PCOS & Infertility: Understanding the treatment options
Polycystic ovarian syndrome, or PCOS, is a hormonal disorder and lifelong health condition affecting 5 to 10 million women and girls in the U.S.
Despite its name, not all women with PCOS have cystic ovaries, and not all women with ovarian cysts have PCOS. Instead, women with PCOS produce too many androgens, or “male” hormones, especially testosterone. Though the ovaries naturally produce both male and female hormones, PCOS causes an imbalance.
This hormonal imbalance can create a variety of different symptoms, and no two women with PCOS have exactly the same experience. The most common symptom, however, is abnormal ovulation, which leads to irregular menstrual cycles.
And of course, unpredictable cycles (or fewer cycles overall) can make it difficult to conceive naturally!
In fact, PCOS is a leading cause of infertility — and it’s the most common cause of abnormal ovulation and irregular cycles in women with infertility.
In addition to causing fertility issues, PCOS puts patients at a higher risk for certain health conditions, like diabetes, endometrial cancer, metabolic syndrome and sleep apnea.
When you’re ready to have a baby, treating PCOS begins with proactively managing your overall health, and then working on specific fertility issues.
As with many lifelong health conditions, your doctor may first recommend a few lifestyle changes. Fortunately, even small improvements to your health can increase your chances of successful infertility treatment.
For example, multiple studies have demonstrated the benefits of weight loss for PCOS patients who are overweight or obese, but a drastic drop isn’t necessary to see an improvement. Losing even just 5% of the initial weight has been associated with higher pregnancy rates in PCOS patients.
If you’re not already physically active, getting more exercise is a great start. Many women also see benefits from following a PCOS diet, which encourages veggies, whole grains, and lean protein, and limits refined carbohydrates, sugary drinks and snacks, processed foods, and red meat.
Once your overall health is optimized, it’s time to treat your infertility.
Oral medications to induce ovulation are often the first line of treatment. Because women with PCOS don’t ovulate regularly or as often, medications like Clomid or Femara may be effective on their own. Most pregnancies occur on lower dosages, within the first few ovulatory cycles.
A potential side effect of these medications includes a negative impact on cervical mucus production, which is helpful for conception. This can be overcome, however, with intrauterine insemination (IUI).
It's important to note that both Clomid and Femara increase the risk of a multiple birth. Even a twin pregnancy increases risk for mom and the babies.
In vitro fertilization (IVF) is also a good option. Women with PCOS tend to be excellent candidates for the treatment and have high success rates. A single IVF cycle can also produce multiple embryos which can be saved and frozen for future pregnancies. Transfer of just one embryo at a time minimizes the risk of multiples while still offering high chances for success!
Affordability is often a concern for patients who are interested in IVF. Fortunately, innovations in assisted reproductive technology have led to new, more accessible forms of IVF.
Our effortless IVF® treatment uses the revolutionary INVOCELL device to incubate the eggs and sperm, rather than an expensive lab. The result is a more natural and affordable form of IVF, with similar success rates. Women with PCOS are often excellent candidates for effortless IVF®.
Though PCOS can be an obstacle in your fertility journey, a diagnosis does not mean you won’t be able to have a baby. You may just need a targeted approach.
The first step to building your family is to meet and discuss your history with a fertility specialist. With all new patient consultations taking place virtually via telehealth, taking the first step has never been easier.