Can a Woman with Polycystic Ovarian Syndrome (PCOS) get Pregnant?
In a normal woman every month 4-5 small follicles are recruited in one ovary from the pool of eggs and one of the follicles becomes dominant follicle and releases an egg. In a woman with PCOS, her ovaries produce abnormally high levels of male hormone that prevents follicles from opening and releasing eggs – due to which the periods may become irregular or absent altogether. The follicles remain in the ovaries as cysts, making it increasingly difficult (but not impossible) to conceive.
How does PCOS affect a woman’s fertility?
The biggest challenge with PCOS is that it affects the normal hormonal pathways (the pathways that are involved in the production of eggs and making the uterus ready for pregnancy). For a woman with PCOS, getting pregnant or sustaining pregnancy is quite a bit challenging due to irregular periods, absence of ovulation, and the lack of preparedness of the endometrium to sustain a pregnancy. Now, let us understand how to improve the chances of pregnancy.
How to increase the chances of pregnancy when you have PCOS?
You don’t have to worry even if you have got PCOS as there are several ways including both natural and conventional by which you can make your hormonal pathways normal and increase your chances of getting pregnant soon. Your lifestyle and nutrition play an important role in augmenting your chances of becoming pregnant with PCOS. The approach that I recommend to you to ensure the possibilities of getting pregnant are the following, which are mostly your lifestyle-related factors.
Follow a low-glycemic-load diet
With my experience, I can say that Low-glycemic diet is essential to cope up with insulin resistance and imbalanced sex hormones and to increase fertility. The best way to do this is by limiting carbohydrate intake to 16 grams per meal and 7 grams per snack. Furthermore, if you are more active, you may require a slightly higher carbohydrate intake. Next, you can check your glycemic load by including fibre, proteins and healthy fats in your diet along with carbohydrates.
The other vital things that you can do include cutting down on starches, refined and highly processed sugars, white floor, white potatoes, white rice and high-fructose sugars and syrups (present in processed foods). If you do this successfully, then you will be able to reduce insulin resistance, decrease androgens, and regularize ovulation & menses.
By doing this lifestyle changes you are compensating the role of the drug that normally controls sugar levels in the blood.
Women who are obese and overweight with high waist-to-hip ratio are at increased risk of abnormal hormonal levels, insulin resistance and infertility because their condition is attributed to PCOS with high androgen, estrogen and insulin levels. This has been noticed in nearly about 40 to 60% of women with PCOS. Such women must focus more on losing weight because a mere 5% reduction in weight can make promising changes in their menstrual cycles and ovulation. Apart from a healthy exercise regimen, they can also focus on reducing carbohydrate load as mentioned above.
Don’t wait for anything start getting into the groove and indulge yourself in some form of physical activity to reduce insulin resistance and have a positive effect on your body and mind.
What is the treatment for PCOS-related infertility?
Metformin is a drug often prescribed to you if you have PCOS and are trying to get pregnant. It helps reduce high insulin levels and stabilize hormones. Thus, metformin, by lowering insulin resistance helps induce ovulation. There are some nutritional supplements like Vitamin D, A-Acetyle Cysteine, and Myoinositol that work like metformin and help lower insulin resistance. But you should never take such supplements without under any proper medical supervision.
Ovulation induction involves the use of medication to stimulate the development of one or more mature follicles (where eggs develop) in the ovaries of women who have ovulation problems and infertility. Ovulation induction can be done with Clomiphene and Injectable Gonadotrophins.
The bottom line is that we recommend a woman with PCOS to try several if not all of the lifestyle recommendation to augment her body’s fertility. We recommend this for at least 6 months, and then address the next measures once the cycle becomes more regular. If you are the one with PCOS and are unable to conceive, then meet your gynaecologist for the best PCOS treatment in Hyderabad and discuss your case – delaying consultation for no reason can make the condition worst, and, as the time passes, conceiving becomes more and more difficult.
Dr T. Rajeshwari Reddy
MBBS, MS (OBG), DES (Germany), FAMS (New Delhi), PGPMAX (ISB)
Consultant Obstetrician, Gynaecologist & Laparoscopic Surgeon
Department of Obstetrics and Gynaecology