PCOS and Fertility: What’s the Connection?

PCOS stands for Polycystic Ovarian Syndrome, implying the presence of many small fluid-filled cysts in the ovaries. There is a direct link between PCOS and fertility. It affects 27% of women in their childbearing years. 

As a result of the cysts, the ovaries produce a lot of a hormone called androgen, often considered a male hormone. This overproduction causes symptoms like facial hair growth, irregular menstrual cycles, heavy menstrual flow, weight gain, acne, and fertility problems. It raises the risk of developing lifestyle diseases like diabetes and high blood pressure. 

Since its prevalence is during the reproductive years of a woman’s life, PCOS and fertility go hand in hand. Most healthcare professionals prescribe birth control pills and diabetes drugs like metformin to combat hormonal imbalances and improve fertility with PCOS. 

Let’s explore how PCOS makes an appearance and how it affects a woman’s health differently.

The Symptoms of PCOS 

Each woman discovers PCOS in her own time. It has been the case for some since their first period, whereas some notice it when they put on a few kilos. The majority find out about it when they try to conceive.

Here are some common PCOS symptoms:

• Weight gain: Almost 40 to 80% of women are obese and have trouble maintaining a steady weight. The gain is more in the belly region.
• Poor menstrual health: There may be irregular or no periods. Some women report heavy bleeding. Some have light periods. For some others, periods occur after 35 days. 
• Acne: The male hormone androgen can cause the skin to become oilier than usual. The more oily the skin, the more chances of developing acne. The areas affected are the face, upper back, and chest. 
• Darker skin: Dark patches or skin darker than usual can be seen around the neck, under the breasts, and in the groin. The darkening of skin in PCOS is called acanthosis nigricans. 
• Excessive facial and body hair: Almost 70% of women with PCOS see increased hair growth on the face, back, belly, and chest. Excessive growth of hair in PCOS is called hirsutism.
• Hair loss: Hair loss among PCOS patients appears as male-patterned baldness or gets thinner and falls out. 

Some other possible symptoms are:

• Headaches
• Infertility due to no ovulation or irregular ovulation
• Excess skin growth on the neck and armpits
• Pelvic pain

How does PCOS affect fertility? 

Nearly 70 to 80% of women with PCOS battle infertility. PCOS affects a woman’s health in many ways. But it mainly affects fertility in different ways. 

• No ovulation
• Increase in testosterone levels
• Hormonal imbalance prevents the uterine lining from implanting a mature egg.
• Menstruation is irregular, so ovulation doesn’t happen every month.
• Increase in insulin levels
• Taking a long time to get pregnant 
• The outer shell of the ovaries becomes thick.
• Formation of small, painless, fluid-filled cysts in the ovaries 

Infertility in women can arise owing to many reasons. But one of the main ones is PCOS. It is also one of the most common and treatable causes of infertility. 

The Causes of Infertility in PCOS 

Let’s understand the link between PCOS and infertility with the following steps:

1. Insulin resistance, excessive secretion of androgens, inadequate secretion of progesterone, and oxidative stress
2. Low-grade inflammation of ovarian tissue and uterine lining
3. PCOS development 
4. Infertility in PCOS

Treatments for Infertility in PCOS 

Here are the ways to improve fertility when you have PCOS:

Lifestyle changes

Obese pregnant women with PCOS have a higher risk of suffering from gestational diabetes mellitus, miscarriages, raised blood pressure during pregnancy, and congenital deformities of the baby. So, a significant reduction in weight via physical activity can reduce the risk of such anomalies. 

Folic acid supplementation

Folic acid administration to obese pregnant women with PCOS helps reduce the risk of fetal spinal cord defects. 

Avoidance of tobacco and alcohol

These risk factors further contribute to the complications of PCOS in pregnant women. PCOS women are prone to liver problems if they consume alcohol. One usually succumbs to alcohol and tobacco as a substitute for regular food. 

How to improve your chances of pregnancy with PCOS 

Follow these tips to increase your chances of getting pregnant with PCOS:

Keep track of your ovulation

It’s the fertile window period during which you get pregnant. It falls in the ovulatory phase of the menstrual cycle. Two days before and after are when you must try to get pregnant. Use test strips to confirm your ovulation. Keep a note of your ovulation every month so it becomes easy for you to understand how frequently you ovulate and your chances of getting pregnant. 

PCOS diet for fertility

Choose a PCOS diet for fertility. Eat to become healthily pregnant. Add freshly cooked vegetables and fresh fruits to your diet. Opt for beans, lentils, brown rice, oats, and barley. If you love fish and chicken, have them. Add omega-3 to your diet through walnuts, chia seeds, fish, salmon, tuna, and flax seeds. If you love consuming tea, try adding ginger to it. Other herbs that can be added to a PCOS diet for fertility are maca root, ashwagandha, holy basil, chaste berry, cumin, fennel seeds, and bay leaves. 

Keep your weight under control

Evening losing 5% of your body weight contributes positively to PCOS and pregnancy. Check the exact number of steps you need to walk every day and go for a walk. Try lifting weights while you do sedentary work, like watching TV. Stay in touch with your healthcare provider so they can give you a reference for a dietician to plan your weight loss regimen.

Tips for managing PCOS and Fertility 

PCOS and fertility can be dealt with if you remain mindful of the following points:

Cut down on carbohydrates

One of the most crucial things in a PCOS diet for fertility is cutting down on carbohydrates. White bread, sugars, pastries, cakes, white rice, and other foods that increase blood sugar levels can increase insulin levels. Increased insulin levels can worsen the situation for PCOS. So, choose a protein-rich, high-fiber, and low-fat diet. 

Better your PCOS and pregnancy with yoga

Stress is a multifaceted causative factor for many diseases, one of which is – PCOS. So, it’s essential to meditate to gather the strength to deal with the everyday stressors of life. Basic yoga techniques like stretching, breathing exercises, and mindfulness can relax your nerves. If yoga and meditation bore you, learn a new skill like photography, painting, or writing. 

Reduce the portion size of your food

One of the best ways to improve fertility with PCOS is having small meals every three to five hours. Try consuming low-fat cheese, boneless and skinless chicken, no-sugar yogurt, and one hardboiled egg. These meals help make you feel fuller. Ensure your meals are fresh and minimally processed. Such foods are a powerhouse of nutrients, minerals, and vitamins. 

Here are some other ways of dealing with PCOS

• Acupuncture acts as an alternative treatment for PCOS. It increases blood flow to the ovaries, reduces the levels of stress hormones, and improves your sensitivity to insulin hormone. 
• Follow a sleep routine of eight to ten hours every night, sleeping every day at the same time, and avoiding fatty foods before sleep.
• Consume probiotics like kimchi, yogurt, and kombucha. 
• Avoid endocrine hormone disruptors like dioxins, pesticides, BPA, and phthalates.
• Take supplements of inositol, chromium, turmeric, zinc, evening primrose oil, berberine, and cod liver oil. 

Resources for more information about PCOS and fertility 

Understanding PCOS and fertility is confusing. For a layperson like yourself, some concepts around PCOS and fertility may sound too complicated. Here are some resources available at the click of a button for your queries:

• American Congress of Obstetricians and Gynecologists: https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos
• Centers for Disease Control and Prevention: https://www.cdc.gov/diabetes/basics/pcos.html
• Endocrine Society: https://www.endocrine.org/patient-engagement/endocrine-library/pcos
• World Health Organization: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
• Office on Women’s Health: https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Conclusion 

To a certain extent, PCOS can be managed through weight management, a healthy diet, and a regular exercise regimen. These parameters can increase your chances of getting pregnant and reduce the symptoms of PCOS. Lastly, hydrating your body works wonders.

Keeping track of menstrual cycles, maintaining a stable weight, and following a regular dietary and exercise routine can help you understand and get better control over PCOS and fertility.