Polycystic ovarian syndrome (PCOS) and its impact on fertility

Polycystic ovarian syndrome, or PCOS as it’s usually known, is a common condition that impacts your ovaries. It disrupts the reproductive system and can affect your fertility.

In this blog post, we explain PCOS, the symptoms to watch for, how it affects fertility and what you can do to increase your chances of becoming pregnant. Discover all you need to know about PCOS and fertility with the Bristol Centre for Reproductive Medicine.

What is PCOS?

PCOS is a hormonal condition that affects how your ovaries work. Your ovaries are two small glands on either side of your uterus that produce eggs and hormones that result in menstruation.

Usually, your ovaries release one egg per month (ovulation). If sperm doesn’t fertilise the egg, the body recognises this and sheds the uterus’s lining during your period.

In PCOS, the release of eggs may not occur consistently or at all. This can make it challenging to become pregnant naturally.

Experts believe that an overproduction of androgens (male sex hormones) contributes to PCOS, which can disrupt how your ovaries function.

Symptoms of PCOS

PCOS can cause varied symptoms, but some women may not know they have the condition until they face difficulty becoming pregnant.

Symptoms may include:

Irregular periods – because your ovaries aren’t releasing eggs as often as they should or are not releasing them at all. An irregular cycle is defined as any < 21 or > 35 days or < 8 cycles per year
Excess body or facial hair (hirsutism) – due to high levels of androgens
Polycystic ovaries – your ovaries become enlarged and contain multiple fluid-filled sacs (follicles) as the eggs aren’t released each month and build up on your ovaries

Other symptoms that can be associated with PCOS but may have other underlying causes include:

Weight gain
Thinning hair
Oily skin
Acne

PCOS also increases your risk of developing type 2 diabetes because it is linked to insulin resistance, making it hard for your body to maintain normal blood sugar levels.

How does PCOS affect fertility?

PCOS can affect your fertility because it disrupts ovulation by stopping eggs from maturing and releasing, which may make trying to conceive naturally more challenging. The severity of ovulatory dysfunction may fluctuate over time.

Some women may conceive while having PCOS if they ovulate sporadically. It can take them much longer to become pregnant naturally, but it is possible.

However, the good news is that you can still have a baby even with PCOS – you may just need some fertility support.

What are my chances of becoming pregnant with PCOS?

With PCOS, your chances of natural conception can be a bit lower than the general population.

However, if doctors diagnose your condition and provide the correct fertility treatments, your chances can increase to be similar or in line with other women your age without PCOS.

Can PCOS affect my pregnancy?

PCOS can potentially affect your pregnancy because it can increase your risk of complications like:

Gestational diabetes – high androgens and insulin resistance may cause you to develop diabetes while pregnant (known as gestational diabetes). However, this can be detected and managed and gestational diabetes usually resolves once your baby is born.
Miscarriage – hormonal imbalance in the body can affect embryo quality, and the womb’s environment can be affected, making it more challenging for a pregnancy to implant.
Pre-eclampsia – insulin resistance and high androgen levels can increase your risk of pre-eclampsia, which causes high blood pressure and protein in your urine. This condition can be dangerous and can mean your baby must be delivered early.

You might also be more likely to need a caesarean section due to the increased risk of complications like pre-eclampsia and gestational diabetes, which can mean an early delivery.

At BCRM, we’ll provide the comprehensive support you need before undergoing fertility treatment, giving you confidence when approaching pregnancy and birth with PCOS.

What fertility options do I have with PCOS?

There isn’t a cure for PCOS, but there are ways to treat symptoms and support your fertility.

One of the most effective actions you can take is to lose weight if you’re considered overweight. Losing 5% of your body weight can significantly improve PCOS and fertility. Similarly, losing weight can decrease your risk of complications during pregnancy.

The safest way to decrease your body weight is to eat a well-balanced diet combined with regular physical activity. A healthy diet ensures that you’re getting the right nutrients your body needs and can help to support your overall wellbeing and fertility. Learn more about diet and fertility in our blog post ‘Diet and fertility: foods to eat to help support conception’.

However, you may need fertility treatment if you’re trying to become pregnant and haven’t conceived naturally.

Fertility options for women with PCOS include:

Medications like Letrozole, gonadotrophins and Metformin – encourage ovulation and lower insulin and blood sugar, respectively.
Intrauterine insemination (IUI) – medications are given to ensure ovulation is occurring. The best sample of sperm is then inseminated through the neck of the womb just prior to egg release.
In vitro fertilisation (IVF) – this fertility treatment can help you fall pregnant as it fertilises an egg outside the womb before returning it for implantation and potential pregnancy.

IVF can be an effective fertility treatment for women with PCOS as it bypasses the need to ovulate – we can collect your eggs during the egg retrieval process instead.

Speak with a fertility specialist at the Bristol Centre for Reproductive Medicine

Our team can help if you think you may have PCOS symptoms or doctors have diagnosed the condition, and you want support starting or growing your family. We can thoroughly investigate your symptoms and ensure you receive personalised care that helps you begin or continue your parenthood journey.

Contact our team today and learn how we can support your fertility if you have PCOS.

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