How Polycystic Ovary Syndrome Affects Fertility
Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women. It’s due to a hormonal imbalance that affects normal ovulation, and it may lead to fewer than eight menstrual cycles per year. PCOS affects 1 in 10 women during their peak reproductive years.
At the OB/GYN practice of Dr. Hany H Ahmed in Houston, Texas, we offer a number of treatments for women struggling with PCOS and infertility. Because you may not be familiar with how PCOS affects fertility, we’ve put together this guide to bring you up to speed.
Causes and symptoms of PCOS
Doctors don’t yet know the precise cause of PCOS, but they believe several factors play a role:
Genetics
Your risk for developing PCOS may be higher if a woman in your family has the condition.
Cysts
Most women discover they have PCOS in their 20s and 30s, when they have difficulty getting pregnant. These women have missed, infrequent, or prolonged menstrual periods.
The ovaries can also develop numerous small cysts (fluid-filled sacs). These cysts affect the ovaries’ ability to produce an egg or release it during ovulation.
High androgen levels
All women make some androgens, but these hormones primarily determine male traits. Women with PCOS may have higher-than-normal androgen levels, preventing the ovaries from releasing an egg during ovulation.
Androgens can also cause “masculine” side effects: facial hair growth, male pattern baldness, and acne.
High insulin levels
Insulin is a hormone produced in the pancreas that helps process food into energy your body can use. When you develop insulin resistance (Type 2 diabetes), your blood levels of the hormone rise, and you can’t process what you eat.
Many women with PCOS also develop insulin resistance, especially those who are overweight or obese, don’t eat well, and don’t get enough exercise.
PCOS complications
Left untreated, PCOS may lead to a number of complications, many of which affect fertility:
- Infertility
- Miscarriage or premature birth
- Gestational diabetes
- Eclampsia (pregnancy-induced high blood pressure)
- Abnormal uterine bleeding
- Endometrial cancer
- Liver inflammation
- Sleep apnea
- Depression, anxiety, and/or eating disorders
PCOS may also lead to metabolic syndrome, a collection of conditions that increase the risk of heart disease.
Treatments for PCOS that increase fertility
PCOS has no cure, but you do have options if you want to get pregnant. These include:
Medications
If Dr. Ahmed has ruled out other causes of infertility for both you and your partner, he might prescribe a drug such as Clomid to help you ovulate normally.
Intrauterine insemination (IU) or in vitro fertilization (IVF)
If medication doesn’t work, IU or IVF may be options. With IU, your egg is fertilized with your partner's sperm within your uterus; with IVF, it’s in a tube or dish. In the latter case, Dr. Ahmed then places the fertilized egg in your uterus to attach and develop.
Losing weight
If you’re overweight or obese, and especially if you’ve developed insulin resistance, losing weight by eating healthier and getting regular exercise can go a long way toward making your menstrual cycle more regular. That helps improve your fertility.
In 85% to 90% of cases, infertility treated with conventional medical therapies is successful.
Surgery
Surgery is considered only when all the other options fail. One procedure is known as ovarian drilling. The ovaries’ outer shell (cortex) becomes thickened in women with PCOS, and may be responsible, in part, for preventing spontaneous ovulation.
With ovarian drilling, Dr. Ahmed drills holes through the shell into the surface of your ovary. This usually restores ovulation, but only for about 6-8 months.
If you’re struggling to get pregnant, it’s time to visit the office of Hany H Ahmed, MD, for a consultation to determine if polycystic ovary syndrome is the cause. Give the office a call at 713-489-3348, or book online with us today.