What to Know About PCOS and Fertility

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Understanding polycystic ovary syndrome can help you build a better strategy for getting pregnant.

Approximately 5 million women deal with PCOS, making it one of the most common hormonal endocrine disorders among individuals of reproductive age. Read on for more information on what it is, how it affects pregnancy, and what you can do to improve your odds of having a baby.

What is PCOS?

PCOS is a hormonal imbalance that affects women of childbearing years. This condition causes the ovaries to produce an excess of male sex hormones called androgens, which are usually present in women in small amounts.

Often, the ovaries develop numerous small fluid-filled sacs (also referred to as follicles or cysts), and fail to routinely release eggs during a menstrual cycle.

When a woman doesn’t make enough of the necessary hormones required for ovulation, her ovaries can develop additional small cysts. These cysts produce more androgens and cause symptoms of PCOS, including irregular periods.

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While there’s evidence that genetics and environmental factors play a part, there’s no exact cause of PCOS. You might be more likely to develop the condition if your sister or mother also has it.

How can a woman know if she has PCOS?

Polycystic ovarian syndrome has many symptoms. It’s common for women to only exhibit a few of them, leading to a later diagnosis from their health care provider.

According to John Hopkins Medicine, the typical signs of PCOS include:

  • Infertility
  • Missed periods, irregular periods, or very light periods
  • Larger ovaries or ovaries containing many cysts
  • Excessive hair growth on the chest, stomach and back
  • Weight gain, especially in the abdominal area
  • Oily skin and acne
  • Baldness or thinning hair
  • Skin tags
  • Dark or thick skin patches on the back of the neck, in the armpit area or underneath the breasts

If you’re experience a few or more of these symptoms, bring it up with your doctor to start a conversation about your concerns. In addition to a physical exam, she may also recommend an ultrasound or a blood test for further diagnosis.

How does PCOS affect pregnancy?

Because ovarian cysts interfere with ovulation, you can have trouble getting pregnant naturally. The good news is you might be able to increase your chances of conception with the guidance of a specialist and the use of fertility treatments.

Women of reproductive age who have PCOS are at higher risk of early pregnancy loss. According to a study by the Journal of Clinical Endocrinology and Metabolism, the medication metformin (typically used to treat type 2 diabetes) may help to reduce the chance of miscarriage in pregnant women.

In addition, PCOS is related to an increased risk of the following pregnancy complications:

Gestational Diabetes

This type of diabetes only affects pregnant women and generally clears up after delivery when treated properly. Babies whose mothers have gestational diabetes can be quite large for their gestational age, have lower blood sugar levels, and trouble breathing. Mom’s chances of a cesarean birth are also increased due to baby’s size.

Preeclampsia

Characterized by high blood pressure that pops up in the second half of pregnancy (after the 20-week mark), preeclampsia can cause damage to organ systems in mom’s body, most often the liver and kidneys, as well as the brain. When left untreated, preeclampsia can become life-threatening, leading to seizures and even death.

Preterm Birth

Newborns are considered preterm if delivered before 37 weeks of pregnancy. These preemies can suffer lifelong effects, such as poor health and growth, visual and hearing impairments, learning disabilities and more.

What should I do if I’m trying to conceive?

The Centers for Disease Control (CDC) states that up to 12 percent of women in the U.S. experience difficulty getting pregnant because of untreated PCOS. Because women often do not know they have this condition or have not been properly diagnosed, this number may be larger in reality.

If it’s been determined by a professional, or if you think you may have PCOS and want to have a baby, talk with your doctor about planning for a healthy pregnancy and delivery.

Starting at a healthy weight before conception is important for any mother-to-be, but it’s especially critical for women with PCOS, as obesity can increase your chance of experiencing severe pregnancy complications.

Have your weight and body mass index (BMI) measured by your provider to know whether or not you are at a healthy weight and how much of your body composition is fat. This will determine if weight loss is recommended before moving forward; a healthy lifestyle can lead to more positive pregnancy outcomes for mom and baby.

Using an ovulation calendar, at-home tests or tracking app will help you better monitor your cycles and identify the best days of the month to try and conceive.

In addition, balancing your blood sugar levels is recommended for problems with fertility. This is because PCOS can change how your body uses insulin, an important hormone that transports glucose (sugar) in the body for optimal production. Through a mindful diet, exercise, and sometimes medication, your blood sugar levels can improve.

If you decide to work with a fertility specialist, she may also recommend medications (such as Clomid, metformin or birth control for hormone balancing) in addition reproductive technology (IVF) to help you get pregnant.

Will PCOS affect breastfeeding later on?

According to the PCOS Awareness Association, it is safe to breastfeed your newborn even if you’re on insulin medication. What’s more, if mom was diagnosed with gestational diabetes during pregnancy, nursing lowers her risk of developing type 2 diabetes down the road.

While PCOS usually clears up post-delivery, it’s a good idea to continue managing symptoms, as breastfeeding can change hormonal fluctuations in the body, and thus, interfere with symptoms a mom may experience before finding her new normal as a brand-new mama.

Lauren Lisle

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