Most women know about PCOS as a condition associated with ‘woman issue’ like weight gain, body hair, acne and in some patients, mood swings. But what women are less aware of is its strong link to infertility. PCOS comes with its perks (which girl would not be happy with having lesser periods in a year) but when it comes to fertility, the perk can be a problem too.
There are fewer solid facts about PCOS and its role in fertility than undisputable misconceptions and outright myths which causes needless panic. To put it straight, PCOS is the commonest cause of infertility in women. 60% of women with infertility issues have PCOS & this figure is certainly worrisome.
Let’s get some facts about PCOS & ways to get pregnant inspite of having PCOS.
1. How is PCOS linked to Infertility?
Normally there is an orchestrated signal path between the brain and the ovary each month which controls the growth and release of an egg. However, in PCOS this orchestration goes out of sync because of over abundance of androgen which disturbs the balance of the estrogen hormone preventing release of an egg every month. Release of an egg is prerequisite for a conception to occur.
PCOS is a vicious cycle. Abnormal hormone level leads to cyst in the ovary, which further leads to hormonal imbalance, obesity and infertility.
All menstrual cycles in a PCOS patient may not necessarily be anovulatory (no ovulation). There may be a couple of cycles in a year wherein you may ovulate but it is not possible for you to figure out which cycle would that be.
2. If that’s the case, then what exactly is happening to my eggs?
PCOS patients will grow many small follicles (sac that contains egg) in ultrasound, but there will not be a big one that will grow and release an egg. Since there is no release of an egg, there is no opportunity for a pregnancy to happen. Women with PCOS do not have problem in producing an egg; the problem lies in them not growing their follicle. They are stuck at the starting line.
Ultrasound is the best modality to know whether you’re ovulating or not.
3. Should I see a Fertility Specialist, if I want to plan pregnancy after 6 months?
It’s important, if not mandatory, for you to see a fertility specialist for the following reasons -
- Some medications needed to manage PCOS may be unsafe during pregnancy and these will need to be changed or discontinued.
- A consultation with a fertility specialist will help you increase your chances of conception naturally by altering your lifestyle leading to spontaneous ovulation.
- Your fertility specialist will ensure that you’re in the best of your health before you conceive so as to reduce risk of miscarriage, gestational diabetes and/or pregnancy induced hypertension
4. What are my options if I’ve not been able to conceive naturally with PCOS?
The good news here is that infertility treatment for women with PCOS is very effective. Your doctor will prescribe you medication for your follicles to grow; the goal is just to get the eggs off the starting line. Usually these medications work since the problem isn’t in your egg.
If these basic measures do not work, you may be offered ovarian drilling (a small surgery to make holes in the ovaries to help the monthly release of the eggs); rarely IVF may be needed. A point to never forget – all the fertility medications will work only if you work on altering your lifestyle which includes healthy eating and exercise. Don’t take PCOS only as a fertility hurdle; take it up as a wake-up call.
5. Do I still need to be vigilant once I have conceived with PCOS?
- PCOS patients who conceive are 3 times more likely to miscarry than expecting mothers without PCOS. You may be recommended to have optimal hormonal support for the first 3 months of pregnancy to avoid miscarriage.
- Exercise improves body's use of insulin, normalizes hormone levels and keeps your weight in check.
- PCOS patients have problems related to high insulin levels. A diet high in protein and fiber can help lower your insulin levels. It is important to limit your carbohydrate intake and pair your carbohydrates with fiber, protein and/or healthy fats. Eliminate all processed foods, refined sugar and starch.
Take Home Message
Every bad thing turns into a good thing in the end. It’s just a matter of patience... strive and wait for the right moment! Whatever method you may need to resort to, it is realistically highly possible for PCOS patients to conceive. Struggling to get pregnant with PCOS makes you appreciate parenthood even more. Do not let your faith, hope and love drop down because of the obstacles you face.