Introduction to PCOS and Fertility
What is PCOS?
Polycystic ovary syndrome (PCOS) is one of the common hormonal conditions that affects women of reproductive age. This usually happens during adolescence. But the symptoms may deviate from time to time.
How PCOS Affects Fertility
The PCOS in general causes an imbalance in hormones, fluctuating menstruation, excessive androgen levels, and cysts in the ovaries. Owing to these multiple issues, there is a lacuna in ovulation, which leads to infertility or hindrances to getting pregnant.
Signs of PCOS That Impact Pregnancy
Common Symptoms of PCOS
Some of the PCOS symptoms are given below:
- Acne
- Extra hair growth on face
- Male after baldness
- Thinning hair
- Putting on weights
- Acute long and intermittent menstruation
- Infertility
Hormonal Imbalances and Ovulation Issues
Hormones and Polycystic Ovary Syndrome
A wide variety of hormones are produced by your body. Hormones play an important role in regulating several bodily processes as chemical messengers. There are a few that have an effect on your fertility and menstrual cycle. Your reproductive hormones are imbalanced when you have polycystic ovary syndrome. Primary cumulative hormonal syndrome (PCOS) is influenced by several hormones.
Polycystic ovary syndrome resistance to insulin
The hormone insulin controls how much sugar your body absorbs. Insulin resistance is present in 30–80% of PCOS patients, according to the scientific community. Too much insulin can build up in the body when insulin doesn’t work as intended. Overproduction of androgens may be triggered, at least in part, by this extra insulin, according to some experts.
The condition is also influenced by other hormones, such as:
Male hormones
Although they are commonly associated with men, everyone contains these hormones. Ovarian hyperandrogenism is a hallmark of polycystic ovary syndrome (PCOS). This can disrupt your menstrual cycle by preventing your ovaries from producing eggs at the usual intervals. Many signs of polycystic ovary syndrome (PCOS), such as acne, hair loss, and undesirable hair growth, are caused by excess androgens.
Inhibitor of Ovulation
This hormone is involved in both the regulation of your menstrual cycle and the preparation of your body for ovulation.
The hormone that luteinized tissues
The ovaries are stimulated to release eggs when this happens, which helps control your monthly cycle as well.
A woman’s natural estrogen
A deficiency of this hormone may be seen in PCOS patients. As a result, you may have lengthy stretches without a period or struggle to anticipate the start of your period.
The female hormone
A potential symptom of polycystic ovary syndrome is an imbalance between estrogen and progesterone levels.
Why Does PCOS Cause Infertility?
Insulin Resistance and its Effects
PCOS-insulin resistance relationship
Obesity increases insulin resistance. PCOS’s insulin resistance is caused by metabolically active marginal tissues, including adipose tissue and skeletal muscle, reacting improperly to insulin. Insulin resistance in obese PCOS women may cause improper glucose and lipid catabolism. As insulin increases, sex hormone-binding globulin (SHBG) decreases and free androgens increase, preventing follicle development and causing irregular menses and impotence. PCOS women ate more sugary foods like white bread and fried potatoes. Fatty tissues release adipokines that affect insulin resistance differently. Visfatin may activate the insulin receptor and have insulin-like action, but adiponectin makes insulin sensitive. Adipocyte-released adiponectin is a multimer protein. It includes high, low, and medium molecular weights. Some research linked adiponectin to PCOS independent of BMI, whereas others found that it was deleterious. These adipokines can indicate insulin resistance in PCOS individuals independent of BMI. Reduce total fats, saturated fatty acids, and cholesterol to prevent diabetes and heart disease. They affect ovarian dysfunction. Insulin overproduction may activate pituitary gland insulin receptors to release luteinizing hormone and increase ovary and gland androgen excretion. It may reduce hepatic sex hormone-binding globulin (SHBG) and increase free testosterone. Androgen excess can cause acne, alopecia, and ovarian follicle stunting.
Hormone levels and irregular cycles
PCOS causes irregular, long menstrual cycles due to excessive androgen and low-sex hormone-binding globulin. This hormonal change may raise ovarian cancer histologic subtype risk. In the New England Case-Control Study (1992–2008), we examined whether menstrual cycle features and self-reported PCOS were linked to ovarian cancer risk in 2041 epithelial ovarian cancer patients and 2100 controls. Menstrual cycle duration, irregularity, and PCOS were examined in person. Polytomous logistic regression investigated risk by histologic subtype, whereas unconditional logistic regression calculated overall ovarian cancer risk odds ratios (ORs) and 95% CIs. Never-regular periods and menstrual cycles >35 days did not increase ovarian cancer risk, with ORs of 0.87 (95% CI=0.69-1.10) and 0.83 (95% CI=0.44-1.54), respectively. Self-reported PCOS did not predict ovarian cancer (OR=0.97; 95% CI=0.61-1.56). Different correlations were found between menstrual cycle irregularity, ovarian cancer subtypes, BMI, and OC intake (heterogeneity=0.03, pinteraction<0.01). Menstrual cycle irregularity was related to a lower incidence of high-grade serous tumours but a higher risk of serous borderline tumours in overweight women who had never used OCs. A broad alliance may reveal these relationships in future research.
Can You Get Pregnant Naturally with PCOS?
Hyperandrogenism, irregular menstruation, ovulation, and infertility may precede PCOS. Anovulatory infertile women had obesity-exacerbated PCOS 80% of the time. Anovulatory infertility delays pregnancy, requiring fertility tests and therapy. One observational study found that PCOS women had fewer pregnancies but were more likely to have given birth at least once and had their first pregnancy younger. PCOS women reported more biochemical pregnancies, reduced spontaneous conception, and worse ART results.
After 12 months of infertility (or six if you’re 35 or older), see a doctor. Her GP is your initial stop, but she may suggest a reproductive expert.
She needs medication to conceive if her periods are irregular. Ovulation induction begins medical therapy. Injections or tablets stimulate the ovaries to release an egg for IUI or intercourse.
If this fails, IVF or other invasive treatments may be needed to conceive.
IVF stimulates egg production using injections. Ultrasound is used to extract mature eggs under minimal anaesthesia. Sperm and eggs create lab-grown embryos.
A few days later, the uterus accepts an embryo to hopefully become a baby. If no pregnancy occurs, some embryos can be kept.
Ovarian hyperstimulation syndrome may occur; however, specialists can do IVF. Overreaction to egg-producing reproductive therapy. The symptoms may include stomach discomfort, nausea, vomiting, fast weight gain, and blood clots.
Success Rates and Factors to Consider
At the Ovum fertility clinic, it identifies the issue and the corrections that a PCOS patient requires. Hence, we follow the below-mentioned things:
Lifestyle Adjustments That Can Help
- Reducing weight
- Diet restrictions
- Controlling diabetics level
- Hormonal medicine, which would simplify the fluctuating menstruations
- Consistant exercise
Fertility Treatments for Women with PCOS
Medications to Induce Ovulation
Several PCOS medications may help you conceive:
Clomiphene citrate pills (UK consumers know Clomid well). These trigger egg release from follicles.
Regularise your menstruation with metformin. It can help improve insulin resistance and minimise miscarriage risk in PCOS patients.
Patient can take metformin with clomiphene citrate
If using clomiphene citrate, the first round of therapy includes a transvaginal scan to evaluate egg development and dosage.
It’s only supplied for six months. Long-term usage may cause ovarian cancer.
Clomiphene citrate may fail, thus you may be offered:
Gonadotropins: Another ovulatory medication. You may get twins or more if gonadotropins cause too many eggs to mature. You will be scanned often to monitor egg development.
Laparoscopic ovarian drilling Ovarian tissue that generates too much testosterone is destroyed.
Intrauterine Insemination (IUI) and In Vitro Fertilisation (IVF)
IVF: One of your eggs is removed, fertilised outside the body, and placed back in the uterus.
IUI Sperm fertilises eggs better with intrauterine insemination (IUI). This therapy may help some couples and individuals conceive.
Ideal circumstances allow only a few hundred sperm to reach the egg during intercourse. Your doctor inserts millions of healthy sperm directly in the uterus, closer to the egg, using IUI.
Diet and lifestyle changes to Boost Fertility
Best Foods for Hormonal Balance: Exercise and Weight Management Tips for PCOS
Optimise BMI with food and activity for a healthy pregnancy and PCOS reduction. Self-monitoring and early action on small weight rises and avoidance of subsequent weight gain seem more practical and successful for normal BMI women than weight reduction in obese women. Weight loss of 5%–10% improves ovulation, fertility, and metabolism. Personalised nutritional counselling, a low-energy diet, and 150 minutes of weekly exercise are effective lifestyle adjustments. Even without weight reduction, five 30-minute workouts each week, including three aerobic sessions, enhance clinical outcomes, including insulin resistance. Exercise and diet improve clinical outcomes more than diet alone.
Alternative and Natural Treatments for PCOS Fertility
Herbal Remedies and Supplements
A medical study found that aloe vera and chamomile increase ovarian follicles, improving fertility. Octane and Vitex agnus-castus both lower testosterone and androgen, lowering hirsutism. Liquorice, ginseng, cinnamon, and de chiro Inositol reduce cholesterol and blood glucose levels, improving PCOS-related diabetes. In PCOS, Stachys lavandulifolia and fennel reduce oestrogen and hyperplasia to change endometrial tissue characteristics.
The Role of Acupuncture and Holistic Health
Beta-endorphin levels in the ovarian follicular fluid of healthy women during ovulation were much greater than plasma levels. Acupuncture may induce ovulation by increasing beta-endorphin production, which may alter GnRH secretion.
Understanding the Risks and Misconceptions
Myths Around PCOS and Pregnancy
1. Myth #1: Single symptoms indicate PCOS
PCOS is a disorder; hence, one sign cannot diagnose it.
Several of 36 GPs, endocrinologists, and gynaecologists complained about PCOS misdiagnosis and overdiagnosis in our study. Many women self-diagnosed or were misdiagnosed due to irregular cycles or polycystic ovaries on ultrasounds.
However, many young women have polycystic ovaries without PCOS. Without a clear line, symptoms range in severity.
Face and body hair differ by ethnicity in women.
Also, acne is common. One study found clinical acne in 40% of 20-year-old women, 25% of 30s women, and 12% of 40s women.
Stress, hormonal contraceptives like the pill, obesity, thyroid issues (which change metabolism), overexercising, and disordered eating can also seem like PCOS.
Misdiagnosed PCOS women are denied treatment. Hypothalamic amenorrhoea—when periods stop owing to stress, weight loss, or intense activity—can cause bone loss if addressed.
2. Myth #2: PCOS women don’t need contraception.
PCOS women may need medication to ovulate while attempting to conceive. PCOS women have spontaneous pregnancies and intended family sizes. Women with and without PCOS had similar birth rates.
However, many PCOS women believe they cannot conceive. Life-changing effects may occur.
Our recent study found that PCOS women have long-term infertility anxiety. Some had difficult conversations with their husbands, felt pressure to conceive early, and modified their family goals to not have children.
Some risked contraception and had unwanted babies. Contraceptive use decreased in other studies.
PCOS women need comfort and accurate pregnancy risk information to realise they need contraception.
3. Myth #3: All PCOS women have “metabolic complications.”
Insulin resistance, type 2 diabetes, and metabolic syndrome rise with PCOS.Thus, many PCOS women fear about their health.
Not all diagnosed women suffer the same effects. Women with irregular menstrual cycles and polycystic ovaries without androgen excess have different metabolic risks.
This was unknown to most doctors we asked. Some PCOS women are misdiagnosed as high-risk, causing anxiety.
Online, PCOS women are thought to have a greater heart disease risk. Very little data suggests otherwise.
4.Myth #4: PCOS causes weight gain/loss.
PCOS increases women’s risk of obesity; however, the relationship is uncertain.
Diet and behaviour change programs have found that women with and without PCOS lose the same amount of weight, notwithstanding their weight worries.
Recent research found that a high BMI might cause PCOS and aggravate symptoms. It appears PCOS does not affect BMI. More research is needed to elucidate these links.
PCOS symptoms might improve with even a small weight loss.
Women with PCOS should start by eating healthily, exercising, and not smoking. However, stress and despair may make these modifications tougher for PCOS women, highlighting the need for help.
Unsupported assumptions and generalisations are dangerous. PCOS women have unique risks and contributing factors. Patient-centred care improves outcomes, controls conditions, and decreases anxiety.
Conclusion: Overcoming PCOS for Healthy Pregnancy
Nourishment is one of the keys that can get patient relief in terms of getting rid of such issues. On this note, anyone can visit Ovum Fertility if she’s having a prolonged PCOS issue. Our dedicated healthcare experts, who have ample experience in this field, can help to cope with such health issues with proper guidance and treatment.
FAQs
1: If anyone is having prolonged menstruation issues, does it mean PCOS?
No, it certainly is not. But if she faces any of the prolonged symptoms such as blood discharging, blood clotted urination, or acute cramp in the abdomen, these may indicate PCOS.
2: Does it cause pain?
Yes, it causes acute menstruation; sometimes a woman might suffer from fever.
3: Is there any possibility of getting anxious?
During this phase, anxiety is very common. But if anyone has been suffering from such anxiety for a longer period of time, then it’s suggested to visit the nearest mental health expert.
4: What is the future of PCOS patients?
As of now, there is no such cure for PCOS, but with proper treatment, this can be addressed and can be arrested to some extent.
5: Can high BP and sugar impact?
Yes, indeed, these have a massive impact on the PCOS disease; hence, it is suggested to keep high blood pressure and sugar under control so no such issue would occur.