For most women, getting pregnant is not a major problem. For those with PCOS, it can be challenging. Polycystic ovary syndrome (PCOS) is caused by an imbalance of sex hormones, specifically, progesterone, estrogen, luteinizing hormone (LH), and follicle-stimulating hormone (FSH).
If you have PCOS, there’re no mature eggs to be released for fertilization. An increase in insulin levels is also observed. High levels of insulin can influence the ovaries into producing more androgens or male hormones such as androstenedione and testosterone. Hirsutism may occur due to high levels of androgens. It is characterized by excessive hair growth on the body and face.
Is It Possible to Get Pregnant with PCOS?
In most women who have normal menstrual cycles the ovaries are stimulated by the FSH and LH secreted from the pituitary gland. When there is a surge of LH, it signals the ovaries to start the process of ovulation and release mature egg cell. This happens during the middle of the menstrual cycle. If an egg cell is not fertilized, menstruation begins.
In women with PCOS, regular ovulation does not occur due to high levels of LH present at the beginning of the menstrual cycle. Since the LH levels are already high, ovulation does not take place. Without ovulation, fertility problems and irregular periods may occur.
Nonetheless, you can get pregnant even if you have PCOS. Though it can be harder than normal women, it is quite possible with the following measures taken.
Getting pregnant with PCOS: What to Do
Maintain a Healthy Lifestyle
Weight Loss and Weight Management
High insulin levels are common in women with PCOS. This can affect your weight. As observed, most women with PCOS are carrying more weight. Being overweight can lead to an imbalance in your sex hormones. Thus, getting a healthy and ideal body mass index (BMI) is the first step in increasing your fertility.
Dietary Changes
To achieve an ideal weight, you have to watch what you eat. Insulin resistance can be managed through dietary changes. Having a low-carbohydrate diet is recommended for those with PCOS to reduce insulin levels. If you’re going to eat carbohydrates, opt for foods that have a low glycemic index. Eliminating refined and highly processed carbohydrates from your diet will help lower your insulin levels, reduce androgens, and regulate your menstrual cycle or ovulation.
Regular Exercises
Regular exercise is always a part of any weight loss regimen. However, that is not the only reason why exercise is recommended for women with PCOS.
Exercises, specifically strength training, can increase insulin sensitivity. It can also help regulate stress hormones such as cortisol and adrenaline. Some experts believe that cortisol has a role in hormone imbalance. Thus, the endorphin-boosting and cortisol-reducing effects of exercising are very helpful in managing PCOS.
Reduce Stress
Stress can disrupt the menstrual cycle. Most women with PCOS are also prone to depression and anxiety. To fight these problems, doing activities that induce relaxation is beneficial. As much as possible, try to live a stress-free life and do things that make you feel happy.
Detoxification
Did you know that getting pregnant with PCOS is more difficult if your body is constantly exposed to toxic compounds? Toxins can affect the body in a negative way. For women with PCOS, these harmful compounds can affect ovulation and the levels of progesterone and estrogen in their body. One study has noted that ovarian diseases are more prevalent in those females with high levels of toxins such as pesticides and bisphenol A (BPA). Thus, internal cleansing or detoxification may help manage PCOS. One way to detoxify your body is to eat cleansing foods such as cruciferous vegetables.
Say No to the Three Killers of Fertility
Smoking is hazardous to the health. It can also affect fertility. According to various studies, if you smoke one pack of cigarette a day or you started smoking before 18 years old, your fertility rate decreases.
Caffeine can also affect fertility. Excessive drinking of coffee and other caffeinated products can aggravate infertility. It is recommended to drink only 2 cups of caffeine or less per day.
Alcohol is another killer of fertility. There is no specific amount of a safe level of alcohol consumption. Thus, it is best to give up any beverages with alcohol if you are trying to get pregnant with PCOS.
Herbs and Other Supplements
Taking multivitamins can help manage PCOS. The important vitamins are vitamin C, D, E, and B vitamins such as niacin (B3), folic acid (B9), and pyridoxine (B6). Minerals such as magnesium, manganese, and chromium are essential.
Omega-3 supplements can help counteract the systemic inflammation associated with insulin resistance.
Natural products such as chasteberry, milk thistle, raspberry, ashwagandha, and maca can also help regulate hormones.
Medications
Birth Control Pills
This may seem counterproductive. However, taking birth control pills can increase your chance of getting pregnant because it can help regulate your menstrual cycle and hormones. These drugs can also help reduce excessive hair growth and acne problems, which are common in patients with PCOS.
Fertility Drugs
Another option for getting pregnant with PCOS is to take fertility drugs. The most commonly prescribed drug to induce ovulation is clomiphene (Clomid®). It induces ovulation by helping egg cells reach maturity and get released from the ovary.
Drugs such as letrozole (Femara®) and gonadotropins are also prescribed. Letrozole can slow down the production of estrogen and helps in the production of follicle-stimulating hormone (FSH), a hormone essential for ovulation. Gonadotropins are hormones administered through injections.
Anti-androgen Drugs
Anti-androgen drugs do not regulate your hormones. They are also not approved by the FDA for the treatment of PCOS. However, they are prescribed to lower your body’s androgen levels, which may cause excessive hair growth in the body and acne. Although spironolactone is an anti-hypertensive drug, it is commonly prescribed since it also has anti-androgenic properties.
Metformin
Metformin is typically prescribed to patients with type-2 diabetes. However, since a common symptom of PCOS is high insulin levels, metformin can also be used. Furthermore, this drug has anti-androgenic properties. As an observation, taking metformin for a few months can restart ovulation.
Typically, doctors prescribe a combination of metformin and clomiphene to increase fertility in women with PCOS.
In vitro Fertilization (IVF)
If both medications and lifestyle changes are ineffective, in vitro fertilization is another option you can consider. In this method, the doctor takes your egg cell and your partner’s sperm cell. He places them in a petri dish for fertilization. The fertilized egg is then injected into your uterus to grow and develop.
IVF treatments have a higher rate of success compared to medications and lifestyle changes. Your doctor may also be able to control your chance of conceiving twins or triplets through this process.
Surgery
Ovarian drilling is another option if both medications and lifestyle changes are ineffective. In this surgical procedure, the surgeon makes a small laceration in your abdomen and inserts a laparoscope. Next, the surgeon punctures the ovary using electrosurgical needles. This restores ovulation by lowering the body’s androgen levels. However, ovulation lasts only for about 6 to 8 months.
Compared to IVF, this surgical procedure is less expensive. You also have a lower risk of conceiving twins or triplets. However, it can lead to scarring in the ovaries
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