PCOS Fertility Treatment: All You Need To Know

While fertility treatments can seem daunting to begin with, it is important for you to discuss the right course of action with your doctor so that you may undertake the best path possible to conceive.

Posted on May 6, 2022 ·

BY Team Veera

Medically Reviewed

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One of the first things you hear when people know that you have PCOS is about how you are going to have a tough time conceiving or planning your family because your ovaries no longer work the way they should. PCOS is a medical condition that causes hormonal imbalances and problems in your metabolism. It does affect your ovaries but it is not a direct indicator of infertility. You can always conceive and get pregnant even with PCOS.

This misconception amongst people is because PCOS can become a common cause of infertility if its symptoms are neglected and not treated timely. Let’s look at how PCOS and fertility are linked.

PCOS and fertility

If you have PCOS, you have an imbalance in your hormones and most of your symptoms are because androgens (male sex hormones) are present in high levels. These androgens do not let the ovary ovulate and form small fluidic sacs in the ovaries, which leads to thickening of the ovaries. Simultaneously, your insulin levels also rise in your blood. All this can interject the process of ovulation and cause irregular periods. 

Fertility treatment options for women with PCOS

As complex of a condition as PCOS is, there is no cure available for it and the only way to take care of it is to treat its symptoms. When PCOS causes infertility, the treatment usually has methods to regularise ovulation and help you conceive eventually. These medications can also act to regulate periods so that women with PCOS can shed the lining of their uterus and not develop endometriosis.  

Talking to your doctor can help you understand your PCOS journey more clearly. Losing weight and maintaining it is essential while treating your PCOS. Your diet should be nutritionally rich and lower your blood glucose levels. Exercise and a balanced diet can take care of the weight gain, and keeping a check on your periods can help you understand the likely time that you might be ovulating.

In case these options do not seem to work for you and make it difficult for you to conceive, your doctor might ask you to take some medications such as:

Clomiphene citrate

Clomid or clomiphene citrate stimulates the ovaries to ovulate and doctors prescribe it to you according to your menstrual cycle. It works by blocking oestrogen feedback to the brain and it is taken orally. According to your weight and other severity parameters, your doctor might modulate your doses.

Letrozole

This has become a common medication to treat infertility in women with PCOS. While it is used to treat breast cancer in a different context, but it is known to start ovulation in women with PCOS. It blocks the production of estrogen as well as increase the number of hormones that can stimulate the formation of follicles and ovulation.

Metformin

This is a common medication in the household of people who suffer from diabetes, and it increases the ability of our body to use insulin in a better manner. Because of this, Metformin is not the standard of care treatment for PCOS, but it can be used to induce ovulation and regularise periods. If you are trying to conceive, your doctor may prescribe you with Clomid or Letrozole since they are more effective. 

Gonadotropins

These are hormones that can be injected in the blood that can help you ovulate. Your doctor might schedule multiple consultations for this treatment to ascertain that you are responding properly to this method of regularising your periods. 

 

Sometimes, when you do not respond to these medications, your doctor may look at the problem from a different perspective. There might be an overlap between your diagnosis of PCOS and endometriosis that might have caused it difficult for you to conceive. Endometriosis is a medical condition in which the uterus tissue lining thickens and grows abnormally, thereby restricting and damaging the egg or the sperm. In that case, your doctor will re-focus on how to induce the shedding of the uterine lining so that conceiving is no longer difficult.

Disclaimer: Content on Veera is provided for informational purposes only and is not intended as medical advice, or as a substitute for medical advice given by a physician

Verified by Dr. Iris Lee

Fellow in Reproductive Endocrinology and Infertility, University of Pennsylvania

Dr. Lee is a fellow in reproductive endocrinology and infertility at the University of Pennsylvania. She completed medical school and residency training at the University of Pennsylvania as well. Her work focuses primarily on PCOS, particularly the metabolic and mental health implications. Outside of work, she enjoys baking, reading, and spending time with her husband and two puppies.

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