Maternity Care in Agra | Dr. Shubhra Goyal - Comprehensive Pregnancy Care

PCOS and Fertility: Understanding the Connection

By Dr. Shubhra (MBBS, – Obstetrics & Gynaecology)

Introduction

As a gynaecologist, I, Dr. Shubhra, aim to help women understand PCOS, its impact on fertility, and the available solutions.

What is PCOS?

PCOS is a hormonal disorder where the ovaries produce excess androgens (male hormones), leading to:

  • Irregular periods or no periods at all
  • Multiple small cysts in the ovaries (not always present)
  • Ovulation problems, making conception difficult
  • Hormonal imbalance, affecting overall health

PCOS can also lead to other health concerns like insulin resistance, weight gain, acne, hair thinning, and excessive hair growth (hirsutism).

How Does PCOS Affect Fertility?

PCOS interferes with regular ovulation, which is essential for conception. The main issues include:

  1. Irregular or Absent Ovulation
    • Without ovulation, an egg is not released for fertilization, reducing the chances of pregnancy.
  2. Hormonal Imbalance
    • High levels of LH (Luteinizing Hormone) and Androgens can disrupt the menstrual cycle.
  3. Insulin Resistance
    • Many women with PCOS have high insulin levels, leading to weight gain, which further worsens ovulation problems.
  4. Poor Egg Quality
    • Due to hormonal imbalance, egg quality may be affected, making conception more challenging.

Can Women with PCOS Get Pregnant?

Yes! While PCOS makes conception harder, it is treatable, and many women successfully conceive with the right approach.

Here are some effective strategies to improve fertility with PCOS:

1. Lifestyle Changes (First-Line Approach)

  • Maintain a Healthy Weight Even a 5-10% weight loss can restore ovulation.
  • Healthy Diet Focus on low-carb, high-fiber, and protein-rich foods to manage insulin levels.
  • Exercise Regularly Moderate physical activity like walking, yoga, or strength training can improve hormonal balance.

2. Medications to Induce Ovulation

If lifestyle changes alone are not effective, the following medications may be prescribed:

  • Clomiphene Citrate (Clomid) Helps stimulate ovulation.
  • Letrozole (Femara) Often more effective in PCOS for ovulation induction.
  • Metformin Used in women with insulin resistance to improve ovulation.
  • Gonadotropins (Injectable Hormones) Used in resistant cases under medical supervision.

3. Assisted Reproductive Techniques (ART)

If medications do not work, assisted reproductive techniques may be recommended:

  • Intrauterine Insemination (IUI) Sperm is directly placed in the uterus during ovulation.
  • In Vitro Fertilization (IVF) Eggs are fertilized outside the body and implanted in the uterus.

4. Surgical Option (For Severe Cases)

  • Ovarian Drilling A laparoscopic procedure where small holes are made in the ovary to lower androgen levels and restore ovulation.

Pregnancy and PCOS: What to Expect?

Women with PCOS can have healthy pregnancies, but they need extra care due to risks such as:

  • Gestational Diabetes Increased risk due to insulin resistance.
  • High Blood Pressure & Preeclampsia
  • Preterm Birth
  • Increased Risk of Miscarriage

Regular prenatal check-ups, a healthy diet, and proper monitoring help ensure a safe pregnancy.

Frequently Asked Questions (FAQs)

1. Can PCOS be cured?

PCOS cannot be cured, but it can be managed effectively with lifestyle changes and medical treatment.

2. Can women with PCOS have normal pregnancies?

Yes! Many women with PCOS conceive naturally or with treatment and have healthy pregnancies.

3. How long does it take to get pregnant with PCOS?

It varies. Some women conceive within months, while others may take longer and need treatment.

4. Should women with PCOS take birth control pills if they are not trying to conceive?

Yes, birth control pills help regulate periods and reduce PCOS symptoms if pregnancy is not a goal.

Final Thoughts by Dr. Shubhra

PCOS can challenge fertility, but with early diagnosis, proper management, and personalized treatment, pregnancy is absolutely possible. If you have PCOS and are planning to conceive, I encourage you to consult a specialist to develop the best fertility plan for your health.

Let’s take control of PCOS and make your motherhood dream a reality!

Dr. Shubhra MBBS Obstetrics & Gynaecology PCOS & Fertility Specialist