatments that can help minimize the risk of any pregnancy complications. Book a free consultation today!

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