So you have been diagnosed with or suspect you may have polycystic ovarian syndrome (PCOS) and are left wondering… will it affect my ability to get pregnant?
The short answer to this question is that it can certainly have an impact on fertility, however there are ways to effectively treat it and help women to conceive and go on to have healthy pregnancies.
How exactly can PCOS affect my ability to conceive?
PCOS is a complex condition that impacts the process of ovulation by a number of mechanisms. Normally the brain sends out a series of hormones called GnRH, LH, and FSH that are responsible for telling our reproductive organs how to respond. FSH is responsible for stimulating the follicles (immature eggs) within the ovaries to grow and release estrogen. As estrogen levels rise LH will surge and trigger one mature egg to be released during the process of ovulation. At this point the follicle that once housed the egg will begin producing progesterone, an important hormone that helps to thicken the uterine lining and maintain a pregnancy should one occur.
In women with PCOS the pituitary gland releases more LH in relation to FSH. This creates a disconnect between the brain and the ovary and results in the formation of several follicles (often appearing as “cysts” on ultrasound) that fail to mature properly. Because of the mixed signaling, the “LH surge” never takes place because it is relatively high throughout the cycle. High levels of LH result in the formation of excess “male” hormones called androgens to be produced, which have an inhibitory effect on ovulation. Androgens are also made by another common mechanism in PCOS, wherein the body fails to respond appropriately to the effects of insulin. With these underlying imbalances, patients with PCOS may have trouble conceiving because they have irregular periods and don’t ovulate regularly. If ovulation doesn’t consistently take place the body’s production of progesterone will be low, which increases the risk of implantation failure and early miscarriage if conception happens to occur at a future time.
What can be done about it?
The good news is that although irregular periods and anovulation are common with PCOS, there are ways to effectively overcome it. Working with a doctor that understands the complexity of what underlies the condition is important because many of the symptoms can be minimized and even reversed with simple interventions.
Naturopathic therapies are aimed at regulating the hormonal imbalances and metabolic dysfunction that arises with PCOS to aid the body in the restoration of ovulation. Diet and lifestyle interventions can have a profound impact on fertility and should be a main part of every plan. A number of supplements can be used to help balance hormones and restore ovulation, including things like N-acetyl-cysteine, myo-inositol and black cohosh, however these should only be prescribed under the supervision of a naturopathic doctor who understands your unique case history to ensure they are appropriate for you. Having the proper blood work is essential in the treatment of PCOS, as it can present in several different ways depending on which hormones are affected. Acupuncture can be used as an adjunctive treatment to manage symptoms and improve fertility outcomes in those who are trying to conceive.
If you would like to get to the bottom of your PCOS before or while trying to get pregnant, click HERE to book a consultation with Dr. Geil.
Dr. Jessica Geil, ND