How to get pregnant with PCOS?
Polycystic ovary syndrome (PCOS) is one of the conditions which predisposes women of childbearing age to infertility. The hormonal imbalance associated with the condition (reduced insulin sensitivity, raised insulin secretion, reduced progesterone, and increased male sex hormone levels) leads to a reduction in the rate of egg maturation and ovulation and therefore, fertility.
More often, the formation of multiple fluid-filled cavities in the ovaries occurs in conjunction with these, which further contributes to infertility.
Regardless of these challenges to the reproductive cycle, many women would still be able to conceive. This is achievable through a combination of diet and lifestyle, medications, and medical intervention procedures.
How does PCOS cause infertility?
The hormonal imbalance in PCOS is the root cause of infertility as it results in the following:
There is the failure of ovulation either owing to genetic factors or otherwise.
This failure leads to a reduction in progesterone levels which is the pregnancy hormone and which controls the release of most other female sex hormones.
This loss of control leads to the abnormal excessive secretion of the male sex hormone
Excessive male sex hormone levels result in further reduction in the maturation of the egg and its ejection during ovulation.
Also, the male sex hormone reduces the body’s sensitivity to insulin, causing the body to release even more insulin in a bid to counter insulin insensitivity. This large amount of insulin has a positive effect on the increased secretion of the male sex hormone, worsening anovulation (absent ovulation).
Insulin insensitivity results in the excessive conversion of blood sugar to fat, causing obesity, which in turn, worsens insulin sensitivity.
All these happen in a pervasive vicious loop, causing infertility, including insulin resistance and obesity, both of which further reduces the chances of conception.
Considering the above, a woman of childbearing age with PCOS can improve her chances of conception by taking steps to counter these mechanisms through which the condition arises.
This will help the body to improve its sensitivity to insulin, thus reducing the amount of insulin in circulation and ultimately, its positive effect on the secretion of the male sex hormone. In fact, some studies have shown that shedding weight can help bring back menstruation and ovulation, although there is still a need to include other treatment modalities.
Weight loss can be achieved via dietary modifications and regular exercise such as running, walking, skipping, dancing, and swimming, among others.
Healthy dietary lifestyle:
Healthy eating goes a long way to control weight, more so in women who are trying to conceive with PCOS. This is because the diet is a major way not only to control weight but also to improve nutrients needed to enhance fertility.
A healthy diet would involve high protein, low carbohydrate meals such as eggs, fish, legumes, beans, high vegetable meals, fruits and healthy fat like fish oil.
This would help reduce and control insulin insensitivity and the resulting surge in blood sugar often seen in PCOS, ultimately downsizing the influence of insulin on the secretion of male sex hormones.
However, diet alone is not enough to restore fertility therefore, there is a need to incorporate other treatment modalities.
There are medications that can help women who have PCOS achieve fertility especially when combined with other treatment modalities such as weight loss, dieting, and exercise, among others.
Metformin: this is a glucose-lowering agent which helps to lower blood sugar by enhancing the body’s response to insulin. This will help to rid the body of excess blood sugar, reduce the level of circulating insulin and ultimately, its effect in the secretion of male sex hormones. This will have a positive effect on egg maturation and ovulation.
Clomid: this is a drug that can help the ovaries overcome the influence of abnormally raised androgen levels and eject matured eggs in ovulation. Although not all women are responsive to treatment with Clomid, most women with PCOS will conceive with this drug. Some studies suggest that a combination of metformin and Clomid improves the effect of both drugs.
Gonadotropins: Luteinizing hormone (LH) and follicle-stimulating hormones (FSH) are deranged in PCOS. There is a decrease in FSH and an excessive increase in LH. Supplementation of these hormones (such as Ovidrel and Bravelle) can help in the correction of some of these imbalances.
It should be noted that these drugs are to be prescribed by a doctor so you should consult your physician before taking any medication.
Medical Procedures for conception in PCOS
When medication is not enough, there are procedures that can help. The most notable ones are as follows:
Wedge resection: this involves the surgical removal of a small part of the uterine tissues. The aim is to remove some of the cells producing excess androgen.
Ovarian drilling: this involves making tiny holes in the ovary using a laser device. It is done to de-bulk the ovarian tissue and so reduce the amount of androgen secreted.
In vitro fertilization: this is the retrieval of eggs through the vagina after stimulating the ovaries to mature and release more eggs. The eggs are then fertilized with sperm cells outside the body, cultured and then transplanted into the womb.
Artificial insemination: the ovary is stimulated using Clomid or gonadotropins. Then sperm is injected into the womb to fertilize the eggs that are released.
One of the major problems associated with PCOS is infertility arising from hormonal imbalance and the formation of cysts in the ovaries.
For the women who have this kind of infertility, solutions can be found in methods - pharmaceutical and otherwise - which can reverse the mechanisms that lead to infertility.
These solutions can be found in weight loss via exercise and healthy eating, drugs such as Clomid, metformin and gonadotropins, and intervention procedures such as artificial insemination, in vitro fertilization, and wedge resection.