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Understanding PCOS and fertility: Keeping an eye on the dos and don’ts

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Globally, there are approximately 100 million women grappling with polycystic ovarian syndrome (PCOS). Its most prevalent symptoms encompass irregular menstrual cycles, abdominal weight gain, hirsutism characterised by excessive body hair, particularly on the stomach and chest, as well as frequent acne breakouts. In certain instances, individuals with PCOS may experience hair thinning and infertility. Diagnosis of PCOS entails a comprehensive medical history review, a general physical examination, and diagnostic procedures such as ultrasound scans to identify cysts, along with blood tests to assess androgen and hormone levels that can contribute to PCOS.

Treatment typically involves dietary modifications and an increase in physical activity. Gynaecologists may also prescribe oral contraceptives to regulate menstruation and diminish acne occurrences. PCOS arises due to heightened androgen production by ovarian cells, which subsequently exerts an influence on the pituitary gland. Hyperandrogenism is responsible for amenorrhoea, resulting in irregular or missed menstrual periods.

PCOS affects your chances of conceiving:

Irregular Ovulation: One of the primary mechanisms through which PCOS affects fertility is by inducing irregular ovulation or preventing it entirely. The absence of consistent egg release makes conception more challenging.

Hormonal imbalances: PCOS disrupts the balance of hormones in the body, particularly insulin and luteinizing hormone (LH). These imbalances can further hinder ovulation and affect the quality of eggs released.

Increased risk of miscarriage: Those with PCOS may face an increased likelihood of miscarriage due to hormonal imbalances and other factors linked to the condition.

The dos and don’ts for those trying to conceive while dealing with PCOS:

Do’s:

Seek advice from a fertility or gynaecological specialist: If you have PCOS and are attempting to become pregnant, it is crucial to consult with a healthcare professional, preferably a reproductive endocrinologist or fertility expert. They can offer customised advice and treatments designed to address your unique requirements.

Maintain a healthy lifestyle: Adopt a balanced diet and engage in regular physical activity to help manage weight and insulin levels. Maintaining a healthy weight can improve fertility in individuals with PCOS.

Monitor your cycle: Track your menstrual cycle and use ovulation prediction kits to help pinpoint when ovulation occurs. This information can assist in timing intercourse for optimal chances of conception.

Consider medications: Your healthcare provider may prescribe medications such as clomiphene citrate or letrozole to stimulate ovulation. These drugs can be effective in regulating the menstrual cycle and enhancing fertility.

Manage stress: Stress can exacerbate PCOS symptoms and impact fertility. Explore relaxation techniques such as yoga, meditation, or mindfulness to reduce stress levels.

Don’ts:

Delay Seeking Help: If you’ve been trying to conceive for an extended period without success, don’t wait too long before seeking professional assistance. Early intervention can increase your chances of a successful conception.

Overlook other factors: While PCOS is a significant factor in fertility issues, it’s crucial to consider other potential factors, such as your partner’s health and any additional underlying conditions. Comprehensive testing can identify any coexisting issues.

Self-medicate: Avoid self-prescribing fertility medications or herbal remedies without consulting a healthcare provider. These substances may interact with your PCOS or other medications and cause complications.

Neglect emotional support: Infertility can be emotionally challenging. Don’t underestimate the importance of seeking emotional support from friends, family, or support groups. Counselling or therapy can also be helpful in managing the emotional aspects of fertility struggles.

PCOS can certainly influence the likelihood of achieving pregnancy, but it’s not an insurmountable hurdle. With appropriate medical direction, lifestyle modifications, and following the recommendations provided in this article, numerous individuals grappling with PCOS can effectively achieve their goal of conceiving and creating the families they aspire to have. Keep in mind that every individual’s path is distinctive, and it’s vital to seek professional guidance and assistance to navigate the complexities of PCOS and infertility.

(The author, Dr. Lavi Sindhu, is a consultant at Birla Fertility & IVF, Gorakhpur.)

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