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PCOS and Fertility Explained | PFCLA IVF Clinic Blog

Written by PFCLA | 20 Sep 2024

September marks Polycystic Ovary Syndrome (PCOS) Awareness Month, a time to shed light on how this condition impacts fertility and overall reproductive health. In this blog, we’ll explore the links between PCOS and fertility challenges, discuss treatment options, and highlight the importance of understanding this condition for those looking to conceive.

What is Polycystic Ovary Syndrome? 

Polycystic ovary syndrome (PCOS) is a hormonal condition affecting between 8% to 13% of all women of reproductive age. Unlike common identifiable diseases, it encompasses several problems and symptoms typically found together.

It is common for those diagnosed with PCOS to also face fertility struggles. Those who suffer from severe PCOS may not regularly release eggs or ovulate therefore people with this condition may also have a lower chance of getting pregnant. It is only natural to consider other alternatives to help with conception. Thanks to advancements made in Assisted Reproductive Technology (ART) there are a variety of fertility treatments available for PCOS patients. 

How is PCOS Diagnosed?

Unfortunately, there is no one size fits all test to diagnose polycystic ovary syndrome. A PCOS diagnosis involves a combination of clinical presentation, supportive blood tests, and a pelvic ultrasound. 

To be diagnosed with PCOS, you must meet at least two of the following three criteria:

  • Irregular menstrual cycles
  • Several ovarian cysts
  • Signs of abnormally higher androgen levels

Due to the variance in symptoms, oftentimes the condition goes misdiagnosed, which can be critical when it comes to family-building timelines and fertility treatment.

PCOS Symptoms

As we mentioned above, polycystic ovary syndrome can affect different people differently. PCOS patients can demonstrate a combination of symptoms.

The symptoms of PCOS may include:

  • Irregular menstrual cycles
  • Excessive hair growth on the face chest, and back (hirsutism)
  • Polycystic ovaries
  • Skin changes such as acne or oily skin or skin tags
  • Male-pattern baldness or thinning hair
  • Weight gain and challenges loosing weight
  • Infertility

Diagnosis of PCOS is important as it can shed light on a person's risk of developing a growing list of comorbidities.

Patients with PCOS have a higher risk of:

  • Depression
  • Sleep apnea
  • Obesity
  • Cardiovascular diseases
  • Endometrial cancers
  • Hyperglycemia or hypoglycemia
  • Type 2 diabetes
  • Miscarriages
  • Liver disease
  • Kidney disease

If you are experiencing symptoms of PCOS and are not yet diagnosed, talk with your healthcare provider and see what testing may be available to you.

Cause of PCOS

The exact cause of PCOS remains unclear, as there is no definitive medical explanation for the hormonal changes associated with the condition. Various factors, including genetic predisposition, insulin resistance, and inflammation, may contribute to the development of PCOS, but the impact among these elements is not fully understood. As research continues, it highlights the complexity of PCOS and the need for a multifaceted approach to its diagnosis and management.

PCOS Treatment

Polycystic ovary syndrome treatment is unique to each individual diagnosed, as there is no cure for the condition. Typically, PCOS is managed by addressing symptoms and any underlying issues, with a focus on lifestyle changes, medication, and, when necessary, fertility treatments. This personalized approach ensures that each patient receives the care best suited to their specific needs and health goals. 

Lifestyle Changes

Lifestyle changes can significantly improve PCOS symptoms. 

Below are lifestyle changes that may help with managing PCOS:

  • Balanced diet
  • Regulate insulin
  • Regular physical activity
  • Stress management

By making these lifestyle adjustments, individuals with PCOS may experience improved hormonal balance, better menstrual regularity, and enhanced fertility potential.

PCOS Medication

Medications for polycystic ovary syndrome are aimed at managing symptoms and addressing hormonal imbalances. Hormonal contraceptives, such as birth control pills, are commonly prescribed to regulate menstrual cycles and reduce symptoms like acne and excess hair growth. Anti-androgens, like spironolactone, can help manage hirsutism by blocking the effects of male hormones. Additionally, metformin is often used to improve insulin sensitivity and support weight management in those with insulin resistance. For women seeking to conceive, fertility medications, such as clomiphene citrate, may be prescribed to stimulate ovulation. These treatments are tailored to each individual's needs.

PCOS Surgery

When other treatments prove unsuccessful, surgery becomes the next viable step. Your fertility doctor will carry out several tests and a vaginal ultrasound scan before recommending surgery. You will learn all the details about the procedure from your doctor.

Laparoscopic Ovarian Drilling (LOD) is a minimally invasive surgical procedure used primarily to treat those with PCOS who are experiencing infertility or have not responded to other treatments. During LOD, a surgeon makes small incisions in the abdomen and uses a laparoscope to visualize the ovaries. They then create small holes in the ovarian tissue, which can help reduce the production of male hormones (androgens) and promote normal ovarian function.

Getting Pregnant With PCOS 

Pregnancy can be challenging with PCOS due to hormonal imbalances and irregular menstrual cycles. Elevated androgen levels often disrupt ovulation, resulting in complications when trying to conceive. Tracking ovulation is important; methods like monitoring basal body temperature or using ovulation predictor kits can help identify fertile days.

Ovulation Induction With Fertility Medications

The first PCOS infertility treatment option that your doctor will recommend is the use of fertility medication that encourages ovulation. Oral drugs such as letrozole and clomiphene citrate (Clomid) can help regulate ovulation. Injection-delivered fertility medications are the next alternative if oral drugs prove unsuccessful.

Fertility medications that are injected into patients are very effective at stimulating egg growth. However, continuous medical supervision is important since it can lead to the production of several eggs, which poses a risk of multiple births.

IVF With PCOS

In Vitro Fertilization (IVF) is an excellent option when PCOS fertility medications fail. With IVF, there are higher chances of getting pregnant with lower risks. For starters, fertility doctors can reduce the chance of multiple births by only transferring a single embryo into your uterus.

IVF With PCOS Success Rates

The success rate of IVF in PCOS is about 70%, which is excellent for patients with PCOS who want to conceive. PCOS and IVF protocol include several steps, all of which your healthcare provider or doctor will provide you with guidance. However, you can start early by looking through our website to better understand the IVF fertility treatment procedure.  

PCOS Effects Pregnancy

Women with polycystic ovary syndrome may face several pregnancy-related complications due to the hormonal imbalances associated with the condition. Research indicates that these women are at a higher risk for miscarriage, which can be attributed to irregular hormone levels and potential ovulatory dysfunction.

In addition, PCOS increases the likelihood of developing gestational diabetes, a condition that can impact both the mother and baby's health. Women with PCOS are also at higher risk for preeclampsia, a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems. This can lead to premature delivery and often necessitates cesarean sections.

Overall, while many women with PCOS can have healthy pregnancies, it is important to monitor and manage these risks through regular prenatal care and consultations with healthcare providers. 

Fertility and PCOS Options With PFCLA

Are you a struggling with PCOS and trying to have children? Our PCOS Specialists have helped many families with this condition achieve their dreams of family.  PFCLA has contributed to the birth of over 13,500 babies to families around the world through assisted reproductive technology like IVF. Contact us today to get started.