PCOS Awareness Month 2023: Fertility Challenges For Individuals With PCOS

PCOS has undoubtedly become a major cause of female infertility, decreasing the odds of becoming pregnant naturally and experiencing the joy of motherhood.

Fertility Challenges For Individuals With PCOS

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In today's fast-paced world, where individuals often find themselves caught in a relentless rat race, lack of importance to health and well-being has become increasingly common. Polycystic ovarian syndrome is one such disorder which has strong genetic roots, yet is influenced by environment, lifestyle and endocrine factors.

In this regard, Dr Astha Dayal, who is the Lead Consultant, Obstetrics and Gynaecology at CK Birla Hospital, Gurugram said, "Polycystic ovary syndrome (PCOS) is a common condition that affects 5-10%  women of childbearing age. Women with PCOS have a hormonal imbalance (irregular periods), metabolic problems (insulin resistance causing diabetes, obesity, hypertension, high cholesterol) and changes in appearance( acne, facial hair)."

Talking about the diagnosis of PCOS, she said, "We generally diagnose  PCOS  if there are 2 out of these 3  features( Rotterdam PCOS diagnostic criteria)"

• Irregular menstrual periods caused by anovulation or irregular ovulation
• Evidence of elevated androgen levels. The evidence can be based upon signs (excess hair growth, acne, or male-pattern balding) or blood tests (high androgen levels)
• Polycystic ovaries on pelvic ultrasound.

Unfortunately, PCOS is not only a syndrome that causes hormonal imbalance and metabolic issues; it primarily affects the ovaries, causing fertility concerns in women. PCOS has undoubtedly become a major cause of female infertility, decreasing the odds of becoming pregnant naturally and experiencing the joy of motherhood.

Dr Astha Dayal said, "About 30% of women with PCOS have problems getting pregnant. This is because in PCOS, the hormonal imbalance, specifically elevated levels of androgens (male hormones) and insulin, disrupts the process of growth and release of eggs from the ovaries (ovulation). If women do not ovulate or ovulate infrequently, which means they have irregular or absent periods it is  difficult to get pregnant."

Fertility Challenges Faced By Women With PCOS:

Dr T Shilpa Reddy, who is a Consultant - Reproductive Medicine at Milann Hospital, Kumara Park listed the fertility challenges faced by women, who grapple with PCOS:

• Menstrual Disorders : Women with PCOS experience a spectrum of menstrual disorders ranging from irregular heavy periods to no periods at all. Such changes in the menstrual cycle can on the long term increase the chances of uterine cancer. With irregular cycles, determining the fertile window is unpredictable which in turn would place a lot of emotional burden on the couple trying to conceive .
• Anovulation: For women with PCOS, it is the anovulation that really speaks as the reason for infertility, which means the ovaries may not release eggs consistently or at all. Women with PCOS may find it extremely difficult to become pregnant naturally due to irregular or absent ovulation. Thus, fertility therapies, such as ovulation inducers, are frequently required to address this condition.
• Increased Miscarriage Risk: Women with PCOS are also more likely to miscarry, especially in the early stages of pregnancy. There is also a higher incidence of gestational diabetes mellitus ,hypertension and preterm birth. Hormonal imbalances and other PCOS-related variables are thought to contribute to this increased risk. As a result, seeking early prenatal care and monitoring can help reduce this risk and increase the likelihood of a successful pregnancy.
• Obesity: Managing reproductive issues caused by PCOS necessitates cautious weight management. Many PCOS patients gain weight or have difficulty shedding it. This is where obesity aggravates PCOS symptoms and can lead to insulin resistance, which further lowers fertility. As a result, maintaining a healthy weight through diet and exercise is generally recommended to boost your chances of becoming pregnant. It is infact noted that even 5 %of weight loss would help restore ovulation and menstrual regularity 

Lifestyle Changes That Have A Positive Impact On Fertility:

In this regard, Dr. Bhavna Banga, who is a Clinical Director, Reproductive Medicine & IVF, at Cloudnine Group of hospitals, Noida & Kailash Colony said, "The target oriented lifestyles with lack of attention nutritive meals is a perfect recipe for suboptimal reproductive health. The current lifestyles of prolonged traveling hours, sedentary work culture, excessive use of mobiles & laptops, preference of fast food, alcohol, smoking & addictions, discordant work hours between couples has put a huge strain on reproductive health."

Dr Astha Dayal said, "Adopting a healthy lifestyle not only has a positive impact on fertility, but also improves overall health. It significantly decreases pregnancy risks associated with PCOS, like miscarriage and gestational diabetes, pre eclampsia, preterm birth, large for age baby, and also reduces the long-term risk of type 2 diabetes, high blood pressure and heart disease."

Dr Astha also went on to list the lifestyle changes required:

• Maintaining a healthy low carbohydrate diet rich in whole grains, fruits, vegetables, lean proteins and healthy fats
• Regular exercise, such as brisk walking and swimming, can help manage weight, reduce insulin resistance and regulate hormone levels. Aim for 30 minutes of moderate exercise three to five times a week.
• Manage stress levels through relaxation techniques like yoga or meditation which can aid in fertility.
• Maintaining a healthy weight is vital.Even losing 5% to 10% of your body weight has been shown to help in restoring a normal ovulation cycle and improve the chances of pregnancy. Reaching a healthy weight before you get pregnant will reduce pregnancy complications too.

In addition to this, Dr Priyanka Suhag, who is a Consultant, Dept of Obstetrics & Gynaecology at the CK Birla Hospital (R), Delhi said, "Balancing blood sugar through a low-glycemic diet and engaging in regular physical activity can enhance hormonal regulation and increase the chances of successful conception. In more complicated situations, it may also be required to monitor menstrual cycles and hormone levels and consider assisted reproductive treatments such as in vitro fertilization (IVF)."

"Throughout this process, emotional support is important. PCOS-related fertility issues can be emotionally exhausting, so seeking counselling or joining support groups will give the right direction and inspiration that a person needs. Remember that each person with PCOS experiences the condition differently, and many can overcome their fertility issues and fulfill their ambition of having children with the help of the appropriate techniques and support," she added.

Reproductive challenges associated with PCOS can be daunting , yet they aren't impossible to overcome. In fact, there is no cure for PCOS, but treatment can certainly improve the disease status and lead to a healthy pregnancy. With accurate medical guidance from fertility experts, and lifestyle adjustments, women with PCOS can indeed fulfill their once-in-a-lifetime moment of starting a family and can surely experience the joy of parenthood. Thus, always remember that when it comes to PCOS and fertility, an ounce of prevention is truly worth a pound of cure.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]