How PCOS Impacts Infertility in Women

PCOS - Healthians

Contributed by- Dr Pooja Chaudhary

Polycystic Ovary Syndrome is one of the leading health problems in females, affecting almost 1 in 10 women of childbearing age.

PCOS is a hormonal imbalance that can influence the overall health and appearance of a female. It is one of the top causes of infertility in women, affecting them both emotionally and physically.

 

Hormones involved

Hormones are substances that help in various bodily functions. The ones associated with PCOS are as follows:

  • Androgens: These are the male hormones, but they are present in females too. PCOS will have an elevated level of androgens, which can lead to symptoms like hair loss, hair in unwanted places like face and can also cause infertility issues.
  • Insulin: These are the blood sugar regulators in the body. In females with PCOS, cells do not react to this hormone, the way they are supposed to.
  • Progesterone: Lack of this hormone can contribute to the irregularity of the menstrual cycle.

 

Signs and symptoms of PCOS

Females suffering from PCOS experience several random and unrelated symptoms, which can leave them overwhelmed. PCOS early symptoms can show their presence in early teens or in the early 20s. Some common PCOS symptoms are:

  • Irregular menstrual cycle or maybe no periods at all (in some cases)
  • Infertility in women or difficulty in getting pregnant
  • Weight gain
  • Excessive hair growth in areas like face, buttocks, chest or back
  • Thinning of hair or hair loss, especially from the front
  • Acne or oily skin
  • Patches or thickened skin
  • Headaches
  • Insomnia or trouble sleeping
  • Fatigue or feeling tired all the time
  • Pelvic pain

 

These symptoms can vary from mild to sever. However, it is not necessary that all these symptoms show their presence in females suffering from PCOS.

 

Causes of PCOS - Healthians

Causes of PCOS

The exact cause of PCOS is still not clear but genetic and environmental factors seem to play a role. Following are several contributing factors for the development of PCOS:

  • Hereditary
  • Elevated levels of insulin
  • High levels of androgen
  • Obesity
  • Inflammation

 

PCOS and Infertility

Most of the females are not even aware that they are suffering from PCOS and get diagnosed when they are planning to start a family. Females suffering from PCOS fail to ovulate or may infrequently ovulate that leads to irregular or no monthly cycle, hence chances of pregnancy with PCOS reduces.

It is estimated that almost 8-10 females in their reproductive age are affected with PCOS symptoms and the infertility rate is also very high. Most of the females have difficulty in getting pregnant and usually require infertility treatment.

It negatively impacts the fertility of women as they are unable to ovulate or release the monthly eggs due to an overproduction of the estrogen hormone. As there is irregular ovulation, the menstrual cycle becomes irregular, and there is an increased level of hormones like testosterone. An increased level of these hormones can:

  • Effect the quality of the egg
  • Inhibit ovulation
  • Lead to insulin resistance
  • Increased risk of disorders like gestational diabetes

 

There has been an established link between PCOS and pregnancy, that do not have their limitation only till the infertility symptoms. Women with PCOS are believed to be at a high risk of the following problems:

  • Increased chances of miscarriage
  • Gestational diabetes
  • Preeclampsia
  • Caesarian section
  • There are chances of the baby being very heavy, a condition called as Macrosomia

 

PCOS and Health Issues

Apart from the PCOS and the infertility issues, it can also lead to various health complications later in life. These issues include:

  • Females suffering from PCOS are at a high risk of getting into depression and mood swings
  • Increased risk of developing Type 2 diabetes
  • High blood pressure and high cholesterol levels are common. They can lead to various heart diseases and stroke
  • Sleep apnea
  • The chances of developing endometrial cancer in high, especially in women who have had an irregular menstrual cycle
  • Metabolic syndrome
  • Obesity
  • Non-alcoholic steatohepatitis
  • Abnormal uterine bleeding

 

Diagnosis of PCOS - Healthians

Diagnosis of PCOS

Technically there is no single test to diagnose PCOS. Following are the necessary steps that can help in diagnosing PCOS

  • Evaluation of medical history
  • Physical examination is performed for keeping a check on the blood pressure levels, BMI, waist size. The doctor will also check for any pigmentation on the skin, for any further hair growth on the face, cheek or back or any acne problem, etc.
  • Pelvic examination is done for any signs of extra male hormones
  • Blood test
  • Ultrasound

 

Once the diagnosis is made, the doctor works on the treatment plan. Healthians can help you in the journey of the diagnosis of your PCOS!

 

Treatment of PCOS

PCOS can be overwhelming, as it can cause a lot of painful and troublesome symptoms. Sadly, there is no cure for the syndrome; there are only ways to provide relief from the associated symptoms. After the diagnosis, the doctor can figure out the right treatment plan, which is made to avoid any related complication. Following are a few suggestions which can help in easing the symptoms.

  • Lifestyle modifications: It includes eating healthy,  proper sleep pattern, regular exercise, adequate rest.
  • Home intervention: Hormone imbalance can be treated with a combination of the birth control pill and progesterone treatment.
  • Anti-androgen treatment: Medication to block the effects of androgen might be by the doctor for providing temporary relief from the symptoms.

 

Infertility treatment 

Females suffering form POCS usually requires induction of ovulation to get pregnant. The possible ways through which ovulation induction is done are:

  • Clomid
  • Metformin
  • Clomid and metformin
  • Femara
  • Injectable gonadotropins
  • IVF, Invitro Fertilization

 

Pregnancy success rate with the induction of ovaries varies considerably and mostly depends on the following factors:

  • Age
  • Type of PCOS
  • Efficacy of the ovulation medication on stimulating the ovulation
  • Other infertility factors involve

 

The pregnancy success rate is likely to occur in the first 3-4 months of the treatment, after that there is a considerable drop in the monthly success rate.

 

When is the time to consult a doctor?

Mostly POCS is going undiagnosed, as initially, the symptoms are not of much concern. If there are signs of the following symptoms, then a visit to the doctor is the best decision.

  • Excessive vaginal bleeding (You must change the pad after every 1-2 hrs)
  • Irregular menstrual cycle
  • Have been trying to get pregnant from past one year
  • Suddenly experiencing symptoms of diabetes
  • Feeling depressed or having mood swings

 

Your health is in your hand, don’t ignore. It’s essential to take care of your gynae health and get regular check-ups!

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