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PCOS & Infertility

March 5, 2024

PCOS, or Polycystic Ovary Syndrome, is a common hormone disorder that affects women. One of the main challenges associated with it is its impact on fertility. PCOS causes irregular menstrual cycles and is characterized by the presence of small cysts on the ovaries, which leads to difficulties in conception and increases the risk of infertility. Understanding the connection between PCOS and infertility is crucial for those who plan to start a family. Read below to learn more about it.

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What is PCOS?

It is a common hormonal condition where the ovaries do not release eggs to start a period at the end of the menstrual cycle. It is a common condition that affects women of all ages and leads to difficulty in conception for women of childbearing age. If you have polycystic ovaries:

  • You have larger than-normal ovaries
  • You may have fluid-filled pockets or follicles on the ovaries.

Since the most common hormones affected are androgen and estrogen (sex hormones), it results in metabolic changes, hormonal imbalances, and damage to the ovaries, which results in infertility. Plus, the symptoms of PCOS are not related to fertility, and hence, it is diagnosed only when a woman cannot conceive.

What are the Causes of PCOS?

The exact reason behind this condition is not known, but as per research, some factors listed below increase the risk.

  • Insulin resistance and more body weight The hormone insulin controls blood sugar in the body, and insulin resistance is one of the main causes of PCOS. Insulin resistance means that the blood sugar levels are more than normal but not enough to be diabetic. Also, people with PCOS have fat deposits in their midsection, which leads to more production of insulin and leads to developing diabetes.
  • Metabolic and genetic factors: PCOS is more prevalent in women with a family history of this condition.
  • High level of androgen: Having more androgen (male hormone) leads to PCOS and disruption of ovarian functions.

PCOS Symptoms

PCOS is a hormonal condition and the symptoms are not limited to a specific body part. Diagnosis, especially in younger women, is difficult as they do not know about their infertility, which is one of the most common PCOS symptoms. Women experience PCOS in varying degrees; some of the common signs of this condition are.

  • Irregular periods
  • Increased hair growth in the chin, cheek, stomach and back
  • Unexplained weight gain
  • Increased acne and oily skin
  • Mood swings
  • Disturbed sleep
  • Fatigue
  • Thinning hair or male patterned baldness
  • Infertility or difficulty conceiving
  • Dark patches in the armpit, neck, or under the breast.

Irregular periods mean that the gap between periods is not constant. It is not in the average range of 28 days, plus or minus a few days. Not all the symptoms mentioned above are experienced by all women with PCOS. Some may have severe symptoms and others may be milder.

PCOS also increases other health issue risks, like

  • Type 2 diabetes
  • High blood cholesterol
  • High blood pressure
  • Sleep apnea
  • Anxiety and depression
  • Endometrial cancer

How Does PCOS Affect Fertility

PCOS and infertility are usually synonymous. In women suffering from PCOS, the main reason for infertility is the blockages due to fluid-filled ovarian cysts and sex hormone imbalances. Due to this, a mature and healthy egg is not released from the ovaries. Even if the eggs are released, they are not viable for conception, which is why women may have to go for fertility treatments. In most cases, ovulatory issues are the leading cause of infertility; other issues like polyps or fibroids also make it hard for women to conceive. As per studies, women who have PCOS are 4 times more likely to have infertility than those who don’t have this condition.

Also Read : PCOD (Polycystic Ovarian Disease

PCOS Diagnosis

There are no specific tests to diagnose PCOS and a doctor determines it based on several factors. Testing typically includes:

  • A physical exam
  • Evaluation of medical history
  • A pelvic ultrasound
  • Blood tests to check glucose and hormone levels

How to Treat Infertility in PCOS

There is no specific treatment for PCOS, but the symptoms are treatable. For those whose primary concern is conception, many fertility treatments help them get pregnant naturally or with the help of specialists. Treatment options include:

  • Lifestyle changes: Daily exercise, dietary changes, good sleep hygiene and maintaining proper body weight are all ways to reduce the symptoms. If there are mild symptoms, then these lifestyle changes can help you conceive naturally without any medical intervention.
  • Prescription medication: Fertility medications to help PCOS women with ovulation. Hormone-based oral contraceptives, patches, injections, and IUDs are some of the medicines that help make menstruation more predictable and regular.
  • Surgical intervention: When medications and lifestyle changes do not work, surgery can help stimulate the ovaries into ovulation. The cortex may be damaged or thickened due to cysts. With the help of laser surgery, a surgeon can help restore ovulation. However, the procedure is useful for about 6 to 8 months.
  • IVF: This is one of the most common options for infertility. It is performed on PCOS women who have taken hormonal injections to create mature eggs for fertilisation. In this process, mature eggs are harvested from the ovaries and allow the woman to conceive after the fertilised eggs are implanted into the uterus.

PCOS and Mental Health

Having fertility issues can cause a feeling of failure and guilt. But it should be thought of as a medical problem that is treatable like most other conditions and should not be thought of as a shortcoming. Many couples, with the help of fertility treatments, can conceive, and though it is inconvenient, it is forgotten once the baby arrives. For some couples, the treatment is long and complicated, so one should be patient and kind towards themselves and their partner. Invest time in reducing stress and making lifestyle changes to go through the treatments and consultations.

When to Consult a Doctor

If you are unable to conceive or have PCOS symptoms, then you should see a doctor. Even if a woman is not considering bearing a child, getting an early diagnosis is useful as it prevents further health complications. While there can be many reasons for infertility, getting assessed for PCOS gives a targeted treatment and improves conception chances.

Conclusion

PCOS infertility is one of the most common problems in the world. Though not curable, it is treatable. There are various ways to reduce symptoms and enhance fertility. Consult a healthcare provider and get recommendations to manage PCOS.

FAQs

1. Does PCOS lead to infertility?

Yes. PCOS is often associated with infertility.

2. Can a woman with PCOS get pregnant?

Yes. Women with PCOS can get pregnant after making certain lifestyle changes or taking treatment.

3. What percentage of people with PCOS are infertile?

PCOS is one of the most common disorders in women and affects 5–10% of them. The incidence of PCOS and infertility is as high as 70 to 80%.

4. What is the treatment for PCOS infertility?

Lifestyle changes, medications, surgical intervention or IVF are some of the treatment options for PCOS infertility.

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