PCOS and Fertility: Here is Everything You Need to Know

Most women often have concerns about childbearing, including whether they can become pregnant while having PCOS. However, having PCOS does not mean you can’t get pregnant. Women often only realise they have PCOS when they start trying for a baby. Unfortunately, there is no permanent treatment for PCOS, but you can manage and reverse the symptoms. While fertility problems are common for PCOS, a study shows that women with PCOS and women without PCOS have no significant differences in the number of children, live births, or miscarriages. Therefore, it is reassuring that you have good chances of conceiving with PCOS. Nonetheless, you should know how PCOS can influence fertility and what to do about it. 

PCOS: A Brief Introduction

PCOS or polycystic ovarian syndrome is related to hormonal imbalance, where the ovaries don’t always release an egg at the end of the menstrual cycle. As a result, it can cause difficulty getting pregnant. PCOS is a complex hormonal condition which affects up to one in five women of reproductive age. The exact cause of PCOS is unknown, but it might involve genetic and lifestyle factors. For example, if your sister, mother, or aunt suffers from PCOS, you’re more likely to develop the same. 

Symptoms of PCOS

1. Sleeplessness

When it comes to PCOS, you are likely to suffer from insomnia, night sweats, or sleep apnea. You might also face difficulty breathing for short periods while sleeping. 

2. Fatigue

When the sleep quality is bad or poor, you feel extreme fatigue during the daytime. 

3. Hirsutism

Women with PCOS tend to develop excess hair on their feet, chest, abdomen, back, arms, upper lip, cheeks or chin due to higher levels of androgens or male hormone circulating in the body. 

4. Thinning hair

Hair might grow in excess in other body parts, but it leads to thinning at the top of the head, similar to male-pattern baldness.

5. Acne

Skin problems are another issue with PCOS where acne, darkened skin, and skin tags are the problems. 

6. Weight Gain

Even with a hardcore exercise regimen and a fixed diet routine, around 50% of women suffering from PCOS have weight gain issues that are difficult to deal with.

7. Fertility Issues

PCOS and fertility issues top the list, but it is a given that not all women suffering from PCOS will have problems conceiving. Some still give birth to babies naturally with no help. 

8. Mood Instability

Women with PCOS undergo a lot of emotional fluctuation or mood swings or suffer from bouts of anxiety and depression. 

9. Pain in General

PCOS leads to pain in various body parts, including headaches and abdominal and pelvic pain. 

10. Period Irregularity

You can experience your periods with a lighter or heavier flow or spot. It can also bleed heavily for months. 

11. Cysts

Some women develop cysts on their ovaries in case of PCOS. This cyst formation is a combination of many immature, fluid-filled follicles. However, when your age increases, the cysts decrease in number. 

PCOS and Fertility: The Connection

PCOS is associated with difficulties in getting pregnant. Most women with PCOS can conceive, but it may take longer to become pregnant. That is because women with PCOS have an underproduction of female hormones and an overproduction of male hormones. Due to this hormonal imbalance, you experience irregular menstrual cycles because either you don’t ovulate or ovulate only occasionally. As a result, PCOS causes you to take a longer time to fall pregnant, making you more likely to need fertility treatment.

On average, women with PCOS tend to gain weight more frequently. Being overweight reduces fertility and contributes to PCOS women taking longer to conceive. Many women with PCOS are also obese. A study shows that obesity in PCOS caused poorer reproductive outcomes and reduced fertility. 

What are the Chances of Conceiving With PCOS?

As for all women, being in the best possible health increases the chance of pregnancy. Giving exact percentages and statistics is difficult because your chances vary depending on your PCOS severity and treatment method. However, most women with PCOS will be able to have a baby with fertility treatment. For women who are under 35, there is a high success rate in PCOS fertility treatment. However, it is more challenging for those ovulating sporadically or who don’t have enough progesterone. 

Fertility Treatments for Women With PCOS

While your chances of conceiving with PCOS tend to be lower, adopting a healthy lifestyle is the first thing to improve your fertility. It helps in normalising your hormones and periods. Examples include:

• Eating a healthy diet.
• Being in the healthy weight range.
• Get plenty of regular exercises and enough sleep.
• Not smoking.
• Cutting back on alcohol.

If you have a BMI score of thirty or over, you need to lose weight with healthy eating and regular exercise. Being in a healthy weight range alone may get your body ovulating. There are still several things you can do to increase your fertility. Your doctor may prescribe certain medications to assist your body in better dealing with insulin resistance and help regulate your periods. Some people need to go on hormonal birth control to enhance their menstrual cycle for a few months before coming off it. Eating a healthy, low-sugar diet can also help regulate your reproductive hormones. It can also help you lose weight, increasing your fertility if you are overweight.

Some medications that your doctor may suggest are:

Clomiphene Citrate for PCOS

Clomiphene treats infertility in PCOS women who do not ovulate. It is an ovulatory stimulant. You can consume this once a day for five days when your menstrual cycle begins, only after a doctor’s prescription. After that, you will start with a minimal dose, and the dosage can increase. It is pretty helpful in boosting ovulation. 

Letrozole for PCOS

It is significant in treating breast cancer and can jump-start ovulation in people suffering from PCOS. It works to induce ovulation by blocking oestrogen production, leading to increased follicle-stimulating hormone (FSH) release. Those with PCOS commonly use Letrozole in combination with different fertility treatments to increase their chances of getting pregnant.  

Metformin for PCOS

Metformin is not as effective as Clomiphene or Letrozole but increases the ability of the body to produce insulin. You can use this to treat type 2 diabetes in PCOS women. It encourages ovulation well. 

Gonadotropins for PCOS

Gonadotropins are injectable hormones for women to ovulate. So you might have to visit the doctor frequently to keep tabs on how your body responds.  

If medications are not working out, you can also resort to surgery. Laparoscopic ovarian drilling is an option when the ovaries’ outer shell thickens and makes ovulation difficult. A surgeon is said to make a lot of tiny incisions. One incision will look through your internal organs, while a laser or fine needle will make some holes on the ovary surface. Thus, ovulation happens for the next 6-8 months. After that, it is an outpatient procedure under general anaesthesia. 

Alternative Remedies to Deal With PCOS

1. Diet and Exercise

If you have a high BMI or Body Mass Index, you need to shed off the extra kilos. Let a dietician or nutritionist also give valuable input regarding a healthy way of losing weight. 

A lower calorie diet which isn’t focused on carbohydrates but is rich in protein, fibre and healthy fats will provide all the necessary nutrients for someone who has PCOS and will aid with weight loss. This, coupled with a good amount of physical activity, i.e. at least 30 minutes a day for 4-5 days of the week, will help keep weight in check.

2. Acupuncture

As per research, acupuncture is a safe and effective treatment for PCOS. It treats PCOS symptoms by increasing the blood flow in the ovaries or reducing the volume of ovarian cysts. In addition, it keeps Hyperglycemia in check and lowers cortisol levels. Acupuncture also significantly increases beta-endorphin levels, which help the body to regulate the excess androgens. Therefore, acupuncture therapy is a suitable option for those who experience any adverse effects of pharmacologic interventions.  

3. Using Essential Oils

Essential oils are plant extracts with various fragrances to influence how you feel. A lot of people find essential oils quite relaxing and peaceful. As per studies, spearmint blocks testosterone production and follicular development in ovarian tissue. Thus, it shows potential in PCOS treatment. 

Other Ways to Combat Fertility Issues in Women with PCOS

If you have irregular or sporadic periods, you can undergo ovulation induction. It is a process that involves either pharmacologic or non-pharmacologic stimulants to release one or more eggs from the ovary. If you have tried for a baby for a year without success, it’s time to seek help from a fertility specialist. They might recommend more invasive treatments such as intrauterine insemination or in vitro fertilisation.  

Fertility treatments involve injections to stimulate the ovaries to produce multiple eggs. To retrieve your mature eggs, you must undergo an ultrasound-guided procedure under light anaesthetic. Sperm fuse with the eggs in laboratory conditions for embryos to form. If there are multiple embryones, the doctor freezes them for later use as most PCOS women are prone to miscarriage. 

Conclusion

Multiple women with PCOS experience fertility issues, but they can still become pregnant without complications. First, talk with your doctor and understand what your options are. After that, you can move forward with personalised treatment as soon as possible. Losing weight increases fertility for overweight or obese women by causing more regular ovulation. If this doesn’t work, there can be other reasons behind your fertility trouble. PCOS treatment can be long, complicated, and anxious, but the results are satisfying. It is best to receive a preconception health check to get the right kind of advice and support. 

Frequently Asked Questions (FAQs) 

Q. Can I get pregnant with PCOS naturally?

A. While a woman with PCOS can get pregnant naturally, it is challenging as ovulation is irregular and unpredictable. However, you can make specific lifestyle changes and seek medical advice to attain natural conception. Another option is to keep track of your fertile window to boost the chance of getting pregnant.

Q. How likely is infertility with PCOS?

A. The prevalence of infertility in women with PCOS does vary between 70% and 80%. And it is prevalent, affecting about one in every five women. Nonetheless, there are conventional and natural remedies to tackle this problem.

Q. How can I increase my fertility with PCOS?

A. You can enhance your fertility with PCOS by maintaining a healthy weight, cutting on alcohol, sleeping well and exercising regularly. A healthy lifestyle is also critical. A combination of drugs can also help correct insulin resistance, helping to increase your fertility. 

Q. What is the best age to get pregnant with PCOS?

A. As per studies, the ovulatory cycles in women remain normal up to the age limit of 22-38 years with PCOS. Women with PCOS under 35 face fewer complications than the older group. Therefore, the early twenties to mid-thirties can be a suitable age range. 

Q. Can PCOS affect baby gender?

A. No, PCOS does not affect or determine the gender of the baby. Gender is a biological factor. Having PCOS will not alter that genetic makeup. 

Q. How long did it take you to get pregnant with PCOS?

A. With PCOS, you can conceive naturally within a year or even less. So as long as you are ovulating regularly with no risk of infertility, you can get pregnant within a year or even less. But everyone is different. Some can get pregnant within months, while some take a few months to a couple of years.

Q. Is PCOS a serious problem?

A. PCOS can be severe as it exposes you to other health issues like blood pressure, type 2 diabetes, heart problems, mental health concerns, and uterine cancer. In addition, women with PCOS are more likely to have trouble conceiving than other women. But it is not life-threatening as long as you get timely treatment. 

Q. Does PCOS increase the chances of twins?

A. Women in the PCOS group can undergo multiple pregnancies with sets of twins or sets of triplets due to medications and procedures used to treat infertility and fertility treatments can increase the chance of multiple pregnancies.

Q. Does PCOS disappear after pregnancy?

A. No, the disappearance of PCOS is unlikely. Your symptoms might subside, but you still require regular checkups and medications. 

Q. Can I get pregnant with PCOS without treatment?

A. Yes, you can get pregnant with PCOS without treatment. There are cases where women with PCOS conceive naturally without the help of fertility treatments. However, the chances are moderate to slim. 

Q. Does PCOS make it hard to get pregnant?

A. Yes, women with PCOS struggle to become pregnant as they cannot ovulate. And around 70% of women ovulate sporadically. Or have insufficient progesterone for supporting pregnancy in the early stages.