PCOS is the number one cause of infertility in women worldwide. Though usually diagnosed during a woman’s child bearing years, PCOS starts much early in her life. The typical symptoms of PCOS are: absent or irregular periods, high levels of testosterone, hair growth on the face, arms and chest. This is all part of the PCOS roller-coaster.
This leaves most women confused, angry and, hopelessly disoriented about what to do next.
PCOS and Infertility: Role of Hormones
Balanced hormones enable the release of a mature egg every month. This leads to regular periods, conception, pregnancy and childbirth. But in PCOS, there is an imbalance in the secretion of testosterone, luteinizing hormone (LH), and other critical hormones – all of which cause impaired ovulation.
Usually, women with PCOS have low levels of follicle stimulating hormone FSH, and high levels of male hormones like testosterone. These also affect ovulation.
The hormone imbalance also causes the ovaries to fill up with multiple cysts. This happens typically due to the high levels of testosterone in a woman with PCOS. So, there are these multiple, faulty follicles that don’t quite work right on the affected woman’s ovary. These stop the eggs from maturing and also stop the healthy follicles from working.
When a woman has PCOS, her ovaries show up as larger than normal in an ultrasound due to the presence of these multiple tiny cysts that contain immature eggs.
PCOS and Infertility: Risks involved
Women with PCOS are also at a higher risk for miscarriage, gestational diabetes, preeclampsia.
Most women with PCOS are insulin insensitive. This means their body is not sensitive to the hormone insulin which breaks down sugar in their blood into energy. To bring down blood sugar levels, their pancreas have to produce higher levels of insulin. This, in turn, increases the secretion of male hormones instead of female hormones which aid in ovulation. This causes more hormonal fluctuations in an affected woman’s body. A perfect vicious circle!
Both of these, insulin insensitivity and out-of-whack hormone levels, work in tandem to cause infertility or sub-fertility in women with PCOS.
How is infertility in women with PCOS treated?
Food, as we know, can act as medicine to heal polycystic ovaries, just like the right kind of exercise can. Both of these will improve PCOS symptoms and allow women to conceive naturally and carry their pregnancy to term without any problem.
To regulate the period doctors prescribe birth control pills that contain estrogen and progestin- man-made versions of the real hormones to reduce secretion of male hormones. These ensure that the woman with PCOS menstruates every month, even though no egg is released from her ovary.
Metformin is also prescribed in women with PCOS to increase insulin sensitivity and it does help in improving the ovarian health to quite a large extent.
In addition to birth control pills, women with PCOS are also prescribed specific fertility-enhancing medicines to help them ovulate so that they can get pregnant. These drugs are taken only after stopping the birth control pills. Clomiphene is one such drug which helps women with PCOS get pregnant, and so is letrozole.
Last and not the least, women with PCOS need a good support system to lead normal, happy, healthy lives. They need husbands, family, friends and other like-minded women who understand what they are going through and can give them the hope and support to keep going.
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