Understanding PCOS and Infertility

Polycystic ovarian syndrome is surprisingly common. If you’ve been diagnosed, you’re not alone.

By: Erica Anspach Will, M.D.
Sep 27, 2018


*Sources: ASRM, PCOSAA


Approximately 10 million women have PCOS. Yet, only about half of them know it. It’s a leading cause of infertility, but many women aren’t diagnosed until they are trying to start a family.

A PCOS diagnosis can sound scary, and the symptoms can be difficult to deal with. However, if you are armed with knowledge and a trusted medical team, it is a manageable condition. And because so many women are going through the exact same thing, there are many support resources available.

Diagnosing PCOS

There is no single cause of PCOS, meaning there is no single test to diagnose it. A combination of history, symptoms and several diagnostic tests can help us determine if you have the condition.

To be diagnosed with PCOS, at least two of the following symptoms must typically be present:

  1. Irregular menstrual cycles — You don’t get your period on a regular basis, or perhaps at all.
  2. Excess androgens — You have an abnormally high level of male hormones, which can result in things like excess hair growth (including on the face, back and fingers) and acne. A blood test can also identify this imbalance.
  3. Polycystic ovaries — Your ovaries are characterized by having many small cysts. We can see this by doing an ultrasound. It’s important to know that not all women who have cystic ovaries have PCOS.

PCOS is also associated with obesity and insulin resistance, both of which have significant long-term health implications.

PCOS and Infertility

PCOS affects your body’s ability to ovulate — your ovaries’ ability to release eggs to potentially be fertilized. Women who have normal cycles ovulate 12 times a year. That’s only 12 chances to get pregnant. If you are not ovulating and having a period every month, your chances of conceiving drop dramatically.

Often, a fertility specialist will start by recommending lifestyle changes to improve reproductive function. This includes sustainable changes in diet and exercise to help achieve a healthier long-term weight (i.e. creating healthy habits rather than looking to fad diets).

For some women, weight loss alone can result in significant improvements in overall health and even restore fertility. For other women, PCOS makes it difficult to lose weight and see these benefits. While getting to a healthy weight should always be a goal for women with PCOS (and any women trying to get pregnant), we may need to consider other options.

The good news is there are many courses of treatment available. We can use oral fertility medications that help the body ovulate. This intervention can help some women achieve a pregnancy at home. In other situations, we need to couple these medications with additional treatments. More intense therapies, such as IVF, are also occasionally needed for women with PCOS.

Pregnancy with PCOS

Some women with PCOS are at a higher risk for gestational diabetes, miscarriage, preeclampsia, premature birth or the need for a cesarean section (c-section). This means it is important to take steps to ensure a healthy pregnancy, even starting before you conceive.

Working to achieve and maintain a healthy weight through a nutritious, well-balanced diet and appropriate physical activity is key. Consistent care and evaluation by your OBGYN throughout your pregnancy is critical to identifying any potential issues early on.

Living with PCOS

It’s extremely important for women to understand that, while infertility may be one of the more significant effects of their PCOS — and it may be what helped them to be diagnosed in the first place — it is an overarching medical condition that requires management beyond treatment of infertility.

Women with PCOS are more prone to metabolic syndrome, high blood pressure, high cholesterol, diabetes and endometrial cancer throughout their life. Getting to a healthy weight and maintaining a healthy lifestyle can dramatically help with PCOS symptoms, but there is no cure for PCOS. You should continue to monitor the condition under the guidance of a physician.

PCOS Support

Approximately one in 10 women of childbearing age have PCOS. Moreover, one in eight couples struggle to conceive for a variety of reasons. This means it very possible that someone you know is also going through the same things you are.

There are many resources and support outlets available. Midwest Fertility also partners with The Cabin Counseling & Resource Center in Zionsville, who can help women and couples cope with the emotional and mental aspects of a PCOS diagnosis and resulting infertility.

Each individual and couple has a unique situation. A fertility specialist who provides personalized care tailored to your needs and desires makes all the difference.

If you have been diagnosed with PCOS or are experiencing infertility, contact us or request an appointment with one of our doctors.




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