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Does PCOS Cause Infertility? A Complete Guide

Aditi Shenai

December 14, 2022

Women with PCOS often have concerns about their fertility and reproductive health, such as whether they can become pregnant at all. PCOS (polycystic ovarian syndrome) is a complex hormonal condition that affects up to one in five women of reproductive age.

Many (but not all) women with PCOS are prone to anovulation and infertility, which is when the ovaries don’t always release an egg during the menstrual cycle.

As a result, they may experience more difficulty conceiving than other women. Fertility treatment or a long time to conceive may be necessary for most women with PCOS, but receiving the right advice and support can help improve fertility and increase the chances of pregnancy.

Understanding PCOS

Polycystic ovarian syndrome, or PCOS, is when your body suffers hormonal imbalance and metabolic issues, leading to multiple cysts on the ovaries.

The imbalance of reproductive hormones creates problems in the ovaries and causes irregular menstrual periods, weight gain, acne, and facial hair.

PCOS can affect women of all races and ethnicities. However, your PCOS risk increases if your mother, sister, or aunt has PCOS. PCOS can develop at any age after puberty, but most women find out they have the condition in their 20s and 30s or when they experience problems getting pregnant.

Some PCOS symptoms, such as acne, excess body and facial hair, and hair loss, are due to increased androgen levels. Androgens are present in all females, but those with PCOS have slightly higher amounts.

Recently, studies have found that PCOS often causes poor glucose tolerance, prediabetes, and type 2 diabetes. In such a situation, download HealthifyMe, which helps you understand your body’s glucose patterns with Continuous Glucose Monitoring. 

CGM offers real-time and personalised feedback on whether your dietary and lifestyle choices positively or negatively affect processes that drive PCOS symptoms. It works through a tiny sensor inserted under your skin. The CGM wirelessly sends the information to the app on your phone or laptop so you can monitor your blood sugar throughout the day. 

PCOS is challenging enough as it is, so caring for your body to prevent or manage further health issues like diabetes is essential. However, even if you do not have prediabetes or diabetes, committing to HealthifyPro plans can be a powerful way to discover what foods and exercises reduce your chances of developing a more severe health condition.

The instant and personalised guidance from a functional nutritionist or health coach helps you understand what specifically works for your body to optimise your hormone balance, weight, fertility, and overall health.

For example, green tea is good for PCOS, but perhaps your body may not show any favourable response to it. Or it’s a matter of whether you are drinking green tea in the wrong way and at the wrong time.

Here, HealthifyMe can help you understand if drinking green tea before or after a workout makes your body tolerate it better. After all, the body’s response to food is highly individual. 

Will PCOS Affect Fertility?

Suppose you haven’t conceived after 6-12 months of trying (6 months if you’re over 35) and experience irregular and unpredictable periods. It means that PCOS is affecting your fertility.  

Here is how PCOS and its complications affect your fertility:

Hormonal Imbalance 

Women with PCOS often experience an imbalance in their crucial fertility hormones, such as LH (luteinising hormone) and FSH (follicle-stimulating hormone).

For example, an underproduction of FSH can lead to irregular menstrual cycles and difficulty conceiving due to infrequent or absent ovulation. That is because FSH is responsible for maintaining menstrual cycle regularity and producing healthy eggs, while it may also reduce oestrogen levels. All of these hormonal imbalances can cause poor fertility.

PCOS is one of the biggest causes of hormone imbalance in women. It causes an imbalance in the key fertility hormones, such as LH or luteinising hormone, FSH or follicle-stimulating hormone, and oestrogen. 

FSH is responsible for maintaining menstrual cycle regularity and producing healthy eggs. However, PCOS results in reduced levels of FSH. At the same time, you may experience an underproduction of oestrogen. These hormonal imbalances cause irregular menstrual cycles, and you don’t ovulate or ovulate only occasionally. As a result, it causes trouble conceiving and poor fertility. 

Anti-Müllerian hormone supports the early stages of follicle development, which is the reservoir of eggs before fertilisation. So, a balance of AMH is necessary to maintain your ovarian reserve. Unfortunately, a study shows that women with PCOS have higher Anti-Müllerian hormone levels, making conception difficult unless treated. 

Anovulatory Infertility

Anovulatory infertility in PCOS is when the whole process of follicle development is abnormal. It causes an absence of regular menstruation.

There may be some bleeding with anovulatory cycles, which you may mistake for regular menses. Depending on the severity, anovulation can progress into infertility. A study shows that being overweight and having PCOS increases the risk of anovulatory infertility. 

Many women do not find out they have anovulatory infertility if they use hormonal contraception because it allows for a monthly bleed and masks irregular or no periods. 

Insulin Resistance

A study shows that PCOS places women at high risk for insulin resistance and defects in insulin secretion. It occurs in 70-95% of obese women with PCOS and can impair or inhibit ovulation.

Read more: The Insulin Resistance Diet: A Healthy Eating Habit

It can result in infertility if you ovulate irregularly or do not ovulate at all. Insulin resistance due to PCOS can also cause secondary infertility. It is when you have gotten pregnant at least once before but are now unable to conceive.

Weight Gain

Weight gain, a common side effect of PCOS, might be the biggest problem behind infertility. It is also harder to lose weight compared to women that do not have PCOS.

Research reveals that being overweight and obese has a detrimental effect on reproductive health, leading to infertility. Besides the subfertility common in PCOS, obese women undergo perturbations in the system controlling female reproduction. This dysfunction makes obese PCOS women frequently suffer from menstrual irregularities. 

The HealthifyMe Note

PCOS causes oligo- or anovulation, hyperandrogenism, and polycystic ovaries alongside obesity and insulin resistance. These endocrinal diseases are the known risk factors to induce infertility, pregnancy loss and late pregnancy complications, which indicates that PCOS negatively impacts fertility. However, a woman with PCOS can get pregnant with fertility treatment and lifestyle modification, including a healthy diet and exercise. 

Boost Fertility With PCOS: Just Like a Pro

Most women with PCOS will be able to conceive with fertility treatment, but cases vary so much, and different treatments show different success rates. Working through PCOS can be a long, complicated and anxious process. And HealthifyMe would invest time into getting your diet right, create a PCOS-specific fitness program, and de-stress your life.

Have you had trouble conceiving due to weight? Or are you desiring to lose weight with PCOS? The customised weight loss plans from HealthifyMe could be right for you. 

Although having PCOS makes conception more challenging, there are ways you can boost fertility.

Medications

Many women with PCOS can improve their fertile window with the help of ovulation medications. These medications can promote healthy ovulation. First, however, talk to a doctor or fertility specialist to find the best type and correct dose of medicine.

Reduce Stress

When dealing with infertility, lowering your stress shows a considerable difference. You can benefit from therapy, yoga, meditation, exercising, or connecting with loved ones. However, long-term stress with PCOS can take some time to heal. 

Find Your Healthy Weight 

Losing about 10% of body weight can improve your hormonal balance and ovulation. In addition, maintaining a weight compatible with your height and age can improve your menstrual cycle, reduce insulin resistance, and raise overall fertility.

Moreover, women with PCOS who exercise regularly will have a 5% lower risk of infertility than those who don’t. However, overexercising and fad diets to lose weight are unhealthy. Instead, aim for moderate-intensity exercise 3-5 days per week for the best and safe results.

Balanced Diet

A well-balanced PCOS diet allows insulin to function correctly, decrease androgen production, and boost fertility. Choose nutrient-rich food high in vitamins and minerals to reduce the severity of PCOS symptoms.

High-quality, high-fibre carbohydrates aid in stabilising your blood sugar levels, benefiting those who are insulin resistant. However, restricting or avoiding entire food groups will not provide long-term results. Therefore, work with a nutritionist to determine a personalised PCOS diet to optimise your health.

Surgical Options

If lifestyle changes and medications are unsuccessful, surgical procedures are available for women with PCOS to boost fertility. For example, ovarian drilling is a surgical treatment to trigger ovulation. Though ovarian drilling is not always necessary, over 50% of women can get pregnant within the first year after the surgery.

Conclusion

For women trying to conceive, PCOS can make it difficult due to hormonal imbalances and irregular periods. However, it does not mean you can’t get pregnant.

You can lower fertility problems through a balanced diet, regular physical activity, weight loss, and medicines. Enhancing your fertility when suffering from PCOS may take time, effort, and a recalibration of your lifestyle habits, but it can happen. 

Since insulin resistance and high blood sugar are common with PCOS, switching to HealthifyPro is an easy way to monitor your blood sugar patterns continuously.

It is also important to routinely test your metabolic markers if you have PCOS. A HealthifyPRO 2.0 subscription has a comprehensive Metabolic Panel which monitors 80+ key metabolic parameters. With just a single prick sampling, you can access accurate data on your metabolic health at the convenience of your home. A metabolically healthy person is less likely to experience chronic diseases and other health issues, including fertility problems.

About the Author

M.Sc in: Dietetics and Applied Nutrition from Manipal University. Worked: All over India and have been involved in helping set up nutrition departments in start ups. Interested in lifestyle based nutrition. Mantra: A healthy lifestyle isn't a choice to be made or discarded, it's a way of life!


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