The Risk of PCOS and Pregnancy
Many women with polycystic ovarian syndrome often wonder if pregnancy is something they’ll be able to experience. Hundreds of young women dream of becoming mothers and starting a family. And discovering that they have PCOS can be devastating. This situation is a concern for most women with this condition. PCOS affects one in ten women and it can cause infertility in many cases, although this can vary from person to person.
But a diagnosis of this condition doesn’t mean that you’ll be unable to have children at all. There are a number of treatments that can improve your fertility and ensure a healthy and safe pregnancy. But first, it’s key to understand exactly what PCOS is, how it affects you, and what you can do to stay healthy even in the light of understanding your condition.
What is PCOS Anyway?
PCOS, or polycystic ovary syndrome, is a condition in which patients will experience high levels of androgens, or male hormones. This can cause a number of specific symptoms, which we’ll talk about in a moment. But one of the most common and obvious symptoms, of course, is the fact that you may experience the development of polycystic ovaries.
In many cases with patients with PCOS, the ovaries will contain several tiny cysts. The ovaries are enlarged due to the condition, and the cysts will grow along the outer edges of the ovaries.
Now in the ovaries, you’ll find sacs in which eggs are meant to develop. When a woman has PCOS, she will experience many hormonal abnormalities. Because of this, these sacs in the ovaries will not properly develop and will be unable to release an egg. This means that ovulation will not take place or have a difficult time occurring.
Symptoms of PCOS
A patient with PCOS may also have other symptoms such as missed periods or irregular menstruation. Women, especially because of their elevated androgen levels, may also experience extra hair growth (including, in some cases, small patches of facial hair), infertility, weight gain and acne.
The most common difficulty with PCOS and pregnancy is that fact that some women with this condition have absent, irregular or unpredictable ovulation. These women will have irregular periods or may have no periods at all. A woman is less likely to conceive if they have a cycle of more than thirty-five days. However, in some cases a woman may have three or four periods a year and will still be able to ovulate. We’ll talk about how PCOS specifically affects fertility in a moment but the thing to keep in mind about polycystic ovary syndrome is that symptoms can vary from person to person. Some women may be completely infertile. Others may experience thick hair growth. Many women may not realize they have polycystic ovary syndrome at all for years. It’s an extraordinarily common syndrome and the signs can go unnoticed for decades.
How Do You Get Diagnosed With PCOS
Typically, PCOS is diagnosed with a pelvic ultrasound although you should keep in mind that not everyone with PCOS has polycystic ovaries, even though that’s one of the most common symptoms of the disorder. You’ll want to see a gynecologist in order to rule out the possibility of other conditions such as hyperthyroidism and adrenal hyperplasia. You may need to consider blood screening in order to monitor your hormone levels since PCOS almost always involves elevated male hormone levels that you’ll want to check out.
PCOS and Pregnancy: How PCOS Affects Fertility
When talking specifically about fertility, PCOS can affect your fertility in a variety of ways. Keep in mind that having cysts, in itself, doesn’t necessarily affect fertility. Many women experience ovarian cysts. It’s the hormone imbalance that’s almost always involved with PCOS that really has a tendency to affect your fertility.
Testosterone, which you’re experiencing elevated levels of, has a tendency to inhibit ovulation and successful fertilization. You’re also experiencing a reduced number of periods as a result. Your elevated levels of male hormones interferes with the production of necessary female hormones, including progesterone. Progesterone, which causes the lining of your uterus to thicken, is key in inducing ovulation in women. Testosterone inhibits progesterone.
Boost Your Fertility
There are different ways to maximize your chances of becoming pregnant and it involves boosting ovulation. One of the most important things you’ll want to consider is your body weight, which directly impacts your hormone levels, and various medical treatments. But first, due to how big of an affect it can have on your ability to ovulate, let’s consider your body weight and how losing weight and eating well can actually help boost your fertility.
PCOS and Weight
Now, keep in mind that not every woman with PCOS will be overweight, but are more likely to experience a high body weight if they have the insulin resistant type of PCOS.
But it has been found that a high body weight can affect your hormone imbalance, which contributes to infertility. For women who are overweight and diagnosed with PCOS, fertility experts recommend losing approximately ten percent of their total body weight in order to increase their chances of conception. Studies have shown dropping weight can increase a woman’s chances of successfully being able to become pregnant and carry out a successful, healthy pregnancy.
A healthy weight can help to balance out hormone levels, while also reducing high insulin levels. Most fertility experts will recommend losing weight as the first step because obesity is another major reason for infertility in women with PCOS. The more weight a woman gains, the worse the hormone imbalance becomes and this can affect the ovaries. This condition is on the rise as more women become obese or overweight. Exercise and weight loss is crucial for treating this condition. The key will be to circulate insulin levels in the body. Experts advise women to try and get their weight down before they get pregnant.
A woman with PCOS is more likely to have difficulty balancing their blood sugar, and they can become insulin resistant. This can cause the pancreas to release an increased amount of insulin, which will cause the ovaries to produce higher levels of testosterone.
There is now evidence that suggests that diet also plays a large role in helping with PCOS and can increase the chances of conception and staying pregnant. Eat well. Reduce sugar in your diet. Eat more vegetables and fruit, stick to lean meats as opposed to fattier cuts, monitor your caloric intake, and try to ensure you’re drinking plenty of water throughout the day. This will help you balance your blood sugar and, as an added bonus, has the potential to help you drop weight. If anything, you’ll certainly feel a lot better.
Following a healthy diet, exercising at least three times a week and controlling your stress can help to balance out the hormones and reduce any type of negative symptoms that are associated with PCOS. Many women find that losing weight and living a more active lifestyle can help reduce acne, hair growth, irregular moods, and so on.
For cases in which a woman’s cycle has been absent or irregular, losing weight will be enough to resume ovulation, but even if it’s not, it can work to make fertility treatment successful and is recommended to help regulate your hormone levels.
If a woman continues to eat health and maintain a healthy weight during pregnancy, this can help to ensure that she stays pregnant. However, with PCOS, a woman will be at risk for certain problems during pregnancy, which we’ll talk about later on. This is why proper prenatal care is recommended.
Medicine For PCOS
Fertility studies have shown that with treatment, most women with PCOS are able to conceive. Medications, such as Metformin, are able to encourage ovulation. Metformin is ordinarily prescribed to patients with type II diabetes but doctors increasingly prescribe it to women with PCOS in order to help them regulate their insulin levels which, as you remember from earlier, can affect their hormone levels. If your doctor prescribes Metformin, chances are likely that you’ll be able to ovulate normally, though other treatments are available if you’re still unable to conceive or ovulate normally.
Gonadotrophins are prescribed if Metformin is not effective. Gonadotrophins, which are injectable hormones that can be used to treat fertility problems in both men and women, are extraordinarily successful. Gonadotrophins are forms of the luteinising and follicle-stimulating hormones, both of which are necessary for encouraging ovulation and a successful conception.
In many cases, over 85% of women experiencing fertility issues, including polycystic ovary syndrome, will actually be able to ovulate after using gonadotrophins. But be warned. Gonadotrophins pose a risk because they can cause the ovaries to become over-stimulated. This has the tendency to lead to multiple pregnancies. If you’re concerned about how this may affect your family planning, talk to a doctor and have a strong birth control/contraceptive plan in place. Be prepared for the possibility of twins or triplets if you undergo a gonadotrophin routine.
In some cases, you may be prescribed with anti-androgens to block the affects of androgens/testosterone on your body. Many women also report success with birth control in order to manage their estrogen levels, although you’ll want to consider discussing how birth control/hormone replacement therapy will affect your fertility.
Laparoscopic ovarian drilling is a surgical procedure that is recommended if medication therapy fails to be successful. With laparoscopic ovarian drilling, a laser or electrocautery may be used in order to destroy parts of the ovary. The intention is to help trigger ovulation, making pregnancy a stronger possibility. While for the most part PCOS can be managed with medication, laparoscopic ovarian drilling is always a possibility should medication fail to induce ovulation.
If you’re not comfortable with considering laparoscopic ovarian drilling or wish to consider other options, in vitro fertilization is also an option. Before treatment, your physician will check the fallopian tubes for any signs of blockage, which can prevent in vitro fertilization treatments from working.
Healthy eggs will be retrieved from your ovaries and will then be fertilized with healthy sperm in a lab. Once your eggs have been fertilized, they will be introduced back into your uterus. On average, this process can take up to two weeks so be mindful and be patient. Unfortunately, in vitro fertilization can be an expensive and invasive process but it is worth considering if you want to become pregnant and ovulation can’t otherwise be induced. Be sure to talk to your doctor to decide whether in vitro fertilization or other treatments are right for you and your particular situation.
Complications in Pregnancy for Women with PCOS
If you are successfully able to become pregnant, whether through in vitro fertilization or via other treatments, congratulations. But be warned that you may want to watch out for a handful of complications that may result due to having polycystic ovary syndrome.
PCOS and pregnancy will put a woman at greater risk for gestational diabetes, miscarriage, having a large baby and preeclampsia. Evidence suggests that PCOS can be linked to an increased risk of miscarriage, however, the exact role PCOS plays is not yet clear.
Women with PCOS are also more likely to develop type 2 diabetes or gestational diabetes.
Even if a woman is thin or at a normal, healthy body weight and diagnosed with PCOS, they are still at a higher risk for developing gestational diabetes.
It’s important that you keep all of your prenatal appointments so that careful checks can be made on your blood sugar levels and blood pressure. Because of the increased chance of complications, you will be monitored closely with these health issues in mind.
With all this in mind, it’s important to note that not every patient with polycystic ovary syndrome will experience infertility. By losing weight, taking certain medication, and even considering in virto fertilization, among other interventions, you can increase your chances of being able to ovulate normally again and successfully become pregnant. And by being mindful of specific risk factors associated with pregnancy and PCOS, motherhood is possible if you have PCOS. Talk to your doctor today to find out what solutions are right for you.