PCOS & FERTILITY

Polycystic Ovarian Syndrome (PCOS) & Fertility

PCOS is a common cause of female infertility and is the most common cause of infertility in women who do not ovulate normally or have regular menstrual cycles. Polycystic Ovarian Syndrome is believed to affect up to 10% of women.

Contrary to its name, Polycystic Ovarian Syndrome is not a problem that starts in the ovaries. It is a syndrome that impacts your entire body and is caused by an imbalance and overproduction of hormones including insulin and male hormones. This imbalance leads to production of immature follicles that rarely release eggs. Because normal ovulation does not occur in women with PCOS, they often have difficulty getting pregnant.

PCOS is still a topic of some confusion and disagreement in the medical community because it presents with a variety of conditions that vary from woman to woman. However, many natural medical treatments and lifestyle changes can be implemented that not only offer a woman relief from the symptoms of PCOS, but can also help restore ovulation – so she can conceive a child without artificial intervention.

PCOS & FERTILITY

SYMPTOMS OF PCOS

Common symptoms of PCOS include:
• Irregular or long (>35 days) cycles that rarely result in ovulation
• Limited cervical fluid for long periods of time
• High quality cervical fluid with or without ovulation for long periods
• Infertility
• Excessive body or facial hair
• Male pattern hair loss
• Acne
• Weight gain and/or difficulty losing weight

Clinical symptoms of PCOS determined via ultrasound include:
• Enlarged white ovaries with a ‘string of pearls’ on the surface
• Immature follicles that don’t reach maturity to release an egg
• Elevated testosterone and LH levels with LH produced in excess of FSH
• Abnormal ovulation (abnormal egg and corpus luteum)

DIAGNOSING PCOS

There is believed to be a genetic component to PCOS and although women develop the condition in their teens, they are typically not diagnosed until their 20’s or 30’s.

Women with PCOS usually have 2 out of 3 of these symptoms:
• Irregular long (>35 days) cycles
• Increased male hormones causing an excess of body of facial hair, acne or male pattern baldness
• The ‘string of pearls’ on the ovaries determined by ultrasound

The good news is that there is a new diagnostic test to help evaluate for PCOS, the anti-mullerian hormone (AMH) test. AMH measures the number of follicles present and is often considered an accurate marker for PCOS (there are an excessive number of follicles and the AMH level will therefore be high) along with high fasting insulin levels, high free and total testosterone levels, and high DHEA sulfate levels.

TREATING PCOS

Before you venture into medications or medical procedure, you should try to control PCOS with natural methods which include:

• Exercise to achieve & maintain body fat in the mid 20%
• Focus on a low-carbohydrate, low-glycemic diet
• Combine carbs with fat & protein to balance blood sugar
• Select foods with more fiber and less sugar
• Space carbohydrate heavy foods throughout the day to avoid dramatic blood sugar increases
• Minimize foods that trigger cravings
• Stay hydrated & limit caffeine
• Choose monounsaturated & omega 3 fats over saturated & trans fats
• Supplements: calcium; multivitamin with 400mcg of folic acid; d- chiro- inositol

Traditional Medical Treatments for PCOS:

• Birth control pills
• Metformin (Glucophage)
• Cyclical progesterone therapy
• Ovulatory drugs (Clomid & Femara)
• Gonadotropin therapy
• Ovarian drilling and wedge resection