PCOS or polycystic ovary syndrome is one of the most common endocrine disorders that affect women around the world. In India itself, every one in five women is suffering from PCOS. PCOS can affect many areas of your health including reproductive, metabolic, and psychological health. The underlying hormonal imbalance, especially in the levels of male hormones (androgens) and insulin can cause a range of symptoms such as irregular periods, weight gain, excess hair, acne, and scalp hair loss. Also not every woman will have each symptom or fit the PCOS criteria perfectly. This makes it important to get a proper diagnosis from a doctor based on the tests and individual symptoms.
Many women who are diagnosed with PCOS are worried about pregnancy with PCOS. The truth is, women with PCOS are able to have the same number of children as women without PCOS. Although PCOS does affect your ability to get pregnant and carry that pregnancy to term – there are plenty of treatment options available.
PCOS and Infertility
It is first important to remember that PCOS does not make you infertile but it can affect your fertility or reduce your fertility. This is mainly because of the irregular menstrual cycles that are a result of the elevated levels of male hormones and insulin that can disrupt the normal cycle and affect ovulation too.
Ovulation is the process where your ovary releases a fully developed egg every month. This egg then travels to the uterus to be fertilized, and if sexual intercourse has taken place at this time, pregnancy occurs.
However, in PCOS since the normal menstrual cycle is affected, there can be either irregular or no ovulation. If there is no ovulation, no egg is released and hence pregnancy cannot occur. This is the reason why you observe many tiny cysts (which are actually follicles) on the ovary during an ultrasound scan. These follicles are actually immature eggs that have failed to mature and get released.
Apart from irregular ovulation, age-related decline in fertility also starts around the age of 35. This affects all women, regardless of having PCOS or not. However, some studies have shown that this decline can affect women with PCOS at a faster rate.
These factors can make it difficult for women with PCOS to get pregnant. Moreover, PCOS pregnancy also comes with a range of complications if the underlying hormonal imbalance is not managed well. For example, women with PCOS have a higher risk of having a miscarriage than women without PCOS.
How to Increase the Chance of Pregnancy with PCOS
You can successfully get pregnant with PCOS by first addressing the symptoms of PCOS and treating the hormonal imbalance. When you regulate your period and ovulation cycle you can significantly increase your chances of PCOS pregnancy. However, remember that there can be many other reasons why a woman is facing difficulties in conceiving so speak to a doctor to understand if PCOS is affecting your fertility.
Making lifestyle changes is the most effective way to increase your chances of conceiving with PCOS. Although some women do require medications and further medical support, they are likely to show better results along with making lifestyle changes. Medications are never a replacement for following a healthy lifestyle. Every woman and every pregnancy is different, so your doctor can recommend what is the best course of action for you to get pregnant with PCOS. In certain cases, surgery or assisted reproductive technology may be another option if a woman has not been able to conceive naturally.
Maintain a Healthy Weight
If you are overweight, losing even a small amount of weight – 5% to 10% can help restore the normal cycle of ovulation and improve your chances of conceiving. Maintaining a healthy weight before and even during pregnancy can help prevent complications and ensure a healthy pregnancy.
- Eating a healthy balanced diet that is rich in whole foods and has limited processed or packaged foods can help you get all the required nutrients and keep you satiated
- Regular physical activity, usually a combination of cardio and strength training is helpful in managing insulin resistance which can help in weight loss
- Learning how to manage stress can help reduce the levels of cortisol (stress hormone). High levels of cortisol can affect your weight loss journey
Eat for Good Health
Your diet is not only about losing weight, it is about giving your body the nourishment it needs to keep it healthy. With PCOS specifically, many women have nutritional deficiencies such as magnesium, vitamin B12, zinc, and iron. This can be met by including a variety of fruits and vegetables instead of relying on supplements. Your diet is not only important before pregnancy but also during pregnancy. Eating the right kind of foods can make a big difference in your PCOS symptoms:
- Add a variety of fruits and vegetables to your daily meals
- Choose unprocessed foods and avoid packaged or sugary foods
- Increase your intake of protein. Every meal of your day should contain quality protein. This not only helps build muscle but also keeps you full and decreases cravings
- Healthy fats are also important for proper uptake of nutrients and reduce inflammation levels
- Dietary fiber that you get from whole food is also important in keeping your bowel movements and adds to satiety
Balance Blood Sugar Levels
Many women with PCOS struggle with insulin resistance which is the main reason for weight gain, fatigue, cravings and also increasing androgen levels. Managing your insulin levels can improve many PCOS symptoms:
- Including more low glycemic index foods instead of high glycemic index, foods can help maintain blood glucose levels
- High GI foods can spike your glucose levels. These foods include pasta, pizza, pastries, or any processed or fast food. Low GI foods such as fruits, vegetables, and whole grains (millets, brown rice, quinoa) can increase your glucose levels gradually
- Along with diet, adding strength training to your routine can make your cells more sensitive to utilize insulin effectively
Some women may need medications to manage their symptoms and also increase their chances of conceiving. If making lifestyle changes have not helped you conceive naturally, your doctor may prescribe ovulation induction medications. These include tablets or injections that can help stimulate your ovaries to release an egg.
- Letrozole is the most widely used ovulation induction medication. As compared to other medications, letrozole is less likely to cause multiple pregnancies i.e. twins or triplets
- Clomiphene citrate or Clomid is also commonly used to induce ovulation. It is either used as a standalone medication or in combination with metformin to improve its effectiveness. However, Clomid is associated with a higher risk of having multiple pregnancies.
In cases where conceiving naturally or medications haven’t worked, assisted reproductive technology (such as IVF) can be another option. In such cases, your doctor may refer you to a fertility specialist who can guide you through the process. Often these procedures can be demanding and expensive – and is usually tried after other less intensive methods haven’t worked. Usually, this method works better in women who have already made the required lifestyle changes.
Speaking to a doctor is the first step in understanding what your treatment options are in conceiving with PCOS. Before you plan on starting a family, focus on managing your PCOS first. Although there is no rule as to when you should plan on getting pregnant – the recommendation is that you start planning a family early on. By doing so you have enough time to make the required lifestyle changes before the age-related risk of infertility begins. Let your doctor know what your symptoms and concerns are so that you can follow a personalized plan that will work for you.
Pregnancy with PCOS is possible. You can successfully get pregnant and carry that pregnancy to term. However, you need to make certain lifestyle changes and follow those changes throughout to not only manage the symptoms but also reduce the risk of developing pregnancy complications. If you need personalized guidance and care from a team of doctors and experts who understand PCOS the best – join Veera Health’s PCOS program!