How Does My PCOS Affect IVF?

While Polycystic Ovarian Syndrome (PCOS) often produces difficulty with getting pregnant naturally, there are much higher chances of pregnancy in women who suffer from PCOS than from any other diagnosis of infertility. Many women whose infertility is caused by their PCOS often pose as the best type of patient for IVF treatments. PCOS is most common in women that are considered part of the reproductive age group, and only in about 5-10% of the population.

This condition is known for it’s characteristics of abnormal ovary function that is displayed through abnormal menstruation, increased body hair or acne, and increased body mass index. Irregular menstruation is characterized by inconsistent periods, absent periods, and irregular or non-existent ovulations. Women with PCOS often have a history of diabetes in their family or have insulin resistance. While more research needs to be conducted to understand further how this is causing the cysts, it is the abnormal blood profile that contributes to a development of obesity ultimately resulting in cyst production.

Often the cause of irregular menstruations is the symptom of the multiple cysts which also increases the woman’s risks of developing uterine, ovarian and breast cancer later in life. Women who are diagnosed with PCOS should be seen by a doctor for evaluations more frequently than women without PCOS.

How does PCOS cause infertility?

The main disruption that PCOS causes for women is that either ovulation does not happen at all, or ovulation is extremely irregular posing difficulties for conception and fertility.  Although the main reason why many women with PCOS have difficulty conceiving is the irregularity of ovulation, there is a second reason.  Irregular ovulation can mean both nonexistent or over production of eggs in an ovulation. The result or symptom of a missed or over productive ovulation is irregular or missed menstruation. In addition to the often-higher egg production, there is a denigration of the egg quality through over exposure to higher levels of testosterone from cysts, that have been produced by the ovarian stroma.  Both the irregularities of ovulation tied directly to the irregularity of menstruation, along with the over productive and lower quality of egg, cause higher rates of infertility and higher rates of miscarriages in women with PCOS.

Fertility Drugs and PCOS

In the cases of PCOS and fertility drugs, there needs to be a high attention to these cases where a patient with PCOS is offered Fertility Drugs.  These fertility drugs often increase the number of ovarian follicles, also increasing estrogen levels.  This type of increase of follicles and estrogen is referred to as OHSS Ovarian Hyperstimulation Syndrome. With introduction of fertility drugs with PCOS can most often lead to a 40% increase chance of conceiving multiples, and the 10-20% of even greater numbers of multiples like triplets and quadruplets. These multiple birth rates can be devastating and pose a very real-life threat to both mother and embryos.

The different types of PCOS

  1. The first and most common type of PCOS is the Hypothalamic-pituitary PCOS. This type of PCOS is transferred through a woman’s genetic makeup and is usually characterized by a woman’s high Luteinizing Hormone (LH) levels.  LH level is generally at a much higher count than the Follicle Stimulating Hormone (FSH) in a woman with this type of PCOS. Generally speaking a typical FSH level will be higher than the LH levels, these measurements are taken by a specialist and through a blood sample.  Often this type of PCOS is associated with a higher male hormone concentration, and often associated with insulin resistance.
  2. The second most common type of PCOS is Adrenal. The Adrenal glands are located above the kidneys and produce hormones that regulate metabolism, immune system, blood pressure, and other stressors involving hormones in the body. In the case of Adrenal PCOS, a male hormone is overactive rather than a female hormone. In many cases the reason an Adrenal imbalance of male hormones has occurred is because of long term stress. Many specialists have often referred to this type of PCOS as the “fight or flight” body response where the stress hormone has ultimately produced so much cortisol that the body starts to prioritize resources elsewhere besides the reproductive area.
  3. The third type of PCOS is the occurrence of an extreme Pelvic Adhesive Disease, in this type of patient there is more than one ovarian cyst that has been engorged for a long period of time, resulting in size and shape permanence of the cysts. This type of PCOS is common with severe diagnoses of endometriosis, any form of extensive surgery in the pelvic region, and chronic pelvic inflammatory disease. The main distinction about this type of PCOS is that women categorized with pelvic adhesive disease do not respond to fertility drugs with overactive or hyperstimulation but instead are considered to be “poor” responders to the drugs.

The good news about IVF and PCOS

The reason that many PCOS patients find success with IVF is that the main problem with conceiving naturally is eliminated in the process of IVF.  Instead of relying on the ovulation of the woman, IVF relies on the intrauterine insemination which ultimately has a higher success rate in women who have PCOS than in other matriculations of infertility. Although having PCOS may prevent natural conception in many ways it is the ideal patient for IVF and IVI treatments, as the treatment corrects the one prevention that PCOS poses. These cysts are often only preventing release of an egg and not necessarily preventing fertilization or pregnancy, thus if your doctor has diagnosed you with PCOS, IVF may be a viable option with hopefully success numbers.

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How to get pregnant with PCOS

Many women with PCOS will find comfort in the fact that their infertility was caused by the diagnosis of their PCOS. This is actually a very common diagnosis often found in 1 out of 10 women with irregular periods. There are a variety of strategies a woman can take if a diagnosis of PCOS has been confirmed by your doctor after becoming suspicious of your irregular periods.  Many women panic when signs of irregular periods occur although there are many tips and tricks that might help ease the symptoms of PCOS before steps to IVF and other fertility treatments are considered.

  1. Reduce stress: regardless of your specific PCOS diagnosis, stress doesn’t help even the most fertile woman get pregnant. Lowering your stress levels can help to control PCOS symptoms and redirect your hormone production.
  2. Counseling: Not only is counseling good for your relationship during your fertility journey, but counseling can help you discuss all of your options with your partner. In many cases counseling proves to be helpful in the reduction of stress, especially with the volatility of emotions around conception.
  3. Reducing your weight: weight can help minimize cyst size and ovary size. By keeping your weight down, you can maximize the potential for natural conception through reducing your insulin and androgen levels.
  4. Follow a low carbohydrate diet: PCOS patients are prone to gaining weight quickly, so an analysis with a nutritionist could be a very important key piece to naturally conceiving. Choosing to eat a lean meat, plant based, lowering intake of sugars and carbohydrates, can serve as a great basis for losing weight and gaining overall health for potential pregnancies.
  5. Exercise is vital: 30 minutes of physical activity everyday will help lower insulin resistance, in addition to your healthy diet. Making sure you are able to move through walking, light weight lifting, light physical movement everyday will help improve your achievement of pregnancy.
  6. Reflexology: While many people have their opinions about Eastern Medicine, reflexology is being studied in Western Medicine now as having some benefits to reproduction. This is a steroid free, relatively affordable, and safe, while some may say there is a placebo effect, others have seen great results and benefits from the use of reflexology.
  7. Surgery: PCOS patients have seen much success from the procedure of laparoscopic surgery on the ovaries where the cysts have formed. This type of surgery can destroy the testosterone producing ovaries that are preventing pregnancy from occurring. Before this surgery is recommended, a doctor will check to make sure that both ovulation, menstruation and egg quality are at proper levels, otherwise a surgery like this would remain useless.  Ensure that you’ve checked the other elements of fertility before agreeing to a surgery like this.

For many women diagnosed with PCOS, the initial diagnosis does not sound ideal, although you may come to find that it is considerably manageable as far as reasons for infertility goes.  Women often find that either taking the steps to lose weight, manage stress, etc, or the IVF route is relatively successful and, in some cases, makes them an ideal candidate for IVF.