1. Hormonal imbalance
The one main reason PCOS affects fertility is hormonal imbalance. Androgen is a male hormone seen in both men and women. In women, this hormone usually converts into estrogen, but when there is an excess, the hormonal balance is disrupted. Hormonal imbalances in women with PCOS can lead to infertility.
2. No ovulation
When an excessive amount of androgen is present, the eggs can be affected. For ovulation to happen, an egg must develop and be released from the ovary. Generally, after release, the egg moves to the fallopian tube to get fertilized. However, excessive androgen interferes with ovulation, affecting the release of the egg. When no egg is released, fertilization and pregnancy do not take place.
3. A missed period
When there is a hormonal imbalance, menstruation can be disturbed as well. Women with PCOS may experience an irregular menstrual cycle, making pregnancy difficult to achieve. The doctor may prescribe medications to regulate the menstrual cycle.
Getting pregnant naturally
Not every woman with PCOS will experience infertility. However, for many with this condition, fertility struggles are common. Women with PCOS can increase the chance of conceiving naturally by making lifestyle changes such as exercising, eating a healthy diet, and maintaining a healthy weight. In some cases, drugs that induce ovulation, like aromatase inhibitors and gonadotropin injections, may be necessary. If there is no success with conservative treatments, the doctor may recommend surgery or assisted reproductive technology (ART) to help with fertility.
ART for PCOS
In vitro fertilization (IVF) is the most common type of ART used to treat infertile women with PCOS. During IVF, the egg is fertilized with the sperm in the lab and then transferred into the uterus. Depending on the results, more than one cycle of IVF may be required for some couples. There are downsides to IVF, which include chances of multiple births, risk of ovarian hyperstimulation syndrome (OHSS), and high-cost treatment. However, this procedure is one of the best ways to get pregnant with PCOS.
The IVM approach
In vitro maturation (IVM) involves removing and collecting immature eggs from the ovaries and allowing maturation to happen outside the body. IVM is said to lessen the risks of OHSS and is helpful for those with PCOS undergoing IVF. The healthcare provider can determine if this approach is recommended.
Pregnancy is possible
PCOS causes hormonal imbalance and affects ovulation and menstruation cycles. Women with PCOS can experience infertility, but treatments are available. Whether a patient decides to try to balance hormones naturally or proceed with IVF, a baby is still possible even with this condition.