PCOS and Pregnancy
Getting a positive diagnosis for polycystic ovarian syndrome is a dreaded event for many women of childbearing age, as it is becoming more widely known that PCOS and pregnancy don’t go well together.
The effects of having this metabolic disorder conspire to make conception difficult, leading to many sufferers of this syndrome to fear that it has rendered them infertile. While the biological mechanisms of this disease makes it beguilingly difficult for an egg to be produced, then attach to the uterus without being wiped out by unruly hormones at a later date, there are treatments that have been or are being developed that are making PCOS and pregnancy into things that aren’t mutually exclusive.
In this article, you will learn why it is hard for PCOS patients to conceive, as well as the mechanisms behind the various treatments that have made a seemingly impossible dream come true for many women.
How PCOS inhibits pregnancies in women
For most females, the occurrence of the monthly cycle of egg creation, ovulation and menstruation is a rhythm that is so ingrained in their routine that after puberty, most give little thought towards it. For those that suffer from PCOS though, the monthly release of an egg and the subsequent menstrual fluid after no fertilization has taken place is anything but predictable.
In a PCOS patient, the scarred ovaries that she possesses often fail to release an egg, making it impossible for sperm to fertilize. When they do manage to release an egg, it is often done so earlier than usual, resulting in it being immature (1). Hormonal imbalances due to the effects of PCOS also wreak havoc on the fetus in the early days of conception, making the odds of a miscarriage much higher for PCOS women than those without it (2).
Due to the scattershot nature of attempting to conceive when one has PCOS (as well as the higher risk of a miscarriage when one manages to occur), seeking out a supervised treatment protocol via a fertility specialist and your doctor is highly advised.
Is it possible to have a baby successfully if I have PCOS?
While it may be a less than ideal situation for those seeking to start a family, there are ways to get pregnant with PCOS. With the help of your doctor and allied medical professionals in the field of reproductive medicine, more and more women afflicted with PCOS are making their dream of having children come true everyday.
Present day fertility treatments for women that suffer from polycystic ovarian syndrome have a high rate of success, giving the present generation of women of childbearing age more hope than ever before (3).
In fact, with the variety of different medical procedures and treatments that are available, the vast majority of women under the age of 35 will experience success in their endeavor to get pregnant. provided they find the protocol that works best for them.
While we don’t guarantee that every PCOS sufferer will meet with success pursuing the popular treatment protocols that lie below, they have had a long track record of enabling women that they treat to finally start that family that they had always dreamed of having, so check them out and find the one makes the most sense for you.
What are my options for a fertility intervention if I have PCOS?
There are upwards of five protocols available (four involving drugs, and one involving manual intervention) for those afflicted with PCOS-related infertility, and all involve the induction of ovulation. Since the mechanics of this metabolic disorder either actively suppress the release of an egg, or it triggers its release well before it is mature, you will need to pursue methodologies that induce the follicles to release their payload on time.
The medications listed below help follicles to develop fully mature eggs where lifestyle choices and other non-medical treatments have failed to allow the ovaries to function in the manner that nature intended.
There are four types of medication that are used to attain the desired effect of those seeking treatment. They are…
4) Injectable gonadotropins
Let’s go over each of these treatments for PCOS and pregnancy in detail below…
The overproduction of estrogen plays a central role in the suppression of hormones that are required to stimulate the follicles to produce eggs, as counter-intuitive as it may seem (4). Letrozole tapers the production of this hormone while simultaneously boosting the amount of FSH (follicle stimulating hormone) in the subject’s system. This stops antagonistic forces from preventing the follicle from doing its job, while aiding that same structure to fulfill its destiny.
While Letrozole is as effective as Clomid with regards to inducing ovulation, it is still not clear whether it offers superior rates of successful conception and birth rates.
Another option for women juggling the topics of PCOS and pregnancy is Clomid, which is also known as Clomiphene. This drug, which is the favorite of many fertility doctors presently, indirectly causes eggs to mature and be released into the fallopian tubes of women receiving treatment (5). It works in much the same way as Letrozole and is just as effective, it also occasionally has the unintended effect of going overboard on the fertility front, as 1 in 10 women who use Clomid end up having at least twins or triplets (6).
Normally a drug used to treat diabetics, Metformin is increasing being used to help PCOS afflicted women conceive. Since it helps bring insulin levels under control by resensitizing the circulating hormones, there ends up being less of it floating around the system of those being treated with this drug.
This means the amount of insulin available to stimulate testosterone falls significantly, thereby reducing the damage done by the latter compound to the follicles. They can then go on to their job normally without inhibition, leading to an increased success rate for pregnancies in PCOS women (7).
Some fertility doctors may elect to go with injections of compounds called Gonadotropins. Packed with a high dosage of FSH, the effectiveness of this treatment is on the high side, but it does come with a hefty price tag, as some patients may require $400 worth of these hormones everyday for as long as two weeks.
Additionally, this potent follicle stimulator poses a high risk of multiple fertilization, so if you go this route, be sure you can bear the costs of the shots, and the legacy expenses of raising two or more children at the same time (8).
None of these drugs are working … am I barren for life?
If these treatments fail to work, don’t lose hope just yet. You have one more tool at your disposal, and while it is expensive and not always covered by insurance, it has a very high track record of success. With in vitro fertilization, your partner’s sperm and one of the eggs from your ovaries are placed in a petri dish, allowing conception to occur there. The fertilized egg is then placed back into your uterus, where the rest of the pregnancy plays out as per the usual (9).