A Closer Look At How Pcos Can Cause Infertility In Women
First, PCOS is incredibly common, affecting as many as 10 percent of reproductive-age women. A woman who has PCOS has a hormonal imbalance. Namely, the body overproduces androgens, which are typical male hormones , as well as insulin. This hormonal imbalance may impair the signals sent out from the pituitary gland that directs the ovaries to develop eggs when an egg is not released, ovulation doesnt occur and pregnancy wont happen on its own.
Many women are not aware that a problem like PCOS is preventing them from becoming pregnant. In fact, more than 50 percent of women with the condition are undiagnosed. Not only are PCOS symptoms acne, hair loss, mood problems easy to miss or misinterpreted as other problems, but unless shes using an ovulation kit, a woman can’t be sure if shes ovulating or not. Having a period doesnt necessarily mean ovulation has occurred, notes Loren Wissner Greene, MD, a professor of endocrinology and ob-gyn at New York University Langone Health in New York City. Irregular periods, no periods, skipping periods, or especially heavy periods can be a sign that something is off, she adds.
Work Out The Right Amount
Exercising is essential for weight maintenance and stress relief. During IVF treatment, however, women should avoid overly strenuous exercise. For example, women who enjoy running should limit mileage to less than 15 miles weekly during fertility treatments. Instead, opt for hiking, spinning, using the elliptical, or practicing yoga.
Reverse Any Insulin Resistance
Women with PCOS have problems with insulin resistance, which means that your blood sugar levels are elevated, as is your insulin level, this increases your risk of having trouble conceiving. Doctors can prescribe Metformin to help, but there are many side effects to this drug to consider. In the first instance, try cutting out sugar and refined carbs from your diet and making sure you get enough protein, fibre and healthy fats and you will see your blood sugar levels and your insulin level drop. Myo-inositol has been proven effective in treating insulin resistance in some PCOS women. The new InofolicAlpha, which contains both myo-inositol and alpha-Lactalbumin, can help reverse insulin resistance even more effectively.
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Does Metformin Cause Weight Loss
Its also important to keep in mind that just because a woman has PCOS doesnt mean that she also has infertility. As one study points out, 70 to 80 percent of these women are infertile. That leaves up to 30 percent of women who may become pregnant on their own without the use of fertility treatments. If a woman with PCOS hasnt gotten pregnant after six months of trying, its recommended that she seek the advice of her doctor.
When a woman does get pregnant, shell have to work closely with her ob-gyn. According to the National Institutes of Health, PCOS women are more at risk for complications during pregnancy, including a three-times greater risk of miscarriage, gestational diabetes, preeclampsia , preterm birth, and cesarean sections. Drugs like metformin, which improve insulin sensitivity, may lead to better outcomes, but research isnt conclusive. The ob-gyn will consider a womans unique health history and suggest steps to get the right care to reduce these risks and support a healthy, safe pregnancy.
Clomiphene Or Clomiphene Citrate
- This is the most common treatment for infertility in women with PCOS.1 The American College of Obstetricians and Gynecologists recommends that clomiphene should be the primary medication for PCOS patients with infertility.
- Clomiphene indirectly causes eggs to mature and be released.6
- Women treated with clomiphene are more likely to have twins or triplets than women who get pregnant naturally. Women who conceive with the aid of clomiphene are slightly more likely to have multiples, most commonly twins.7
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Will My Pcos Symptoms Go Away At Menopause
Yes and no. PCOS affects many systems in the body. Many women with PCOS find that their menstrual cycles become more regular as they get closer to . However, their PCOS hormonal imbalance does not change with age, so they may continue to have symptoms of PCOS.
Also, the risks of PCOS-related health problems, such as diabetes, stroke, and heart attack, increase with age. These risks may be higher in women with PCOS than those without.
What Is Polycystic Ovary Syndrome
First, lets find out what polycystic ovary syndrome is.
Polycystic ovary syndrome is a condition women experience due to an imbalance in their reproductive hormones.
Polycystic means many cysts and refers to the many follicles that partially form on the ovaries. Each partially formed follicle contains an egg but these rarely mature or produce eggs that can be fertilized.
Women with PCOS often have high levels of insulin or high levels of androgens in some cases, they have both.
Although the cause of polycystic ovary syndrome isnt really understood, its believed lifestyle factors such as diet and environment can influence the development of PCOS.
PCOS is frequently associated with obesity, insulin resistance, and metabolic disorders. These conditions can lead to type 2 diabetes or gestational diabetes during pregnancy.
Polycystic ovary syndrome is also one of the most common endocrine and metabolic disorders in premenopausal women when the functionality of their ovaries decreases.
We think you might like to read Polycystic Ovarian Syndrome for more detailed information about PCOS, signs, and symptoms.
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Getting Pregnant With Pcos: Ovulation Induction And Fertility Treatment Options
Navigating your fertility journey often starts with lots of planning, no matter what your situation is. But when you have a reproductive health condition like polycystic ovary syndrome , you may find yourself planning out more steps in your journey than youd anticipated.
PCOS is a very common hormonal disorder and a leading cause of infertility because of one of its hallmarks: irregular ovulation. While irregular ovulation can make getting pregnant trickier, you can work with your healthcare provider to build a medical plan and increase your chances of conception.We recently held a virtual PCOS panel with OB-GYN Dr. Jennifer Conti, MD, MS, MSc and reproductive endocrinologist Dr. Temeka Zore, MD, FACOG. Heres what we learned about trying to conceive when you have PCOS.
Coping With Pcos And Conceiving A Baby
For any woman diagnosed with Polycystic Ovary Syndrome the first question on her lips is usually Will I be able to have children? PCOS decreases the chances of being able to get pregnant quickly and easily, but the condition doesnt rule out the possibility entirely.
To increase your chances of a healthy pregnancy
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Autoimmune Diseases May Confound The Prospect Of Pregnancy
Women with diabetes or other metabolic disorders are at increased risk of having other conditions that will likely add another layer of complexity to pregnancy, endometriosis, and PCOS. As if having PCOS or endometriosis isnt enough of a challenge, women who have thyroid disorders may face an even more complicated path to pregnancy. Women who have hypothyroidism may find the effort to lose excess weight more difficult, and even subclinical hypothyroidism can interfere with ovulation.9
In exploring the reasons behind your infertility, the experts recommend that you have your thyroid hormone levels checked if you havent already had your blood work done. Its important to work with your doctor to achieve a healthy thyroid function before attempting pregnancy.
Autoimmune disorders like systemic lupus can cause complications for women with endometriosis. Women who are under treatment for lupus usually receive steroids and immunosuppressant agents, which can worsen endometriosis symptoms by reducing the bodys ability to fight the growth of excess endometrial tissue. If you have these or other confounding conditions, youll be in good hand if you work with a team of specialists who can guide you to make decisions that are safest and most sensible for your health and pregnancy goals.
Why Is It Harder To Get Pregnant With Pcos
The main reason PCOS makes it more difficult to conceive is that it often prevents ovulation from occurring, and ovulation has to happen in order for pregnancy to be possible. In addition, PCOS causes hormonal imbalances that change the quality of your cervical fluid, making it harder for sperm to survive.
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Try The Latest Technology: In Vitro Maturation
Most women have heard of IVF, or in vitro fertilization. However, in vitro maturation is a new treatment offering hope to women are struggling to conceive.
Women with PCOS have many cysts with immature eggs. Rather than inducing these cysts to mature, a physician removes the follicles and induces maturation in a petri dish. This reduces the chances of ovarian hyperstimulation and also increases the chances of getting a mature egg by midcycle.
The doctor then uses IVF technology to inseminate the mature eggs before implanting them in the patients uterus. This is still a very new treatment, which means it can be hard to find a fertility doctor who performs it, but many doctors are claiming success rates of around 80%.
How To Get Pregnant If You Have Endometriosis
Endometriosis is another common reproductive condition, affecting more than one in 10 women in the United States. It occurs when tissue found in the uterus grows in other parts of the body, such as the ovaries or fallopian tubes.
Even mild endometriosis can reduce fertility, while severe endometriosis can distort a womans pelvic anatomy and, for example, block her fallopian tubes, according to a 2015 study in The Journal of Obstetrics and Gynaecology of India.
It is still possible for a woman with endometriosis to become pregnant, and, once pregnant, the pregnancy is expected to be no different to that of a woman without endometriosis. Medical treatment through drugs does not improve fertility, according to Endometriosis UK, an endometriosis-focused charity. These medications involve regulating a persons hormones, and can slow the growth of endometrial tissue and prevent new pieces from developing, said the Mayo Clinic. But because these drugs are based on hormones , they actively stop a woman from getting pregnant.
Endometriosis presents differently in different women, so its treatment depends on the individual, according to the American Society for Reproductive Medicine.
Surgery to excise the endometrial and scar tissue may improve fertility rates and help reduce pain associated with endometriosis, researchers reported in the 2015 study in The Journal of Obstetrics and Gynecology of India.
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Ways To Get Pregnant With Pcos
Getting pregnant with PCOS naturally may be more difficult, but the best way to increase your chances is to have unprotected sex frequently. Because women with PCOS don’t ovulate on a regular interval, timing sex for the middle of your cycle people often use day 14 as a default may not work. If you have long cycles, you may be ovulating closer to day 20-22, which can mean that if you default to day 14, youre a full week off from your optimum conception time. On the other hand, if you have short cycles, you may ovulate as early as day 9 or 10, which would make sex on day 14 too late. The best way to find out when you’re ovulating is to track your fertility signs.
Trying to get pregnant with PCOS after the age of 35 can be even more difficult and is likely to require medical intervention. Your doctor may be able to prescribe medications, such as metformin or progestines, and give you advice on lifestyle changes that can increase your chances of conception.
In general, the earlier you get treatment for your PCOS, the better your chances are of getting pregnant successfully. This may mean that you have to be more adamant with your health care providers when you ask for the blood tests that can diagnose PCOS so you can move on to treatments more quickly.
There Are 2 Medical Conditions That May Explain Why Women Face Infertility While Lifestyle Changes May Lessen The Struggle
With Gloria Richard-Davis, MD, and Mary Jane Minkin, MD
Everyone talks about what to expect when youre expecting, but what about when you want to be pregnant but you just cant seem to get there. Fertility problems are one of those things we learn not to talk about, but about 12% of women of all ages are known to have difficulty conceiving or carrying the pregnancy to term.1Two of the most common causes of fertility in women are endometriosis and polycystic ovarian syndrome .1
To better understand how each condition impacts the ability to get and stay pregnant, EndocrineWeb spoke with two fertility experts: Gloria Richard-Davis, MD, FACOG, a specialist in infertility and reproductive endocrinology, and Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology at Yale University School of Medicine.
If you have been trying to get pregnant for months, ask your doctor if PCOS or endometriosis might be the cause of your infertility. Photo: 123rf.
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Why Do Those With Pcos Have Trouble Getting Pregnant
Women with PCOS have higher than normal antral follicle counts on either one or both of their ovaries. The high levels of androgens and other sex hormones found in women with PCOS interfere with antral follicle growth. Hormonal imbalances can cause follicles to mature improperly and not release an egg. When a woman does not release an egg during a menstrual cycle, it is known as anovulation. Anovulatory infertility is a common consequence of PCOS, and 70-80% of women with anovulatory infertility have PCOS .
Kick The Smoking And Drinking Habits
Smoking can lead to fertility problems in both women and men. Chemicals found in cigarette smoke, such as nicotine and carbon monoxide, speed up the loss rate of a womans eggs, according to the American Society for Reproductive Medicine.
Smoking ages a womans ovaries and depletes her supply of eggs prematurely, according to the Mayo Clinic. In a study published in 2020 in the journal Reproductive Biology and Endocrinology, researchers looked at scientific findings around smoking, alcohol, addiction and fertility they found that smoking is linked to decreased fertility.
Its also a good idea for women to stay away from secondhand smoke, which may affect their chances of becoming pregnant. Marijuana and other recreational drug use should also be avoided while trying to conceive.
Its safest for a woman to avoid alcohol when she is hoping to become pregnant. A woman should also stop consuming alcohol if she stops using birth control because she wants to get pregnant. That said, a 2019 Danish study of 1,708 women over a five-year period did not find a link between regular alcohol consumption and binge drinking, and fertility, according to the study published in the journal Human Reproduction.
However, a 2017 study published in the journal Obstetrics & Gynecology found that about half of pregnant women in the United States drink alcohol around the time they become pregnant or in early pregnancy, usually before they know they are expecting.
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Keep Magnesium And Chromium Levels High
Magnesium and chromium are both trace elements that are essential to fertility. Unfortunately, many women are deficient in one or both of these nutrients.
Not only are both elements important to healthy cellular function, they actually reduce both pelvic inflammation and insulin resistance. Taking a small supplement of both or eating foods rich in these nutrients can increase the likelihood of pregnancy with PCOS. All women should look into whether they need these trace elements.
/6when Is The Right Time To Seek Help
Like any medical problem, the earliest intervention makes way for timely help and treatment. Having a baby with PCOS is tricky, but not impossible. A little help from a guiding doctor, making lifestyle changes and controlling weight can go a long way in promoting fertility and good health.
Frequent intercourse, managing stress levels and last of all, being optimistic will help you conceive and have a baby of your own.
Consider seeking help if you face conceiving naturally six months after trying naturally. If you get very few periods in a year or have heavy bleeding, or are over 30, consulting a doctor can prevent problems.
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When Pcos May Challenge Your Ability To Be Pregnant
Women with PCOS may have trouble conceiving because excess circulating hormones can inhibit ovulation. Women with PCOS also typically have insulin resistance and higher levels of insulin-like growth factor that promote androgen production, compounding the problem, by leading to weight gain and type 2 diabetes. This constellation of symptoms places women with polycystic ovary syndrome at higher risk for gestational diabetes.
While it is well known that excess weight can exacerbate the symptoms of PCOS and the hormonal imbalances driving PCOS can promote weight gain, no one knows for sure which comes first. Experts have recently termed this conundrummetabolic inflexibility.6
One thing is certain, if you have PCOS, achieving weight lossalbeit easier said than donerepresents one of the best solutions available to increase your prospects for fertility. In a recent National Institutes of Health-funded study, women who achieved modest weight loss with a change in diet and addition of exercise improved their rates of fertility substantially.6 Dr. Richard-David agrees, and suggests that her patients aim to lose just ten percent of their current body weight, which is enough to significantly increase your chances of conceiving, and improving your pregnancy outcome and that of your baby even losing just two percent of your body weight will help.