Understanding PCOS and its impact on fertility
Abayomi Ajayi
Polycystic Ovary Syndrome is a common hormonal disorder that can significantly impact fertility. It is characterised by irregular ovulation, often resulting in infertility.
Women with PCOS may have ovaries containing numerous small cystic structures. PCOS is the leading cause of anovulation and a major contributor to female infertility, affecting between 40 percent and 80 percent of women with the condition.
The prevalence of PCOS and its associated infertility rates are substantial.
The impact of PCOS on menstruation and fertility is profound. In a typical menstrual cycle, a mature follicle develops, leading to ovulation. If pregnancy does not occur, a woman would expect to have a menstrual period approximately 14 days after ovulation.
The primary difference between polycystic ovaries and normal ovaries lies in the development of follicles. While polycystic ovaries contain numerous small follicles with eggs, these follicles often fail to mature properly, preventing ovulation.
Without regular ovulation, menstrual periods become irregular or absent, and pregnancy becomes difficult or impossible. If you are a woman with PCOS, you would frequently experience abnormal bleeding, infertility, obesity, excess hair growth, hair loss, and acne.
Some women with PCOS may ovulate occasionally or not at all, making conception challenging and often requiring medical intervention to improve fertility.
Hormones, such as testosterone and rostenedione, lead to increased facial and body hair growth (hirsutism). While depression is a potential side effect of PCOS, it may not manifest physically or psychologically in all individuals.
It is important to note that not all women with PCOS exhibit obvious signs or symptoms. Some women may remain unaware of their condition until they undergo fertility testing. Additionally, while approximately half of women with PCOS are overweight, the other half may maintain a normal weight.
The relationship between PCOS and obesity is complex. While weight gain can exacerbate PCOS symptoms, it is not the primary cause of the condition. It is a fact that many women with PCOS maintain a normal weight.
Insulin resistance, a common feature of PCOS, may contribute to weight gain and difficulty in losing weight. As a PCOS patient, you can consult with a regular obstetrician, but if you are diagnosed with severe insulin resistance, diabetes, or high blood pressure, you would certainly require the expertise of a high-risk obstetrician.
Fertility testing is recommended for you with PCOS, even if a previous diagnosis has been made. This is important for both you and your partner to understand your fertility status.
Undergoing fertility assessments for both of you can identify additional factors that may contribute to infertility, such as male infertility, which may also require treatment.
The likelihood of conceiving with a PCOS diagnosis is relatively high. So if you have PCOS, you can successfully have a baby through fertility treatments. If you are under 35 with PCOS, the primary question is not whether treatment can work but rather which treatment option will be most effective for you.
There is no cure for PCOS presently, but some women do have a normalisation of cycles after a pregnancy. Those with fertility problems may find it easier to get pregnant again. Many medications can be used to control PCOS symptoms, and some may be used in combination with each other.
The best course of action depends on individual needs. PCOS may worsen during the prime reproductive years, ages 20-40, especially with weight gain. A healthy lifestyle is probably the best defense.
It seems as women approach menopause that the severity of PCOS improves, as judged by hormonal parameters. Treatment for PCOS and infertility often begins with ultrasound diagnosis. In a polycystic ovary, the numerous small cystic structures, give the ovaries a characteristic “polycystic” (many cysts) appearance on ultrasound.
After reviewing your medical history, the physician will determine which tests are necessary. If you have irregular or absent menstrual periods, clues from the physical examination will be considered next.
Your height and weight will be noted along with any increased facial or body hair or loss of scalp hair, acne and as well as a discoloration of the skin under the arms, breasts, and in the groin. Elevated androgen levels (male hormones), or testosterone help make the diagnosis.
A good option for you as a couple dealing with PCOS is to undergo IVF. How successful IVF will be, though, can depend very much upon your characteristics such as age, length of infertility, and weight.
Additionally, neither IVF nor ovarian stimulation is likely to be successful if you are severely overweight, particularly with a body mass index greater than 30.
Despite the problems that can present themselves to you suffering from PCOS, you can still look forward to getting pregnant. A successful pregnancy is entirely possible and has been experienced by numerous women with PCOS.
In fact, for many women, getting pregnant the second time around is much easier. Furthermore, it is not unusual for you with PCOS to notice that your menstrual cycle begins to regulate itself after a pregnancy.
The bottom line: You can get pregnant with PCOS. You will likely need to have moderate weight, balance your blood sugar levels, and treat other PCOS symptoms with healthy lifestyle changes and medications.
In some cases, fertility medications alone will help you get pregnant. If that doesn’t work, you may need IVF treatment. But regardless of what treatment you explore, don’t lose hope. Success rates are optimistic. In time, you may be smiling, positive pregnancy test in hand.
