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How do polycystic ovaries affect fertility?

polycystic ovaries fertility fertile days

Do polycystic ovaries affect fertility?

 

It is very likely that if you have Polycystic Ovary Syndrome (PCOS) and you are starting to try to get pregnant, you are wondering if they can affect your fertility. 

 

Or you may even have started googling (wrong!) and freaked out because you read that polycystic ovaries make it hard to get pregnant.

 

In this article we are going to see in depth what exactly this PCOS is and how it affects fertility. And as always, from a scientific perspective but explained so you understand.

 

What exactly is Polycystic Ovarian Syndrome or PCOS?

 

It is an abnormal hormonal condition that affects ovulation and the morphology (shape) of the ovaries. 

 

Women with PCOS have higher levels than other women of the male hormone, androgens, and have problems managing another hormone, insulin. This hormonal disorder causes a greater number of follicles to be produced, but they do not mature and consummate ovulation. 

 

This surplus of follicles encysts and, in most cases, creates polycystic ovaries.

 

It is true that PCOS is one of the most common causes of infertility today. 

 

What are the causes of Polycystic Ovarian Syndrome?

The causes of symptom development are believed to be a combination of genetic predisposition, prenatal and postnatal environmental factors, excess oxidative stress, low-grade inflammation, and disturbances in lipid and insulin metabolism. 

 

Studies on polycystic ovaries and fertility

It affects between 5% and 20% of women of reproductive age. These women tend to have a lower natural pregnancy rate, a higher biochemical pregnancy rate, and a reduced response to assisted reproductive treatments.

 

Surprisingly, a 2019 study brings good news for women with PCOS. The study concludes that these women, throughout their lives, have a pregnancy rate similar to women who do not suffer from this pathology, although they take longer and usually need some type of help to achieve it.

 

How do I know if I have PCOS? What are the symptoms?

Eye, we are going to clarify concepts well. You can have ovarian cysts and not have PCOS, and you can have PCOS without having polycystic ovaries. It seems like a tongue twister but it is so. 

 

To suffer from PCOS, three of these four assumptions must occur:

  1. Clinical hyperandrogenism: excess body hair such as beard, sideburns, arms, back, abdomen, etc.
  2. Biochemical hyperandrogenism: excess androgens, more LH (luteinizing) hormone than FSH (follicle-stimulating).
  3. Oligo or anovulation: irregular cycles and irregular ovulation.
  4. More than 12 follicles in the ovaries according to ultrasound analysis.

 

In addition to having three of these four assumptions mentioned above, there are some other symptoms that can give you clues:

  • Overweight.
  • Insulin resistance: abdominal fat. 
  • Diabetes. 
  • Adrenal phenotype: masculine forms and tendency to muscle.
  • Absence of hair on the head.
  • Acne.
  • Infertility.
  • Complications during pregnancy: preeclampsia, prematurity, gestational diabetes.

 

How does PCOS affect fertility?

A woman with PCOS will take longer to achieve a viable pregnancy. This is mainly due to the fact that her irregular cycles reduce the number and quality of ovulations and, therefore, the chances of fertilization. 

 

Being overweight is also a negative factor for fertility, which can add complications when it comes to getting pregnant. Studies say that weight loss between 5 and 10% can trigger regular ovulation. 

 

Although it is not a direct relationship in all cases, weight loss usually makes the medication to promote ovulation more efficient.

 

Of course, it must be taken into account that, despite suffering from PCOS, those women who do not want to become pregnant must also take contraceptive measures.

 

What can I do if I want to get pregnant and I have PCOS?

 

This syndrome is a complex pathology and its treatment can have very different approaches for each woman, depending on the factor that is having the most weight in the development of the pathology.

  1. The best of the recommendations will be to adopt a healthy life style to help control body weight on the one hand and control insulin spikes on the other. 
  2. It is recommended to follow a diet low in simple carbohydrates and rich in fiber which, in addition to promoting weight loss, will help control insulin spikes that favor abnormal tissue growth and promote obesity. Cinnamon, Berberine or mate seem to have beneficial effects on insulin sensitivity. By reducing fat we eliminate a factor that alters the hormonal balance. 
  3. Ensure adequate intake of nutrients to have a healthy thyroid and a sufficient amount of protein and fat to ensure the production of hormones. Eat seafood and fish on a regular basis.
  4. Do not smoke and do not drink alcohol. This implies eliminating these oxidative factors that damage the follicle, which is already weak.
  5. Ensure adequate sleep rhythms combined with regular exercise sessions. With them we will help recover oxidative damage on the one hand and regulate hormonal balance on the other. Regular exercise, combined with a healthier diet, is capable of improving cycle regularity by up to 50%. 
  6. In the case of women with an adrenal phenotype, more masculine physical traits (absence of curves, musculature), lowering the stress level will be essential to control the production of male hormones.
  7. Supplements like Myo-Inositol work on insulin sensitivity and increase sensitivity to ovarian-stimulating hormones (FSH). And taking foods rich in plant estrogens or supplements that contain them, during the first phase of the menstrual cycle, can help the follicle to mature and promote correct ovulation.

 

What does conventional medicine offer me for Polycystic Ovarian Syndrome?

From the specialist doctor, the approach will be to force ovulation with certain medications (Clomid or Letrozole) or by using medication to control high insulin levels (Metformin). 

Ultimately, if changing habits and pro-ovulation medication were not enough, she would suggest resorting to assisted reproduction techniques such as insemination or in vitro fertilization.

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