PCOS and pregnancy
Polycystic ovary syndrome (PCOS) can cause fertility problems and it's been estimated that it affects between 5% and 10% of women.
What is polycystic ovary syndrome?
A diagnosis of PCOS can be made if two of the following three things are present:
- There are a number of small cysts on the ovaries that contain underdeveloped eggs. The cysts form when the follicle containing the egg begins to mature then fails to burst and release the egg.
- Ovulation does not occur.
- A high level of the male hormone testosterone is being produced by the ovaries.
You may have the syndrome even if the cysts are absent. A diagnosis is normally made after an ultrasound scan to look at the ovaries and blood tests to test hormone levels.
What are the symptoms of PCOS?
- Disruption to periods - they will either be absent all together or rather irregular.
- Infertility (because there is no egg released to be fertilised).
- General hairiness because of the excess testosterone. Excess hair can be found on the tummy, face and nipples. The testosterone may also make your hair thinner on your head.
- Spots and oily skin.
- Excess weight, which can itself exacerbate the syndrome by raising insulin levels in the blood and stimulating testosterone production.
What treatments are available for PCOS?
There are various treatments to control the symptoms of PCOS:
- Acne treatments or antibiotics
- Hair removers for excess hair and creams that inhibit hair growth
- Contraceptives to reduce the amount of testosterone produced (although obviously these will not tackle the infertility caused by PCOS).
Other options that target infertility include:
- Drugs such as clomifene citrate (Clomid) and tamoxifen will stimulate ovulation.
- Gonadotrophins can be used to stimulate the ovary but they can sometimes overstimulate them increasing the risk of having a multiple pregnancy.
- Metformin reduces insulin resistance and results in less insulin in your blood, which will reduce the production of testosterone. This gives your ovaries a chance to function more normally and you may begin to ovulate, increasing your chances of conceiving.
- Hormone treatment with anti-male hormones can block the effects of the testosterone.
- An operation called laparoscopic ovarian drilling (LOD) may help by destroying the tissue that produces the male hormones with a laser.
If you do not conceive after six months or a year of taking these drugs, intrauterine insemination might be an option, failing that there are other assisted conception options such as IVF, egg donation or surrogacy.
• Trying to conceive
• Best time to conceive
• Signs of ovulation
• Basal body temperature
• Problems getting pregnant
• Fertility treatments
What can I do to improve my chances of getting pregnant despite having PCOS?
There are a number of things you can do to help reduce the effects of PCOS and boost your fertility.
If you're overweight, then it's important to try to lose weight to help break the cycle of raised insulin levels that in turn raise testosterone levels.
Losing weight will also reduce your risk of developing long-term effects associated with the syndrome, including diabetes, high blood pressure, heart disease and endometrial cancer. According to NHS Choices, a reduction in weight of just 5% can lead to significant improvements.
Having a balanced diet, a healthy lifestyle and taking regular exercise are perhaps the easiest ways you can help limit the effects of the syndrome.
Try to avoid sugary foods, alcohol and caffeine as these can all affect insulin resistance.
What Mumsnetters say about polycystic ovary syndrome
- Women with PCOS have issues with insulin resistance, which means that we make insulin and the sugar/food is in our blood ready to go into our body cells, but our cells don't recognise that it's there. This causes us to crave sugary foods even though we already have enough sugar/food inside our bloodstream to feed our cells. This insulin resistance can also lead to infertility. Metformin is used to treat this, but it can also be controlled by diet. Queenofthefairies
- MY PCOS wasn't obvious as I am not overweight but I did have very irregular periods. They diagnosed it based on an internal and a blood test at what they thought was the right time of the month. Tigresswoods