Get Help With Your Infertility and Other Polycystic Ovary Syndrome Symptoms

Polycystic ovary syndrome (PCOS) does not make you infertile, and you can conceive naturally with PCOS with proper medical treatment. It is encouraging to know that there are many treatment options available that can help improve your fertility, and speaking to a doctor can help you understand your options.

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What Causes Infertility?

Infertility is broadly defined as the inability to conceive after trying for one year.

Getting pregnant and carrying that pregnancy to term is a complex process, and many factors in this process can contribute to infertility. If you are under the age of 35 and have been trying to conceive for more than a year without success, speak to a doctor to understand the root cause.

There are several common causes of infertility:

  • Problems with ovulation: Having conditions such as PCOS, primary ovarian insufficiency (POI), or thyroid problems can affect fertility. Aging and lifestyle factors can also affect the hormones responsible for ovulation.
  • Endometriosis: This is a condition wherein the inner lining of the uterus (the endometrium) grows in other places of the body. This can cause painful periods, heavy bleeding, and physical obstruction to egg release.
  • Structural problems with the reproductive system: Polyps, blocked fallopian tubes, uterine septum and scarring in the uterus can also play a role in infertility.
  • Uterine fibroids: These are non-cancerous growths in the uterus.

Common Signs and Symptoms

The main symptom of infertility is the inability to get pregnant despite having tried regular unprotected sex. Apart from that, having irregular or no periods can indicate that you have not been ovulating regularly. There might not be other visible signs and symptoms, so your doctor may ask you about a history of fertility problems, endometriosis, repeated miscarriages, painful periods, or pelvic inflammatory diseases.

Why Does PCOS Cause Fertility Issues?

The main reason women with PCOS face problems with fertility is due to irregular or no ovulation (egg release). In PCOS, the ovaries produce higher than normal levels of male hormones called androgens, which causes hormonal imbalance. The presence of high levels of androgens interferes with the normal cycle of menstruation and ovulation.

As a result, fluid-filled sacs called follicles, which contain the egg, do not mature and hence do not release an egg. These follicles are the “cysts” you can observe on your ultrasound scan. The term cysts are actually misleading because these are actually just immature follicles. With the absence of ovulation, there is no egg ready to be fertilised by the sperm.

Another factor is the age-related decline in fertility, which starts around the age of 35. Some studies suggest that this decline can occur at a faster rate in women with PCOS. Although women with PCOS may have a high number of eggs to start, they are not immune to the age-related decline in fertility.

Other Factors That Impact Your Hormones

Having irregular or no ovulation is one of the main reasons for infertility, and PCOS is the leading cause affecting the process of ovulation. The underlying hormonal imbalance, especially elevated levels of insulin and androgens, hampers the normal release of the egg and affects the menstrual cycle.

Other factors and conditions can contribute to hormonal imbalance and affect ovulation, such as:

  • Weight gain or obesity
  • Stress
  • Hypothyroidism
  • Hyperprolactinemia
  • POI
  • Pituitary gland disorders

What Is the Infertility Rate With PCOS?

Around 70% of women with PCOS experience some difficulty or problems getting pregnant. PCOS is the most common cause of infertility in women, as PCOS affects the process of ovulation. However, infertility is not just a women’s issue; both men and women can contribute to infertility. If you’ve been trying to get pregnant but haven’t had any luck or are over the age of 35, speak to a doctor who can refer you to a fertility specialist to understand the root cause of your fertility problems.

Can You Get Pregnant if You Have PCOS?

Yes! Getting pregnant with PCOS is possible with proper medical treatment. In fact, it can be encouraging to know that women with PCOS have had the same number of children as women without PCOS and are healthy mothers.

Having said that, PCOS does affect many areas of your health that can impact your chances of conceiving. The earlier you control your symptoms and manage PCOS, the better your chances of conceiving naturally. If you have PCOS, it is recommended to start family planning early on. This leaves plenty of time to manage your PCOS and explore available fertility treatment options. This is because the risk of infertility increases above the age of 35, which happens in all women, whether they have PCOS or not.

Testing and Diagnosis

Diagnosing infertility can be a long process, and it may take some time to complete all the tests and understand the root cause. The first step is to understand whether you are ovulating regularly. You might be asked to keep track of your body temperature each morning, check cervical mucus consistency, or use a home ovulation test kit. Doctors can also check for ovulation through blood tests and scans. If ovulation is happening normally, there are other fertility tests to perform.

Here are some of the common tests that form a part of the diagnosis:

  • Performing an ultrasound to check if the ovaries and uterus are normal in appearance
  • Performing anti-Mullerian hormone (AMH) and follicle stimulating hormone (FSH) tests to assess ovarian reserve. Ovarian reserve is a term used to describe the number of total healthy, immature eggs present in the ovaries. The number of healthy eggs naturally diminishes with age, however, this can be accelerated in conditions like PCOS.
  • Performing a hysterosalpingography test to check for any physical barriers in the fallopian tubes or uterus
  • Measuring other reproductive hormones such as progesterone and oestrogen to check if you are ovulating

Treatment

Experiencing infertility can feel frustrating and emotionally difficult. But it can be encouraging to know that there are plenty of treatment options to help you build a family.

There is no one-size-fits-all treatment when it comes to infertility. Gaining a better understanding of your body, your menstrual cycle, your ovulation signs, and your fertility window can help you and your partner plan to have intercourse at the most opportune time and is an important part of treating infertility.

Fertility treatment options can seem complex, demanding, and multifactorial. However, there are several commonly offered treatments.

  • Weight reduction: Obesity is not a cause of infertility, but it can add to other health risks and pregnancy complications. Especially if you are dealing with PCOS, losing even 5% to 10% of your body weight can help treat the underlying hormonal imbalance. Weight loss also reduces the risk of developing conditions such as diabetes, heart conditions, and metabolic syndrome — all of which can affect pregnancy and postpartum health.
  • Ovulation induction: This is the most commonly prescribed treatment modality for women who don’t ovulate or don’t ovulate regularly. These medications are taken orally or injected and are given to stimulate the release of one or more eggs from the ovaries. Letrozole is the most widely used ovulation induction medication and is more effective than other medications such as clomiphene citrate.
  • In vitro fertilization (IVF): IVF is a well-known type of assisted reproductive technology. IVF is often the last resort after other less-invasive procedures haven’t worked. In IVF, the sperm and the egg are combined in the lab to create a viable embryo that is later transferred to the woman’s uterus.

Ayurveda and Natural Remedies

Some women use natural remedies as a way to improve their fertility and overall health. Although such herbal medicines don’t have a lot of supportive research to prove their benefits, you should speak to your doctor before taking them so you can avoid contraindications.

Natural remedies that some believe may help improve symptoms include:

  • Peony and liquorice
  • Cinnamon
  • Ashwagandha
  • Shatavari
  • Guggul

Tips to Improve Fertility

Some factors that affect fertility are in your control, and your lifestyle counts the most. Your lifestyle choices can have a direct impact on your fertility outcomes. If you have PCOS and are planning to get pregnant, you must be wondering what you can do to improve your fertility.

Here are some tips to follow:

  • Maintain a healthy weight.
  • Eat nutritious, balanced, unprocessed foods.
  • Exercise regularly.
  • Manage stress.
  • Take prenatal supplements.
  • Avoid alcohol and tobacco.
  • Avoid toxic chemicals.

Talk to a PCOS Professional

Infertility can have multiple causes, and the treatment modality can differ accordingly. If you are planning to start a family and are diagnosed with PCOS, it is important to speak to a doctor who can do a detailed assessment of your hormonal profile and scans to discuss your treatment options. If need be, your doctor can also refer you to a fertility specialist who can work with you closely to understand your options for conception.

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Our online assessment is designed to understand what your PCOS risk levels are. Depending on your risk score, you can speak to one of our PCOS experts who can discuss your treatment options based on your symptoms and concerns.