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Understanding Fertility and Polycystic Ovary Syndrome (PCOS)

One of the most common and serious symptoms of PCOS is infertility. Women with PCOS often face difficulties with ovulation, or releasing an egg that can mature. This happens due to an excess production of estrogen in their ovaries. Women with PCOS also experience irregular periods, so their ovulation does not occur regularly, and an increase in testosterone production in the body affects egg quality. Apart from that PCOS also leads to insulin resistance, which can lead to many high-risk health conditions post-pregnancy, like gestational diabetes.

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What Is the PCOS Fertility Rate?

Almost 70%-80% of women who are suffering from PCOS also suffer from infertility, and this occurs due to certain hormonal changes that hinder their ovulation. Changes that are associated with PCOS include:

  • Excess production of androgens
  • Small, painless and fluid-filled sacs growing in the ovaries
  • The outer layer of the ovaries gets thicker
  • Increased insulin levels in the blood

A Brief Overview

Many women believe that being diagnosed with PCOS means they cannot conceive in the future — this is not true. By taking control of PCOS with proper management and medical care, you can naturally get pregnant and reduce the risk of future complications.

What Is PCOS?

Polycystic ovarian syndrome or more popularly known as PCOS is a prevalent endocrine condition that is found in women who are in their reproductive age. It affects approximately 5-10% of young women and along with the numerous symptoms that come with it, it also often leads to a lower fertility rate. Some of the symptoms women with this condition can experience are irregular periods, abnormal hair growth, acne and the growth of multiple small cysts on their ovaries.

Common Signs and Symptoms

Signs and symptoms of PCOS usually show up in late adolescence or early adulthood. They are sometimes so subtle that women with PCOS often misdiagnose themselves and begin their PCOS treatment too late. So here are some tips to identify whether you have PCOS or not:

  • Hirsutism is a very common symptom of PCOS, in this condition there is an excess growth of body and facial hair.
  • Ironically enough on one hand there is an excess growth of body and facial hair and on the other hand, there is a thinning of scalp hair.
  • Your skin becomes excessively oily and has numerous breakouts.
  • You can also get skin tags mainly around your neck and armpits.
  • Another common skin condition associated with PCOS is acanthosis nigricans, with this condition you develop patches of thick, darkened skin that occur particularly on the neck, groin or underneath the breasts.
  • The most easily detectable symptom of PCOS is sudden weight gain which becomes very difficult to lose.
  • Some other rare but serious health conditions associated with PCOS are poor insulin resistance, irregular periods, heart disease, etc.

Its Impact on Fertility

PCOS can affect your chances of getting and staying pregnant, but it is not impossible to get pregnant. The hormonal imbalances can affect regular ovulation cycles which can affect the chances of getting pregnant naturally. Not just this, if PCOS is left untreated, it can also increase the risk of developing pregnancy complications.

Testing and Diagnosis To Determine If You Are Fertile

The most important step toward an improved fertility rate in women with PCOS is its diagnosis and then eventually its treatment. Tests for female infertility try to find out if any of these processes are impaired. Your diagnosis starts with a general physical exam, including a regular gynaecological exam and:

  • Ovulation testing: You will be given a blood test that will measure your hormone levels to determine whether you're ovulating.
  • Hysterosalpingography: As tricky as this condition is to pronounce it's equally essential for your fertility. It evaluates your uterus’s condition and assesses the condition of your fallopian tubes, eventually looking for blockages or other problems. The process involves injecting an X-ray contrast into your uterus, and an X-ray is taken to determine if the cavity is normal and to see if the fluid spills out of your fallopian tubes.
  • Ovarian reserve testing: This testing helps to determine the number of eggs available for ovulation. This approach often begins with hormone testing early in the menstrual cycle.
  • Hormone testing: Many other hormone tests are also prescribed to women suffering from infertility to check levels of ovulatory hormones, as well as pituitary hormones that control reproductive processes.
  • Imaging tests: A pelvic ultrasound looks for uterine or ovarian diseases. Sometimes, a saline infusion sonogram or sonohysterogram is used to see details inside the uterus that are not seen on a regular ultrasound.

Treatment & Medication Options

Now that you have determined whether or not you are suffering from infertility caused by PCOS it is time to talk about treatment. Although there is currently no permanent or one-step cure for PCOS, it can surely be reversed through proper management. Treatment for infertility caused by PCOS involves resolving ovulation issues and tackling metabolic problems, such as insulin resistance.

Consult a gynaecologist followed by a PCOS expert to begin your PCOS reversal journey. Some basic goals that will be given to you initially are maintaining a healthy weight to regulate menstruation and restore hormonal balance. Some medications that are involved in this process are:

Clomiphene citrate (Clomid)

Clomiphene citrate is an ovulatory stimulant that helps with blocking estrogen feedback to the brain. This is an oral medication and is taken once a day for 5 days at the beginning of your menstrual cycle. You will be prescribed the lowest possible dose, but your doctor can increase it as needed. Research has shown that Clomiphene citrate (Clomid) is quite effective in helping women with PCOS ovulate.


An aromatase inhibitor called Letrozole (Femara) is also prescribed for treating fertility problems. It’s commonly used to treat breast cancer, but it also helps with jump-starting ovulation in people with PCOS. This medication blocks estrogen production and increases the release of follicle-stimulating hormone (FSH) to stimulate ovulation.


One of the most effective and popular medications that are used for treating PCOS is metformin which is mainly used to treat type 2 diabetes. It also boosts the body’s ability to effectively use insulin. Metformin is not particularly prescribed for women with PCOS who are suffering from infertility, because it’s not as effective as letrozole and clomiphene, but it is a vital medication to reverse other PCOS symptoms. But, a lesser-known fact is that it can encourage ovulation, so if you are taking metformin and do not want to become pregnant you should use birth control, as you may start ovulating.


These are injectable hormones that can help you ovulate. This treatment may require frequent doctor’s visits to see how your body is responding.


If your body is not responding to the medication doctors suggest you can go through a type of surgery called laparoscopic ovarian drilling. However, this is rarely done in practice. PCOS can sometimes thicken the outer shell of your ovaries and block ovulation. In this procedure, the surgeon will make several tiny incisions. This surgical procedure generally restores ovulation for 6 to 8 months.

Ayurveda and Natural Remedies To Promote Fertility

Diet and Exercise

A balanced diet is an important solution to various health conditions and leads to overall health for anyone. But it is almost a doctrine for those who are suffering from infertility caused by PCOS. It is not just about losing weight but more about eating the right amount of food depending on your requirements.

You should aim for at least 30 minutes of moderate exercise 3 times per week. If your BMI is high, symptoms of PCOS can be improved by losing excess weight. It’s also helpful to speak with a dietitian or nutritionist, who can provide input on healthy eating and offer motivation.

Essential oils

Essential oils are fragrant natural healing oils that are made from plant extracts and have multiple beneficiary characteristics. Many people find inhaling essential oils relaxing or invigorating, this can help you through infertility treatments and stressful times. Others use essential oils to ease symptoms of various health conditions. Essential oils are also used in aromatherapy, in this process you inhale the essential oils and they travel from the olfactory nerves directly to the brain and especially impact the amygdala, the emotional centre of the brain.

Another beneficial herb tea that helps with PCOS is spearmint and consuming spearmint tea can reduce testosterone levels in your body and restore follicular development in ovarian tissue. There’s not enough research to make firm conclusions.

Herbs and supplements

Even natural herbs and supplements can interact with medications. If you’re taking medicine for PCOS-related infertility, speak with your doctor before taking supplements. Myo-inositol is a supplement that has time and again proven that it can improve egg quality in women with PCOS. One study found that taking inositol improved egg quality and resulted in more eggs being able to be fertilized. Talk with your doctor about your diet and whether you’re lacking in nutrients, and whether supplements are a good choice for you.

What To Expect for a PCOS Pregnancy

Sadly the journey of difficulty for women with PCOS does not end when they get pregnant but continues throughout the pregnancy and sometimes even after the birth of the child. Having PCOS can increase your risk of some complications during pregnancy, such as

  1. You might have constant high blood pressure that can affect your child’s health
  2. You can also get gestational diabetes, in this condition, your body is unable to produce enough insulin during pregnancy.
  3. You can also give birth prematurely.
  4. PCOS women have higher chances of caesarean delivery and at-birth complications.
  5. They are also prone to miscarriages and stillbirths.

Talk to a Professional with Veera

If you have symptoms of PCOS, see your doctor for diagnosis and treatment. If you plan to get pregnant at any point, the sooner you start treatment for PCOS the better. We at Veera Health have an extensive team of doctors and technicians who are trained to diagnose any signs of infertility and walk you through the journey of fertility treatments. You can avail our PCOS conception package if you are already diagnosed and want to conceive. Click here

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