Navigating the path to fertility can be overwhelming, especially for those with Polycystic Ovary Syndrome (PCOS). PCOS affects the ovaries and impacts women’s fertility, making it more difficult when trying to conceive. Hence, couples will need to understand how to manage PCOS with the relevant strategies to cater to their bodies’ unique needs when trying to conceive. 

In this article, we will explore the common challenges that women with PCOS face when they are trying to conceive and provide actionable steps in which they can manage their PCOS to improve their journey to parenthood.

What is PCOS? 

PCOS is a common hormonal conduction that affects women of reproductive age, which may cause them not to ovulate. Hence, women with PCOS may have high levels of androgen and have small cysts on the ovaries which causes irregular periods.

PCOS symptoms

Common symptoms of PCOS might include:

• Irregular periods or absence of periods

• Hirsutism (increase in facial or body hair)

• Hair loss on the head

• A rapid increase in weight, being overweight or difficulties in losing weight

• Oily skin and acne

• Skin tags (tiny excess flaps of skin) in the armpits or neck area

• Acanthosis nigrican (areas of darker, thickened skin in body folds and creases)

It is important to note that these symptoms can vary in severity and combination among individuals. A thorough medical evaluation is necessary for an accurate diagnosis of PCOS. 

Book an appointment with our fertility specialists at Thomson Fertility Centre here.

How is PCOS diagnosed?

1. Pelvic exams

   • Doctors can recommend a pelvic exam where they check your reproductive organs for masses, growths and other changes

2. Blood tests

   •  Blood tests can measure hormone levels to exclude possible causes that can mimic PCOS such as menstrual problems or androgen excess.

3. Ultrasound

   • An ultrasound can check the appearance of your ovaries and the thickness of your uterine lining.

For more information, please refer to our article on PCOS here.

How does PCOS affect fertility?

Your ovaries contain a number of follicles that grow and burst each month, releasing an egg into one of your fallopian tubes each month if you have a normal menstrual cycle.

Those with PCOS are unable to have these follicles grow or release eggs, and this causes a build-up in the ovaries which can look like cysts. PCOS can also impact the uterine lining, making it hard for mature eggs to implant. 

Additionally, PCOS can also disrupt a regular menstrual cycle and ovulation through low levels of progesterone and high levels of androgen. Research has also indicated that approximately 70% to 80% of women with anovulatory infertility have PCOS, making it a common cause of fertility issues. 

Fertility treatment options for women with PCOS

Several treatment options are available for women facing fertility challenges due to PCOS:

1. Lifestyle modifications

• Weight management: 

  • Losing 5% to 10% of body weight can significantly improve ovulation and overall reproductive health.

• Diet and exercise: 

  • A balanced diet low in glycaemic index foods combined with regular physical activity can enhance insulin sensitivity and promote regular ovulation.

2. Pharmacological treatments

• Clomiphene citrate (Clomid): 

  • This oral medication helps stimulate ovulation in women who do not ovulate regularly. Approximately 75% to 80% of women will ovulate after a course of Clomid.

• Letrozole: 

  • Another oral agent that has shown effectiveness in inducing ovulation in women with PCOS.

• Metformin: 

  • Often used to manage insulin resistance, it can also help regulate menstrual cycles and improve ovulation rates

3. Advanced reproductive technologies

• Intrauterine insemination (IUI):

  • This procedure involves placing sperm directly into the uterus around the time of ovulation.

• In vitro fertilisation (IVF):

  • IVF may be recommended if other treatments fail. It involves fertilising an egg outside the body and implanting it into the uterus.

4. Surgical options

• Laparoscopic ovarian drilling: 

  • This surgical procedure may be considered if other treatments are unsuccessful. It involves destroying tissue on the ovaries that produce excess testosterone, potentially restoring normal ovulation patterns.

When to seek medical advice?

Navigating the challenges of fertility due to PCOS requires different comprehensive solutions that involve lifestyle changes to surgical options. Hence, women should consult with a gynaecologist or fertility specialist in order to find a solution that is specifically tailored to their needs so that they are able to increase their chances to conceive. 

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please book a consultation with a specialist at Thomson Medical. Book an appointment with Thomson Medical today.

FAQ

Can you still get pregnant with PCOS?

Yes. While PCOS causes hormonal imbalances that interfere with the growth and release of eggs, which can cause infertility -  it does not mean you can’t get pregnant as it is treatable. You will need to treat your PCOS symptoms with healthy lifestyle changes and medication, which can help you get pregnant. However, if that doesn’t work, you may need to start IVF treatment.

How to boost fertility with PCOS?

You can boost your fertility by adopting a healthier lifestyle - which includes: not smoking, little consumption of alcohol, maintaining a healthy diet and weight, getting plenty of regular exercise, and maintaining a healthy sleep schedule. Moreover, it is best to also consult with your gynaecologists or a fertility specialist early to discuss a plan in case PCOS causes difficulties in conception.

Can PCOS increase the risk of pregnancy complications?

Having PCOS can increase your risk to some complications during pregnancy, such as:

• High blood pressure

• Gestational diabetes

• Premature birth

• Miscarriage

Thus, if you have PCOS, and are pregnant, it is best to talk with your obstetricians/gynaecologists, or fertility specialists on how to reduce these pregnancy complications by monitoring your PCOS symptoms, taking extra care during your pregnancy, and deciding what is the best delivery option for you once you enter labour.