PCOS and Pregnancy: Potential Difficulties and Solutions
What Is PCOS and How Is It Diagnosed
Polycystic ovary syndrome (PCOS) is one of the leading causes of female infertility that affects millions of women worldwide. According to the U.S. Department of Health and Services, around five million American women of childbearing age are sufferers.
If left untreated, long-term health risks of PCOS include Type 2 diabetes, high cholesterol levels and even heart disease. Coping with PCOS can be emotionally difficult too – on top of worrying about your ability to have children and your health, this condition also causes hirsutism (excessive hairiness) and acne, which can further dent your self-esteem.
Your doctor is your first port of call if you suspect you have PCOS. Be open with them and share any symptoms you might have, no matter how embarrassing they might be. You will be referred for blood tests and an ultrasound scan to rule out other conditions with similar symptoms, such as thyroid problems.
Why Is PCOS Causing Infertility?
If you suffer from polycystic ovary syndrome, a disproportionate amount of male hormones (testosterone) are produced by your ovaries. This is often caused by an insulin imbalance, which is also responsible for weight gain. This excessive amount of male hormones can affect the development of follicles in the ovaries so ovulation can be irregular or will not occur at all, making pregnancy difficult with PCOS.
Polycystic ovaries usually contain more cysts than normal ovaries, but there are cases of women suffering from PCOS who don’t display this symptom in a scan. These cysts might be harmless but can seriously affect your fertility. Some women with PCOS might also have a high level of luteinizing hormone, which stimulates ovulation on one hand but also works with insulin to produce more testosterone.
Pros and Cons of Fertility Treatments for PCOS
If you have PCOS and want to get pregnant, ovulation can be induced with clomiphene citrate (commonly known as clomid), a fertility drug that is administered orally. Side effects include a higher risk of a multiple pregnancies, while prolonged use is not beneficial.
The alternative treatment, used at many IVF clinics, is injecting gonadotropins. This is a more expensive medication that is not only associated with multiple births but has undesirable side effects such as depression, abdominal pain, allergic reaction and breathing problems.
If ovulation is occurring but irregular, intrauterine insemination is a recommended treatment – your partner’s sperm will be placed into your uterus to facilitate conception.
Alternative Treatments for PCOS
Other medical treatments are available if you don’t want to go down the IVF route. These include controlling insulin levels with metformin (a diabetes drug still under review by the Food and Drug Administration), hormone treatment with contraceptive pills and surgery. The latter is a minor procedure called laparoscopic ovarian drilling, which is performed under general anesthetic to correct your hormone imbalance.
If you are overweight, lifestyle changes will be suggested by your doctor, such as following a healthy, balanced diet and regular exercise. This will protect you from the risks of contracting diabetes and heart disease. Diet, exercise and even stress reduction may also help reduce the symptoms of PCOS, and pregnancy may potentially be possible without having to resort to medications.
Further Reading
Understanding Polycystic Ovarian Syndrome
Treatment Options for Women With PCOS
Tips for Women Who Have PCOS and Want to Have a Baby
References
Polycystic Ovary Syndrome - WomensHealth.Gov - US Department of Health and Human Services
