PCOS & Infertility: The Often Ignored But A Deep Connection

Introduction

Polycystic ovary syndrome (PCOS) is a medical condition where the hormonal levels of women are severely affected.

PCOS causes women to create higher male hormones than they should. This hormonal imbalance women to miss menstrual cycles, making it difficult for them to conceive.

PCOS is indicated by hair growth on the face and body, as well as baldness. It can also cause long-term health problems, including diabetes and heart disease.

Birth control pills and diabetes drugs (which treat insulin resistance, which is a hallmark of PCOS) can assist in correcting the hormone imbalance and alleviating symptoms.

The prevalence of PCOS in India varies between 3.7 and 22.5 per cent, depending on the population investigated and the diagnostic criteria utilised.

Symptoms of PCOS

Around the time of a woman’s first menstruation, some begin to experience symptoms. Others only find out they have PCOS after they’ve acquired a lot of weight or struggled to conceive. Here are some common symptoms of PCOS:

• Weight gain: Around 80% of women with PCOS suffer from obesity or being overweight. 
• Facial hair: Hair grows on the face and body of more than 70% of women with this illness, including the back, belly, and chest. Hirsutism refers to excessive hair growth.
• Heavy bleeding: Because the uterine lining develops over a longer time, your periods may be heavier than usual.
• Acne: Male hormones can make the skin oilier than usual, which can cause acne outbreaks on the face, chest, and upper back.
• Unbearable headaches:  In some women, hormone change can provoke excruciating headaches.
• Abnormal periods:  During PCOS, the uterine lining is unable to shed every month, due to a lack of ovulation, thus leading to irregular periods. Some women suffering from PCOS can experience as little as eight periods in a calendar year or in some cases, none at all.

PCOS and infertility

PCOS might raise your risk of miscarriage, especially if left untreated.

It is due to reduced levels of the hormone progesterone in women with PCOS, that it is crucial for ensuring that the endometrial lining is thick enough to allow the implantation and development of an embryo. 

Progesterone is also required for the embryo to continue to grow and develop after implantation until the placenta takes over progesterone production around weeks 10 to 12.

This implies that low progesterone levels might raise your chances of miscarriage even before you discover you’re pregnant.

How does PCOS affect pregnancy and lead to complications?

PCOS can have a significant impact on pregnancy and lead to difficulties such as:

• Miscarriage
• Baby spending more time in Intensive Care Unit
• Caesarean section (C-section)
• Heavyweight baby
• Gestational diabetes
• Preeclampsia

Even though PCOS is the most frequent cause of infertility in women, it is also easily manageable. Rather than becoming discouraged, women with PCOS should seek treatment from a specialist.

Diagnosis of PCOS 

In most situations, a patient’s symptoms or complaints indicate PCOS to the doctor.

So the doctor examines the patient’s medical history and does a physical examination to search for indicators of excessive hair growth, insulin resistance, and acne. 

The reproductive organs are analysed and physically examined for any abnormalities, such as bulk, growth, and so on.

Post-that the following diagnostic tests may be recommended:

• Ultrasound: A USG of the reproductive organs is performed to examine the appearance of the ovaries and the thickness of the uterine lining. A transvaginal ultrasound is sometimes used to get a better image of the organs.
• Blood tests: Hormone levels, glucose tolerance and fasting, and cholesterol and triglyceride levels are all evaluated using blood tests.

Treatment of PCOS

There is currently no definitive cure for PCOS. Treatment, on the other hand, can improve the odds of conceiving in people who want to have a family. 

Individual symptoms differ, thus therapy is not always the same.

Here are some suggested options for treatment which also depend on whether a person wants to get pregnant or not:

• Hormonal imbalances can be corrected using birth control tablets
• Insulin-sensitizing medications boost the body’s insulin utilisation and, as a result, testosterone synthesis
• Exercise and a healthy diet can help you feel better and lose weight
• Maintaining a healthy weight can aid in the reduction of insulin and testosterone levels, as well as the alleviation of symptoms
• Medication to manage blood sugar levels in the event of diabetes

Final thoughts

PCOS can cause a woman’s menstrual cycles to be interrupted, making it difficult to conceive.

Unwanted symptoms such as hair growth on the face and body are also caused by high amounts of testosterone levels.

Losing weight can help with PCOS symptoms and increase your chances of becoming pregnant. Weight loss can be achieved by a combination of diet and aerobic activities.

Doctors usually prescribe lifestyle changes as the primary therapy for PCOS, and they often work.

And, above all, keep your health in check by opting for regular PCOS diagnostic check-ups to evaluate the effectiveness of the management techniques.