How PCOS Impacts Fertility
Polycystic ovary syndrome (PCOS) affects up to 13% of women of reproductive age and often goes undiagnosed. This hormonal condition can cause a range of symptoms, including fertility challenges. Although PCOS may lead to infertility, it doesn't mean pregnancy is impossible. It may just require more time and assistance from a fertility doctor.
Below, we'll discuss how PCOS affects fertility and treatments your doctor may recommend to improve your chances of conceiving.
What is PCOS?
PCOS is a hormonal condition that affects the ovaries, the female reproductive organs responsible for producing eggs. This condition is associated with higher levels of androgens (male hormones), which can lead to various symptoms, including:
Irregular or unpredictable periods
Unwanted facial or body hair
Increased risk for other health conditions, such as diabetes and high blood pressure
Fertility challenges due to irregular ovulation
The name "polycystic" refers to the presence of many small fluid-filled sacs, or follicles on the ovaries. However, not everyone with PCOS has noticeable symptoms, which can make the condition difficult to diagnose. Because of this variability, many people with PCOS may not realize they have it.
PCOS and Fertility
PCOS accounts for nearly 80% of anovulatory infertility cases, which is when the ovaries do not release an egg during the menstrual cycle. In a typical menstrual cycle, a follicle in your ovary grows and eventually releases an egg into the fallopian tube. However, with PCOS, this process often doesn’t happen as it should. The follicles may not mature properly or release an egg, which means ovulation becomes irregular or doesn’t occur at all. This lack of regular ovulation makes it more challenging to conceive because the release of a mature egg is necessary for conception.
Diagnosing PCOS
Diagnosing PCOS doesn’t rely on just one test. Instead, doctors use a combination of methods. They start by reviewing your symptoms and medical history, then perform a physical exam. Blood tests check hormone levels, and an ultrasound looks for number and distribution of ovarian follicles. Combining these results helps doctors accurately diagnose PCOS and find the best treatment plan for you.
Treatments for PCOS
While receiving a PCOS diagnosis can feel disheartening, don't lose hope. Many women with PCOS are still able to become pregnant and carry a pregnancy to term. To improve your chances of conceiving, your doctor may recommend one of the following strategies.
Lifestyle Modifications
While there's no cure for PCOS, lifestyle changes may help improve symptoms and increase your chances of becoming pregnant. Women with PCOS are predisposed to becoming overweight, which can make it more challenging to conceive. Research shows that losing just 5-10% of body weight in overweight individuals can help restore normal ovulation and increase your chances of conceiving.
Lifestyle changes your doctor may recommend include increasing your exercise and improving your diet. While these changes may sound daunting, they don't have to be. Exercising more could look as simple as adding a walk to your daily routine and eating better may mean making healthier versions of foods you already love.
Medications
Fertility doctors often use various medications to manage PCOS and enhance fertility. While Clomiphene citrate is one option, many physicians prefer starting with aromatase inhibitors like Letrozole. Letrozole tends to have higher pregnancy and live birth rates when combined with metformin compared to Clomiphene citrate with metformin for patients with a PCOS diagnosis. Additionally, Letrozole has a lower risk of multiple pregnancies, making it a safer choice.
Letrozole works by inhibiting the conversion of excess androgens into estrogen, which helps balance hormone levels. This, in turn, allows the pituitary gland to continue producing follicle-stimulating hormone (FSH), which supports development of a dominant follicle.
Other medications that might be used include:
Gonadotropins: Administered via subcutaneous injections, these drugs mimic FSH to assist with follicle maturation and ovulation.
Metformin: Sometimes used alongside other treatments, Metformin helps reduce ovarian androgen production.
Ultimately, the choice of medication varies based on individual needs.
Assisted Reproduction
If medications aren’t enough, assisted reproduction methods like IVF can be a great option. IVF involves retrieving eggs, fertilizing them in the lab, and then transferring the embryos into your uterus.
Your Fertility Care Partner
A PCOS diagnosis doesn't have to halt your dreams of growing your family. At Beverly Hills Reproductive Center, we provide personalized fertility testing and treatments. Request a consultation today to learn how we can help.