Polycystic ovarian syndrome (PCOS) and fertility
Polycystic ovary syndrome (PCOS) is very common – up to 1 in 10 women of child-bearing age have it. They may only find this out once they start trying for a baby. The combination of a hormonal imbalance and problems with metabolism can make this difficult – but not impossible. It’s one of the most common causes of infertility but also treatable.
Let’s talk you through the science of ovary function and what can be done about it in PCOS.
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How does PCOS affect fertility?
During normal ovulation, multiple eggs mature in the follicles inside your ovaries until the ripest egg is released into one of your fallopian tubes for a chance to be fertilized with any sperm present.
If you have PCOS, the follicles do not develop properly, so there is no release of a mature egg into the fallopian tube. Without the release of that egg, fertilization can't happen, and therefore your fertility can be affected.
Does PCOS mean I can’t have children?
Although many women find out they have PCOS when they have difficulty conceiving, having PCOS does not mean you cannot have children. This can happen spontaneously when eggs are released randomly, or it can happen with the help of medication or with assistance such as in vitro fertilization (IVF) or surgery.
It’s recommended for anyone trying to conceive that you aim to have sex 3 to 4 times per week, regardless of when you predict your ovulation date is. This is also because if you suffer from PCOS, you may have infrequent or irregular periods, so you are maximizing the chance of a sperm meeting an egg by having regular sex.
By the way, it’s recommended not to increase the frequency of sex around your estimated ovulation time, as this may reduce the quantity or quality of sperm.
What are my treatment options?
Although there is no cure for PCOS, lifestyle management is essential. Losing weight is one of the best ways to improve your symptoms. This can be done through regular exercise, a healthy, well-balanced diet, and smaller portions.
You may want to explore fertility treatment.
A fertility doctor may consider starting you on medication to stimulate ovulation called clomiphene (or brand name Clomid). If that doesn’t work, then IVF may be a good option. This is where your eggs are fertilized with your partner’s sperm outside the body and then placed back into your uterus to develop.
Surgery plays a small role in PCOS, where women undergo ovarian drilling. During this, small holes are made into the surface of the ovaries using a heated needle with electricity to restore ovulation temporarily.
How long will it take for me to get pregnant?
Most women can conceive naturally within 1 to 2 years of trying. Natural fertility usually declines around 32 years old, with a sharper drop around 37 years old. Women with PCOS often need longer to become pregnant and are more likely to need fertility assistance due to the irregularity of ovulation.
It is widely understood that if you are under 35 years and have tried to become pregnant for a year without success, you should speak to your doctor. For those over 35 years old, you should speak to your doctor after about 6 months of trying.
You should speak to your doctor if you have not had any periods for 3 to 4 months.
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