Infertility is an increasing medical concern in many couples. The female partner, especially with conditions like PCOS, experiences more infertility issues, affecting their chances of conceiving a baby. Although women with this condition can have children naturally, the problem arises in the conception stage. But how is this infertility issue related to PCOS exactly? And how is a woman’s fertility affected by PCOS? Keep reading this blog to understand why PCOS affects fertility.
What Is Polycystic Ovary Syndrome?
PCOS (Polycystic Ovary Syndrome) leads to hormonal imbalance due to the high production of hormones called androgens. This excess hormone is a result of the ovaries producing a larger number of eggs and releasing them. Hence, your reproductive hormones become imbalanced, which can further lead to irregular menstrual cycles and ovulation.
Causes of PCOS
While genetics is one of the evidence-based factors behind PCOS, there are no exact causes. Here are some other factors that contribute to PCOS:
Lifestyle and Environment
Exposure to certain toxins, stress, and an uncontrolled diet are the lifestyle and environmental factors causing PCOS.
Androgen Hormone
When there is imbalance of hormones, especially high androgen levels, leads to PCOS, along with acne and more hair growth as symptoms.
Insulin Resistance
When your body’s cells are resistant to insulin, the pancreas produces more insulin, leading to more production of androgens in the ovaries.
Obesity & Inflammation
A person weighing more than their ideal BMI has an increased risk of PCOS. This is the same with some inflammatory conditions (low-grade), which can again lead to more hormones like androgens in the ovaries.
PCOS Effects on Fertility
For a successful conception, the ovulation cycle (monthly) needs to continue without any hormonal imbalance. PCOS affects the hormones during ovulation, which is what affects fertility. In fact, most female infertility cases are present due to PCOS, making it a leading cause of infertility among women in the reproductive ages (almost 13%), starting from 15 to 44. Let us see what are the effects of PCOS on fertility:
Insulin Resistance
Insulin resistance is when the (cells) body is resistant to a hormone (insulin) that makes glucose from consumed food. This insulin, produced by the pancreas, becomes more present, and the body’s cells are not able to respond properly. Insulin resistance can further lead to hormonal (insulin) changes in the body, causing the production of hormones, like androgens and testosterone.
Ovarian Follicles
Ovaries have follicles (sacs filled with fluid) that produce eggs. Any disorders that affect the ovaries, like high levels of leptin, can affect the development of follicles. Since leptin is a hormone related to energy reserves, it can cause ovarian disorders.
Hormonal Imbalance
All of the above mentioned conditions, like insulin resistance, ovarian disorders, etc., can lead to an imbalance in the hormones produced by the ovaries, directly affecting fertility in women of reproductive age. For example, more androgen hormones has an effect on the release of eggs in the ovaries and their development as well.
Ovulatory Dysfunction
Ovaries regularly (every month) release an egg into the endometrial lining to prepare the uterus for pregnancy. This ovulation cycle becomes affected by anovulation, which is the lack of eggs developed and released, leading to PCOS-related infertility problems in women.
Treatments/Surgery For PCOS That Improve Fertility
Gonadotrophins
Gonadotrophins (hormones that can be injected) help in the stimulation of the ovaries for the release of eggs. But they are prescribed with close monitoring of ovulation to reduce any chance of overstimulation of eggs or multiple pregnancies.
IVF
In Vitro Fertilization (IVF) fertility treatment is where the eggs from the ovaries are directly retrieved and fertilized with sperm. This fertilized egg is then moved and placed into the uterus of the female partner. IVF for women with PCOS is recommended when medications for ovulation fail, and offers higher chances of successful pregnancy.
Metformin
Metformin is prescribed for insulin resistance management in women with PCOS. This medication is provided to help regulate menstrual cycles and support natural ovulation during this cycle every month. Metformin, along with fertility medications like clomifene citrate, improves overall success rates in conception and reduces risks.
Laparoscopic Ovarian Drilling (LOD)
Here, small holes are created in the ovaries using laser or heat to reduce excess male hormones and promote ovulation. It can improve infertility conditions, and is recommended when other treatments fail.
Clomifene Citrate
This medication works by stimulating the ovaries to release eggs, which can increase the chances of ovulation (egg development & release) and conception in women with PCOS.
Managing Infertility With PCOS
Managing infertility with PCOS often starts with lifestyle changes, as weight management, healthy eating, and regular exercise can naturally make ovulation easier. Stress management and emotional regulation also play an important role, as infertility can be mentally challenging.
Conclusion
In conclusion, Polycystic Ovary Syndrome (PCOS) can highly impact fertility by causing hormonal imbalances and ovulatory dysfunction, making it a leading cause of infertility among women of reproductive age. With the right treatments and lifestyle improvements, many women with PCOS can manage their condition and improve their chances of conception.
FAQs
1. How is fertility affected by PCOS?
PCOS directly affects normal ovulation due to hormonal imbalances and insulin resistance. Irregular ovulation, in turn, reduces the chances of conception, causing infertility issues.
2. Can I get pregnant with PCOS?
Yes. Natural conception for women with PCOS is possible, along with medical help. Treatments like medications, lifestyle changes, or assisted reproductive technologies can improve the chances of conception.
3. Is there any treatment for infertility if I have PCOS?
Yes. Infertility treatments for PCOS include medications like clomifene, metformin, or gonadotrophins, and surgical procedures like ovarian drilling (LOD) and IVF as well.
