Many women experience irregular periods and some may even go months in between periods, not realizing that this can be a symptom of Polycystic Ovary Syndrome (PCOS) and that it can cause infertility. Read on to learn more about the symptoms of PCOS, how it can be managed, and how it can impact fertility.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is caused by an abnormality of the endocrine system or imbalance of estrogen, progesterone, androgen, and insulin hormones. PCOS is one of the most common causes of infertility in women of reproductive age.

With PCOS, several fluid-filled cysts are found in the ovaries. These cysts can sometimes impact ovarian function, causing irregular periods, enlarged ovaries, excessive hair growth, and significant acne.

Causes of PCOS

There is no clear cause of PCOS. It may be genetic or caused by abnormalities of different systems of the body, like the endocrine system, the brain, the ovaries, and/or the adrenal glands, or a combination of factors.

PCOS caused by excessive insulin and testosterone (male hormone) is characterized by increased acne, hair thinning or excessive hair growth (hirsutism) on the upper lip, chin, chest, abdomen, back, and arms and legs. Some women with PCOS may have high levels of prolactin, which normally induces lactation during pregnancy, causing cysts in the ovaries.
PCOS may also be a result of environmental factors, ethnicity, and genetics, such as having a family member with PCOS.

Signs of PCOS

Abnormal periods—irregular periods, very light periods, missed periods, longer than normal cycles, fewer than 8 periods a year
Unexplained excessive weight gain, usually in the stomach, due to insulin resistance caused by PCOS
Changes in appearance due to elevated male hormones, such as excessive hair growth, voice change, hair thinning, acne, etc.
Infertility caused by hormone dysfunction
Dark patches of skin under the breasts, around the neck, and in the armpits; this is called acanthosis nigricans and is associated with insulin resistance and diabetes

How is PCOS diagnosed?

The doctor will start with a thorough health history to understand the symptoms you are experiencing and will ask about your periods, changes in weight, and any other relevant symptoms.
A preliminary physical examination will be carried out to collect basic information, including your height, weight, and blood pressure.
An internal (pelvic) examination may be done to carefully examine the reproductive system.
Blood tests will be done to check hormone levels as each hormone can indicate many disorders, including PCOS.
Transvaginal ultrasound will help the doctor visualize the ovaries and the thickness of the uterine lining, which will provide an accurate diagnosis.

PCOS and Infertility

PCOS can make it more difficult for someone to become pregnant due to abnormal levels of estrogen and irregular periods, and this instability of hormones can lead to infertility. PCOS also increases the risk of miscarriage and preeclampsia. Excessive weight gain caused by PCOS also makes conception more difficult.

Getting Pregnant with PCOS

If you are pregnant and have PCOS, the higher levels of male hormones can cause a miscarriage or other complications, such as gestational diabetes, preeclampsia, and preterm labor. It can also lead to chronic conditions in the future.

If you have PCOS and would like to become pregnant, it is important to manage the PCOS and its symptoms before trying to conceive. However, it is recommended that you see a fertility specialist if you have PCOS and plan to become pregnant. Assisted reproductive technologies like IVF and ICSI are very popular and have good success rates in helping families become pregnant, using techniques to balance the hormones so menstruation is normal.

Risks Associated with PCOS while Pregnancy

Risks for moms with PCOS

Risks for the pregnant person:

Gestational diabetes
Pregnancy induced hypertension
Preterm labor
Miscarriage

Risks for baby

Macrosomia (larger than normal baby)
Fetal death or stillbirth (death of a baby from 22 weeks until less than 1 week after birth)

PCOS Treatments fertility trto Get Pregnant

1. Medications

Metformin is a medication for diabetes that increases the sensitivity of insulin, thus decreasing insulin resistance and blood sugar levels. As metformin treats insulin resistance caused by PCOS, male hormones are reduced, helping reproductive hormones to work normally to induce ovulation.
Chromiphine (Clomid) prevents estrogen function, forcing the pituitary gland to produce more follicle stimulating hormone (FSH) that helps eggs mature and release for fertilization, increasing the chances of pregnancy.

2. Hormone Injections

Hormonal imbalance is treated by taking oral contraceptive pills that contain progestin only or a combination of estrogen and progestin. The birth control pill prevents conception, but also inhibits male hormones.

3. Fertility Treatments

Intrauterine insemination (IUI) is a type of artificial insemination that is most like natural conception. With IUI, the doctor will select the strongest sperm to inject directly into the female partner’s uterus to bypass the process where the sperm must swim up to meet the egg, many of which die on the way. This increases the chances of pregnancy as the sperm can more easily fertilize the egg.
Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology developed from in vitro fertilization (IVF) where sperm is used to fertilize an egg outside the body. ICSI is like IVF in most ways except that the healthiest egg and sperm are selected and the sperm is injected directly into the egg with a small needle to force fertilization. The fertilized egg is then grown in the laboratory until it becomes an embryo and is ready to be transferred into the uterus to grow in pregnancy. ICSI is very popular nowadays as it can treat infertility caused by many factors.

Natural Ways to Get Pregnant with PCOS

1. Eat Healthy

Since insulin resistance is connected to PCOS, causing anovulation, changing your diet can treat insulin resistance. When it comes to eating to manage PCOS, focus on the follow:

Avoid or reduce foods with a high glycemic index (GI)
Eat many different colored fruits and vegetables
Eat plenty of berries
Eat foods high in Omega-3
Eat good fats like olive oil, avocado, nuts, etc.

Changing how you eat can treat insulin resistance and decrease male hormones, improving the function of hormones responsible for reproduction and normalizing ovulation. This in turn increases your chances of pregnancy.

2. Maintain Your Weight

Many people with PCOS struggle with weight gain. If you have PCOS, losing 5-10% of your body weight or keeping your body mass index (BMI) at 20-24 can help ovulation return to normal.

Losing weight can also manage other symptoms of PCOS, such as insulin resistance and excessive male hormones. Unfortunately, PCOS makes it difficult to lose weight, and the failure rate (when trying to lose weight) is as high as 40%.

The basal metabolic rate (BMR) of someone with PCOS is reduced by 500 calories a day. Someone without PCOS has a BMR of 2,000 calories, while someone with PCOS has a BMR of 1,500 calories. Which means that they must limit their caloric intake to prevent weight gain. It is very difficult to stay under your BMR.
The excessive insulin caused by insulin resistance makes someone with PCOS hungrier than someone without, making it more difficult to eat healthily.

However, losing weight when you have PCOS means focusing on the types of food that you eat and exercising consistently and regularly. Set clear goals for yourself and monitor your weight regularly.

3. Balance Blood Sugar Levels

Myo-inositol or Vitamin B8 is important in helping insulin maintain normal blood sugar levels and balance male hormones. Inositol is separated into Myo-inositol and D-chiro inositol that work together in a ratio of 40:1. The benefits of Inositol for someone with PCOS include:

Decreasing insulin resistance
Normalizing ovulation
Normalizing menstruation
Improving egg quality
Decreasing symptoms of male hormones
Reducing stress
Decreasing the risk of miscarriage

Conclusion

Polycystic Ovary Syndrome (PCOS) is a common condition experienced by Thai women. It is important not to ignore symptoms of PCOS and to undergo annual medical screenings, including pelvic exams. PCOS can contribute to infertility due to lack of ovulation or irregular ovulation.

However, a woman with PCOS can still become pregnant if symptoms are treated. Currently, the most popular and effective treatment for infertility in women with PCOS is IVF and ICSI, using hormonal balancing techniques to normalize menstruation.

If you have any questions or concerns about PCOS or infertility, please contact us on Line at @beyondivf.