Painful periods, irregular menstruation, hormonal imbalances, mood swings, thick facial hair growth, and thinning of hair on the scalp are all common signs of PCOS. But, that’s not all. There is an intrinsic relationship between PCOS and fertility too. Simply put, the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation). If you don’t ovulate, you can’t get pregnant.
“Patients with Polycystic Ovary Syndrome (PCOS) also suffer from infertility because there is no ovulation.”
– Dr Sushma Tomar, Infertility Specialist &
Endoscopic Surgeon, Fortis Hospitals
What Is PCOS?
Polycystic Ovary Syndrome or PCOS is a hormonal imbalance caused in the female body. It is triggered when eggs in the ovaries are not released timely and become cysts. It negatively affects fertility because women with the condition do not ovulate, or release an egg each month due to an overproduction of estrogen by the ovaries.
But, having PCOS does not mean you can’t get pregnant. PCOS is one of the most common, but treatable, causes of infertility in women. While it’s not impossible for a woman with PCOS to get pregnant on her own, many women do need to seek care from a fertility specialist.
Did You Know?
Polycystic Ovary Syndrome (PCOS) represents 80% of anovulatory infertility cases in India.
Common Symptoms Of PCOS
The imbalance of hormones manifests as symptoms that can vary across patients. They include:
- Hormonal acne
- Weight gain/difficulty in losing weight
- Increased hair growth on face and body
- Fertility issues
- Irregular or no menstruation
PCOS Health Risks
- Insulin resistance
- Hyperlipidemia (elevated cholesterol and/or triglycerides)
- Increased risk for endometrial (uterine) cancer
- Elevated risk of ovarian torsion (twisted ovary)
5 PCOS Questions Answered By Dr Sushma Tomar
While it may look scary, PCOS is pretty manageable. Regular exercise, customised diet and meal plans and medication prescribed by your doctor can help in major ways. Team TC46 spoke to Dr Sushma Tomar, Infertility Specialist & Endoscopic Surgeon at Fortis Hospital (Mumbai), to answer some burning questions about the relation between PCOS and infertility and pregnancy.
1. Can I get pregnant with PCOS naturally?
Dr Sushma: “Having Polycystic Ovary Syndrome (PCOS) does not mean you will not have a pregnancy; however, it is one of the common causes of infertility. PCOS is not a disease, it is a hormonal imbalance and can be successfully treated with medicine. It can be diagnosed with astute history taking, ultrasonography and hormone tests at the time of menses. Hormonal imbalance interferes with the growth and release of an egg from the ovaries, if you do not ovulate, you cannot get pregnant.”
2. What is the best age to get pregnant with PCOS?
Dr Sushma: “You should try to get pregnant within one year of your marriage. Do not use contraception and delay the pregnancy; it is best to have a pregnancy before 35 years of age, primarily because fertility levels decrease after that.”
3. How do I know if I’m ovulating if I have an irregular cycle because of PCOS? Do ovulation tests work with PCOS?
Dr Sushma: “To know if you are ovulating or not, it is always better to go for a Follicular Study that can be done at a nearby sonography centre or be prescribed by a gynaecologist. In PCOS, irregular menses are common, so you have to use more than 5 strips, and still, if you are not sure if you are experiencing late ovulation or no ovulation, it is advisable that one goes for a Follicular Study.”
4. How does delivery change if I have a PCOS pregnancy? Is a C-section mandatory?
Dr Sushma: “The mode of delivery is not going to change depending on whether the mother-to-be has PCOS/PCOD or not. There is no specific indicator for the C-section because of Polycystic Ovary Disease (PCOD), but patients with Polycystic Ovary Disease (PCOD) are prone to have high blood pressure, diabetes, and risk of preterm delivery, and that could impact the mode of delivery. In such cases, the babies can be underweight, premature, and need neonate care.”
5. Does PCOS affect your health postpartum?
Dr Sushma: “Patients with long term Polycystic Ovary Syndrome (PCOS) are prone to have high blood pressure, diabetes and cardiac problems.”
Dr Sushma Lists Treatment Options For Infertility Caused By PCOS
1. Weight Loss to Restart Ovulation
Women with PCOS who are overweight are more likely to experience more severe anovulation, going months between periods. Regular exercise and a special PCOS diet can help. Research has found that women who have lost weight have a great chance of having fertility treatment success. Losing weight isn’t easy for anybody, and it may be even more difficult for those with PCOS. Also, not all women with PCOS are overweight.
Some women with PCOS need medications to help them conceive. If you’re insulin-resistant, taking the diabetes drug metformin can treat insulin resistance and may help you lose weight. Clomid is the most commonly used fertility drug overall, and also the most commonly used treatment for women with PCOS. Gonadotropins, an injectable fertility drug, is also used as a treatment option.
3. Fertility Treatments
IVF (in vitro fertilisation) or IVM (in vitro maturation) are the commonly used fertility treatments for women with PCOS.
- IVF: This involves using injectable fertility drugs to stimulate the ovaries so that they will provide a good number of mature eggs. The eggs are retrieved from the ovaries during a procedure known as egg retrieval. Those eggs are then placed together with sperm into Petri dishes. If all goes well, the sperm will fertilise some of the eggs. After the fertilised eggs have had between three and five days to divide and grow, one or two are transferred into the uterus. This procedure is known as an embryo transfer. The desired result is a positive pregnancy test after two weeks.
- IVM: It stands for in vitro maturation. Instead of giving you high doses of fertility drugs to force your ovaries to mature many eggs, with IVM you receive either no fertility drugs or very low doses. The doctor retrieves immature eggs from the ovaries and then matures these eggs in the lab. IVM is not offered at all fertility clinics. This is something to consider when choosing a fertility clinic.
PCOS is a condition that affects a woman physically, emotionally and psychologically. But it can be controlled effectively with lifestyle-improving habits. Regular monitoring of weight, insulin levels, blood pressure, cholesterol, sleep patterns and menstrual cycles is an effective way of identifying the progress made. You can also include these yoga asanas for irregular periods in your daily regime. While PCOS can make pregnancy difficult, it is vital to remember that it is not impossible. With the progress made by science, you can choose motherhood through a variety of ways with several available treatments.