If you or someone you know has been diagnosed with PCOS (polycystic ovary syndrome), one of the first questions that may spring to mind is: can PCOS affect fertility? Here, Dr Roland Chieng, Specialist Gynaecology and Medical Director at Virtus Fertility Centre Singapore, walks us through everything we need to know about PCOS and pregnancy. Plus, how to recognise symptoms such as hormonal imbalance.
What is polycystic ovary syndrome – how do I know I have it, and when should I see a doctor?
Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting many women of reproductive age. It can be challenging to diagnose, but there are key signs to watch for. Knowing when to seek medical advice is crucial for managing the condition effectively.
Symptoms of PCOS
- Irregular Periods: One of the most common signs of PCOS is irregular periods caused by hormonal imbalance. This can mean having fewer than nine periods a year, periods more than 35 days apart, abnormally heavy periods, or no period at all.
- Hair and Skin Changes: Elevated levels of male hormones (androgens) can cause unwanted hair growth (hirsutism), thinning hair, or hair loss similar to male-pattern baldness. Other visible signs include darkening of the skin on the neck or under the breasts, and severe acne.
When to see a doctor
If you suspect you might have PCOS or you have difficulty getting pregnant after a year of trying, consult a healthcare professional early. That’s because PCOS is a leading cause of infertility due to ovulatory dysfunction.
The diagnosis is made through a pelvic exam, blood tests to measure hormone levels, and an ultrasound to examine the ovaries. Then, management strategies, lifestyle changes and necessary medications are discussed.
Early diagnosis and treatment of PCOS can help manage symptoms and reduce the risk of long-term complications such as type 2 diabetes, heart disease and endometrial cancer. Depending on factors like age and weight, annual blood pressure checks and diabetes screening are recommended.
How does PCOS affect fertility and the chances of pregnancy?
PCOS does significantly impact fertility. One of the primary ways it does this is through what’s known as anovulation. This is where the ovaries do not release an egg during the menstrual cycle due to elevated levels of androgens (male hormones) and insulin resistance, which disrupt the normal hormonal signals that regulate ovulation. As a result, women with PCOS often experience irregular or absent menstrual cycles. This makes it difficult to predict ovulation and time intercourse for conception.
Additionally, insulin resistance, a common feature of PCOS, can exacerbate hormonal imbalances and contribute to weight gain. Excess weight further complicates ovulation and can lead to other health issues, such as type two diabetes during pregnancy (gestational diabetes) and cardiovascular disease, which also impact fertility.
Despite these challenges, many women with PCOS can achieve pregnancy with appropriate treatment. Lifestyle changes such as maintaining a healthy weight, balanced diet and regular exercise can improve insulin sensitivity and regulate menstrual cycles.
Fertility medications and assisted reproductive technologies (ART) like in vitro fertilisation (IVF) are also effective options for those struggling to conceive. However, the overall success rates depend on age, weight and lifestyle.
Other pregnancy risks are miscarriage in the early months of pregnancy, preeclampsia, hypertension and preterm birth. Regular monitoring and a healthy lifestyle can help manage these risks.
If you’re planning a pregnancy with PCOS, it’s essential to work closely with a healthcare provider to develop a personalised treatment plan and manage your risks.
How can I manage my PCOS to improve my chances of pregnancy?
PCOS affects up to one in five women of reproductive age, making it more challenging for them to conceive naturally. It impacts fertility because the ovaries of women with PCOS contain small cysts or follicles that may not produce viable eggs for fertilisation.
While the condition cannot be cured, it can be effectively managed, especially for those planning to conceive. The first line of treatment often involves lifestyle and dietary changes, which can significantly improve symptoms and overall health.
Lifestyle and diet
Maintaining a healthy weight is crucial for women with PCOS. A balanced diet rich in fruits, vegetables, whole grains and lean proteins, combined with regular physical activity, can help regulate insulin levels and reduce the severity of PCOS symptoms. Additionally, weight loss can help enhance fertility, especially for overweight or obese individuals.
Ovulation induction
Women with PCOS often face challenges with irregular or absent ovulation, making it difficult to conceive. Ovulation induction is a common treatment for these fertility issues. This involves taking medication (such as tablets or injections) to stimulate hormones. Your doctor may start you on oral medication, and you may also be given a series of follicle-stimulating hormone (FSH) injections. These synthetic hormones encourage the ovaries to produce multiple follicles, increasing the chances of ovulation and conception.
Long-term health considerations
While PCOS symptoms do not necessarily worsen with age, ongoing management is essential. Women may continue to experience symptoms such as hormonal imbalance throughout their lives. Additionally, the risk of PCOS-related health problems such as type 2 diabetes, cardiovascular disease and stroke increases with age. Therefore, regular health check-ups are crucial to mitigate these risks.
Virtus Fertility Centre is at #09-01-05 Scotts Medical Center, Pacific Plaza, 9 Scotts Road.
6460 4555 | virtusfertilitycentre.com.sg
Found this article on PCOS and pregnancy helpful? Check out our Health section for more.
To make the most of living in Singapore, read our latest City Guide here for free!
