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How Does PCOS Affect Fertility?

Polycystic Ovary Syndrome (PCOS) may impact fertility, but many treatment options are available to women with PCOS who are hoping to conceive.

How Does PCOS Affect Fertility?

What is PCOS? 

Polycystic ovary syndrome, or PCOS, is a complex endocrine disorder that affects between 4 and 18% of women of childbearing age. It is diagnosed when a woman experiences at least two of the following three symptoms: irregular or absent menstrual cycles, clinical or biochemical signs of excess androgen (male hormones, like testosterone) and the presence of polycystic ovaries (multiple ovarian cysts) found on an ultrasound. For many sufferers, it can take over two years to get an official diagnosis. The exact causes for PCOS are unknown and there is currently no way to cure PCOS permanently, but treatment plans are widely available to help manage symptoms, including infertility. 

PCOS is characterized by various symptoms, including irregular menstrual cycles, hormonal imbalances and the presence of multiple cysts on the ovaries. While PCOS can impact various aspects of a woman's health, one of the most significant concerns is PCOS’s impact on a person’s ability to get pregnant naturally. In fact, PCOS is the most common cause of anovulatory infertility. 

How PCOS Affects Fertility 

While there is no best age to get pregnant with PCOS, sufferers who are under 35 and/or ovulate regularly can usually expect to conceive within a year. However, PCOS can decrease fertility due to a number of factors. 

  • Irregular Menstrual Cycles: Women with PCOS often experience irregular menstrual cycles, where ovulation may not occur or occur infrequently. Ovulation is the release of a mature egg from the ovary, which is necessary for conception. Without regular ovulation, the chances of getting pregnant naturally decrease significantly.

  • Hormonal Imbalances: PCOS is characterized by imbalances in various hormones, including increased levels of luteinizing hormone (LH) and insulin. Elevated levels of LH can disrupt normal ovulation, while insulin resistance can lead to increased production of androgens, such as testosterone. These hormonal imbalances can interfere with the development and release of mature, healthy eggs, reducing the chances of successful conception.

  • Anovulation: Anovulation, or the absence of ovulation, is common in people with PCOS because of irregular hormone levels and the inability of follicles to develop and mature properly. Without ovulation, fertilization cannot occur, making it challenging for women with PCOS to conceive naturally.
  • Egg Quality: PCOS may contribute to lower egg quality, which can hinder successful fertilization and implantation. This can be attributed to the hormonal imbalances and the prolonged time it takes for the eggs to fully mature. Poor egg quality can increase the risk of miscarriage or infertility.

  • Increased Risk of Insulin Resistance: Many women with PCOS also experience insulin resistance, a condition in which the body becomes less responsive to insulin. Insulin resistance can disrupt hormone levels, interfere with ovulation, and increase the risk of developing other reproductive complications, such as polycystic ovaries and gestational diabetes during pregnancy.

  • Increased Risk of Miscarriage: PCOS has been associated with an increased risk of miscarriage compared to women without the condition. The exact reasons for this association are not fully understood, but it is believed to be linked to the hormonal imbalances and the potential impact on the endometrium, the lining of the uterus necessary for implantation. 

Treatments And Options For Women With PCOS 

While PCOS may present challenges to natural conception, there are various treatment options available to help women with PCOS fulfill their desire to have children:

  • Lifestyle Changes: Making lifestyle modifications, such as adopting a healthy diet, regular exercise and managing weight, can improve hormonal balance and increase chances of ovulation. 
  • Nutritional Supplementation: Recent studies have shown that treatment of PCOS with different naturally-found ingredients, including inositols, DIM and folic acid has shown positive results with little to no side effects. These ingredients can help with blood sugar balance & insulin sensitivity, inflammation, the restoration of ovarian function & hormonal balance, and can even help regulate the menstrual cycle. 
  • Medications: Hormonal medications, such as clomiphene citrate or letrozole, can be prescribed to stimulate ovulation in women with PCOS. These medications help regulate the menstrual cycle and increase the chances of successful conception. 
  • Assisted Reproductive Technologies (ART): In cases where other treatments have not been successful, assisted reproductive technologies like in vitro fertilization (IVF) may be recommended. IVF involves the retrieval of mature eggs, their fertilization with sperm in a laboratory, and the transfer of viable embryos into the uterus. 
  • Ovarian Drilling: Ovarian Drilling (OD) is a surgical procedure that may be considered in women with clomiphene citrate therapy-resistant PCOS. It involves using heat or laser to make small punctures in the ovaries, which can help restore ovulation. 

You Can Get Pregnant With PCOS 

PCOS can impact a woman's fertility and make it challenging to conceive naturally. Celebrities like Victoria Beckham, Keke Palmer and Victoria's Secret model Romee Strijd have all shared publicly about their struggles with the condition, from chronic acne to infertility. The irregular menstrual cycles, hormonal imbalances, anovulation, lower egg quality and increased risk of miscarriage associated with PCOS can be obstacles on the road to parenthood. However, with good medical care, lifestyle modifications and other available treatment options, women with PCOS can increase their chances of not only successfully conceiving but also having a healthy baby—just like Victoria, Keke and Romee. 

Seeking guidance from healthcare professionals, getting support from loved ones and maintaining a positive mindset throughout the journey is essential for managing the emotional rollercoaster of PCOS-related fertility struggles and finding the best path forward. 

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