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PCOS and fertility: Are they related?

If you’ve been diagnosed with Polycystic Ovary Syndrome (PCOS) or suspect you have it, you’re not alone. PCOS, which refers to a hormonal imbalance that causes cysts in the ovaries, affects one in 10 women. It is the most common hormone-related problem experienced by women of reproductive age. Many women wonder if there’s a negative relationship between PCOS and fertility, but it’s rarely that simple. Here is some information about the condition and how it may or may not affect your ability to conceive.

The symptoms of PCOS

The most visible symptoms of PCOS that women typically can self-identify include irregular or absent periods, which are caused by non-ovulation. Other indicators are an outburst acne, excessive facial hair growth and balding, which are all caused by high levels of male hormones.

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If you suffer from the above, you should ask your gynecologist for tests. An ultrasound can reveal fluid-filled sacs called cysts in the ovaries, another indicator of PCOS. The ovaries are often larger than normal. Frequently, with cases of obesity, women with PCOS also test as insulin resistant.

What causes PCOS?

Nobody knows exactly what causes PCOS, but scientists think it may be linked to a gene that stimulates the body to produce high levels of luteinizing hormones and insulin. These in turn cause the ovaries to overproduce male hormones, especially testosterone, causing an imbalance in the body that disrupts ovulation.

In a regular reproductive system, about 20 follicles in an ovary mature every month, with one follicle eventually becoming the dominant follicle which delivers an egg. The other follicles are then reabsorbed into the ovary. However, with PCOS, these immature follicles do not get reabsorbed, but stay in the ovaries. They do not produce eggs. When there are more and more of such inactive follicles, infertility problems can occur.

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Does PCOS always hurt your fertility?

While PCOS is a leading cause of infertility, not all women with PCOS experience difficulty with conceiving. If you have regular periods or irregular periods that aren’t too infrequent, you may not have problems getting pregnant at all.

Women who ovulate infrequently or not at all will suffer the most from infertility. Women who are insulin-resistance and obese will also experience more difficulty with conceiving. Unfortunately, this group of women also experience higher rates of miscarriages and more complications during pregnancy.

How is PCOS treated?

PCOS cannot be cured; it can only be treated for its symptoms. There are treatments that focus on different areas like hirsutism, insulin levels and so on. In the case of infertility, the focus is on inducing the body to ovulate. For some women, changing the diet and losing weight is enough to restore ovulation. For others, they are able to get pregnant after a course of medications.

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Women who don’t respond to treatment shouldn’t lose hope though. It is still possible to conceive with the help of reproductive technology. They can receive follicle-stimulating hormone injections to stimulate the ovaries to produce eggs, then proceed to In Vitro Fertilisation (IVF).  Many women conceive this way, and as medical science advances, success rates should go up.

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