Polycystic ovarian syndrome (PCOS) is one of the most common causes of infertility in women, affecting an estimated 5 million females. But you can get pregnant with PCOS. There are a number of effective fertility treatments options available.
Most women will be able to conceive with a combination of lifestyle changes and fertility drugs. While some women with PCOS will need IVF. We at MotherToBe, best fertility centre in Hyderabad provide assistance and help in effective ways of conception.
There are several routes a woman can take when she wants to get pregnant with PCOS. Here are some of the options one can explore:
Diet and Regular Exercise
Eating a healthy diet is really important for women with PCOS. This is partially due to the higher risk of becoming overweight, and partially due to their bodies’ trouble with insulin regulation.
According to studies, a low-carbohydrate diet is the best one for PCOS. The most important consideration is to make sure your diet is rich in nutrient-rich foods and adequate protein and low on high sugar foods. Avoiding junk food and processed foods can go a long way.
A healthy lifestyle may help your fertility treatments work better, and it will certainly help you feel better overall.
Restart Ovulation by Losing Weight
Most women with PCOS face issues of obesity. This is because PCOS negatively affects how your body processes insulin, which can, in turn, cause weight gain.
One of the main reasons women with PCOS can’t conceive is they don’t ovulate regularly, or they don’t ovulate at all. Women with PCOS who are overweight are more likely to experience more severe anovulation (Anovulation is when the ovaries do not release an oocyte during a menstrual cycle. Therefore, ovulation does not take place.), going months between periods.
This process includes a minimally-invasive surgery to induce ovulation. This type of laparoscopic surgery is referred to as “ovarian drilling” and involves puncturing the ovary with a small needle that carries an electric current. This procedure destroys a small portion of the ovary. Although ovarian drilling can help lower male hormone levels and induce ovulation, the effects of the procedure may only last for a few months.
Metformin is a diabetes medication used to treat insulin resistance. It is sometimes prescribed to women with PCOS, even if they aren’t actually insulin resistant. This drug is relatively safe and may help women with PCOS achieve pregnancy.
According to the research, metformin may help :
- Manage weight
- Regulate menstrual cycles
- Improve the effectiveness of some fertility drugs
- Reduce the rate of miscarriage (recurrent miscarriages)
Clomid is the most commonly used fertility drug overall and also the most commonly used treatment for women with PCOS. Clomid helps many women with PCOS in effective conception.
Unfortunately, it’s not successful for everyone. Some women with PCOS will experience Clomid resistance. This is when Clomid does not trigger ovulation as expected. In such cases, a combination of metformin and Clomid may help beat Clomid resistance.
Gonadotropins for PCOS
If the above mentioned drugs are not successful, the next step is injectable fertility drugs or gonadotropins. Gonadotropins are made of the hormones FSH(Follicle-stimulating hormone), LH(Luteinizing hormone), or a combination of the two.
We at MotherToBe might suggest gonadotropins with an IUI (intrauterine insemination) procedure. IUI involves placing specially washed semen directly into the uterus via a catheter.
One of the possible risks of gonadotropins is ovarian hyper-stimulation syndrome (OHSS). This is when the ovaries overreact to the fertility medication. If untreated or severe, it can be dangerous. Women with PCOS are at a higher risk of developing OHSS. Hence, we use lower doses of the injectable fertility drugs to avoid this.
· IVF (In Vitro Fertilization) or IVM (In Vitro Maturation)
If gonadotropins are not successful, the next step is IVF or IVM:
- In- vitro Fertilization:
IVF involves using injectable fertility drugs to stimulate the ovaries to ensure production of effective number of mature eggs. The eggs are retrieved from the ovaries during a procedure known as an egg retrieval. Those eggs are then placed together with sperm into Petri dishes. If all goes well, the sperm will fertilize some of the eggs.
After the fertilized eggs have had between 3 to 5 days to divide and grow, one or two are transferred into the uterus. This procedure is known as an embryo transfer. Two weeks later, a pregnancy test is done to see if the cycle was a success or not.
As with gonadotropin treatment alone, one of the risks of IVF, especially in women with PCOS, is overstimulation of the ovaries. That’s where IVM comes in.
- In-vitro maturation:
IVM stands for in vitro maturation. Instead of high doses of fertility drugs to force your ovaries to mature many eggs, with IVM you receive either no fertility drugs or very low doses. The immature eggs are retrieved from the ovaries, and allowed to maturate in the lab. Hence the name in vitro (in lab) maturation (to mature).
Is an Egg Donor required?
It’s highly unusual for women with PCOS to require an egg donor, unless there are additional fertility issues at hand, like advanced age. However, women who have had ovarian procedures like ovarian drilling or ovarian wedge resection to treat their PCOS may have lower ovarian reserves. In this case, an egg donor may be recommended. This is one reason why surgical treatment for PCOS is not recommended.
If you do become pregnant with PCOS, you may wonder how the syndrome will affect your pregnancy. Having PCOS and getting pregnant does increase the risk of miscarriage, gestational diabetes, high blood pressure, or premature delivery. Still, in general, women with PCOS do experience healthy pregnancies.
If you have PCOS and getting pregnant is your ultimate goal, book an appointment with us at MotherToBe.