How Does PCOS Affect Fertility?

Polycystic ovary syndrome (PCOS) is a medical problem caused by an imbalance of reproductive hormones. It affects 1 in 10 women in their childbearing years. Many women discover they have it when they have difficulty becoming pregnant.

At the OB/GYN office of Dr. Hany H Ahmed in Houston, Texas, we offer innovative treatments for women struggling with PCOS and infertility. 

Symptoms and causes of PCOS and how they affect fertility

With PCOS, a woman may have missed, infrequent, or even longer-than-usual menstrual periods. In addition, their ovaries develop numerous small cysts (fluid-filled sacs) that affect the ovaries’ ability to produce an egg and release it during ovulation.

Additional symptoms include:

• Weight gain or difficulty losing weight
• A propensity toward Type 2 diabetes
• Skin darkening, often in the groin, on the neck, and underneath the breasts
• Skin tags in the armpits or on the neck

Doctors don’t yet know the precise cause of PCOS, but it’s believed several factors play a role:

1. Genetics

You have an increased risk of developing PCOS if your mother, sister, or aunt has the condition.

2. High androgen levels

All women make small quantities of androgens, hormones that primarily control male traits.

However, if a woman’s body produces an abnormally high level of androgens, it prevents the ovaries from releasing an egg during the menstrual cycle. It can also cause facial hair growth, alopecia (pattern baldness), and acne. This collection of symptoms is a good indicator of PCOS.

3. High insulin levels

Insulin is a hormone produced in the pancreas that helps process food into energy your body can use. When the cells develop insulin resistance, as in Type 2 diabetes, your blood sugar levels rise and you can’t process what you eat.

Many women with PCOS develop insulin resistance, especially those who are overweight or obese, don’t consume a healthy diet, and don’t get enough exercise.

Complications from PCOS

Left untreated, PCOS may lead not only to infertility but also to other complications:

• Miscarriage or premature birth
• Gestational diabetes (often resolves after delivery)
• Eclampsia (pregnancy-induced high blood pressure)
• Liver inflammation
• Sleep apnea
• Depression, anxiety, and/or eating disorders
• Uterine bleeding
• Endometrial cancer

PCOS may also lead to metabolic syndrome. This is a collection of conditions that includes high blood pressure, elevated blood sugar, and abnormal cholesterol and/or triglyceride levels that increase your risk for heart disease.

Treatments for PCOS that increase fertility

There’s no cure for PCOS, but you do have options if you want to get pregnant. These include:

Medications

If your doctor can rule out other causes of infertility in both you and your partner, he might prescribe an ovulation drug such as clomiphene (Clomid).

Intrauterine insemination (IU) or in vitro fertilization (IVF)

If medication doesn’t help, IU or IVF may be options. Your egg is fertilized with your partner's sperm either inside your uterus (IU) or in a tube or dish (IVF). In the latter, the doctor then implants the fertilized egg in your uterus, where it develops.

Losing weight

If you’re overweight or obese, especially if you also have prediabetes or Type 2 diabetes, losing weight through a healthy diet and regular exercise can go a long way toward making your menstrual cycle more regular, which increases your fertility.

Surgery

Surgery is always the treatment of last resort, used only when all other options fail. One possible procedure is ovarian drilling. In women with PCOS, the outer shell (cortex) of their ovaries is thickened and may be partly responsible for preventing spontaneous ovulation.

In this procedure, Dr. Ahmed drills through the shell, creating holes in the surface of your ovary. This usually restores ovulation, but it’s a temporary solution; it only works for about 6-8 months.

In 85%-90% of cases, PCOS-caused infertility can be successfully treated with conventional medical therapies.

If you’re struggling with infertility, it’s time to see Dr. Ahmed so he can determine if PCOS is the cause and devise an appropriate treatment plan. Call the office at 713-489-3348 or schedule your consultation online.