I Have PCOS. Can I Conceive?
So you were diagnosed with Polycystic Ovary Syndrome (PCOS). Here’s everything you need to know about its implications for fertility and whether or not you’ll be able to conceive a child of your own.
PCOS affects approximately six to 10 percent of women of reproductive age and is a leading cause of infertility
It can also influence a woman’s cardiovascular health and have other serious implications for her health and lifestyle.
The main symptoms of PCOS
It is associated with irregular or absent periods; excessive male hormones, which can cause extra facial and body hair, acne and male-pattern hair loss; and the appearance of polycystic ovaries in an ultrasound.
There are many causes of infertility in women and men, but in patients with PCOS the main issue is ovulatory function, which means that the ovary does not produce an egg, or that ovulation happens infrequently and unpredictably. This is a problem because it reduces the opportunities for fertilization, and it’s much more difficult to predict when to best time sexual intercourse for the purpose of conception.
Women with PCOS are also more likely to be overweight or obese, and high BMI not only makes it more difficult to get pregnant and stay pregnant, but also increases other pregnancy risks (like high blood pressure or diabetes in pregnancy) for both the mother and the fetus.
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How to increase your chance of conceiving
Keeping all of this in mind, I generally take a two-pronged approach with my patients so they can hopefully conceive. The first is to ensure that the woman’s health is optimized, including checking for diabetes (it’s more common for women with PCOS), testing blood pressure and verifying that she’s taking pre-natal vitamins. I also counsel women to stop smoking and limit alcohol, and verify that there are no other factors that could be affecting fertility. If she is overweight, even a five to 10 percent weight loss can improve outcomes, both in terms of her risks and in terms of regulating ovulation. Rapid weight loss is not encouraged because it increases the risk of having a baby that is too small.
The second is to try to make periods more regular. This can be done with weight loss, and with a medication called metformin — a diabetes drug that has been shown to help regulate ovulation in some women with PCOS. The mainstay of correcting ovulatory function is “ovulation induction,” which can be done with two different oral medications and, if they fail, with injectable medications. The good news is that with one or more of these approaches, ovulation can be successfully induced in the majority of women with PCOS.
As with all women, whether they have PCOS or not, there is an age-related decline in fertility so I always counsel women who want to conceive that trying sooner is better than later, and that taking steps to improve lifestyle even before planning for pregnancy is best. PCOS patients with regular periods are less likely to need the help of their physicians, which is the best outcome of all.
Here’s what to eat to boost fertility.
Infertility, defined as a failure to achieve pregnancy after 12 or more months of unprotected intercourse, doesn’t mean that a woman can never be pregnant; it just means that it may take longer, or for some women simple interventions may be needed.
Many women don’t know these key facts about infertility.
Dr. Sheila Laredo is an endocrinologist at Women’s College Hospital, womenshealthmatters.ca.