Does PCOS Cause Infertility? - Reasons, Diagnosis, Solutions

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Medically Reviewed by Dr. Arti Sharma
Written by Charu Shrivastava, last updated on 16 March 2023
Does PCOS Cause Infertility? - Reasons, Diagnosis, Solutions

Many women tend to wonder, “does PCOS cause infertility”. Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age, affecting up to 10% of women. One of the significant symptoms of PCOS is anovulation, meaning the ovaries do not release an egg every menstrual cycle. This can lead to irregular periods and infertility.   

PCOS and infertility have a direct relationship where the former is known to come in the way of easy conception. Women with PCOS trying to conceive may require medical intervention, such as ovulation induction medication or assisted reproductive technology. However, lifestyle modifications, such as weight loss and exercise, can also improve fertility outcomes in women with PCOS.

Impact of PCOS on Fertility

PCOS and infertility have an extremely strong correlation. It is a hormonal disorder that affects women of reproductive age and is one of the leading causes of infertility in women due to its impact on fertility. Here are some ways in which PCOS affects fertility:

Irregular Ovulation

Women tend to think, “does PCOS cause infertility”. Irregular ovulation is one of the most significant impacts of PCOS on fertility. PCOS can cause infrequent or absent ovulation, meaning the woman may not release an egg every month. 

This makes it difficult to conceive because fertilisation can only occur if an egg is available for the sperm to fertilise. In some cases, a woman may only ovulate a few times a year, reducing her chances of getting pregnant.

Hormonal Imbalances

PCOS disrupts the normal hormonal balance in a woman’s body, leading to imbalances in oestrogen, progesterone, and luteinising hormone (LH). These hormones are necessary for ovulation and pregnancy. 

High levels of LH can lead to the formation of ovarian cysts, which can interfere with ovulation. Imbalances in oestrogen and progesterone can also impact the menstrual cycle, making it difficult to predict ovulation and conception.

Insulin Resistance

Many women with PCOS also have insulin resistance, which occurs when the body’s cells become resistant to insulin, a hormone that regulates blood sugar levels.

As a result, the body produces more insulin, which can lead to the overproduction of androgens. High levels of androgens can interfere with ovulation, making it difficult to conceive.

Endometrial Abnormalities

PCOS can also cause changes in the lining of the uterus, making it difficult for a fertilised egg to implant and grow. Women with PCOS may have a thinner endometrial lining, which reduces the chances of successful implantation. This can lead to a higher risk of miscarriage.

Obesity

Many women with PCOS are overweight or obese, which can further exacerbate hormonal imbalances and insulin resistance. Obesity can also impact ovulation and the menstrual cycle, reducing the chances of conception.

Age

Women with PCOS may have a reduced ovarian reserve, which means they may run out of eggs earlier than women without the condition. This can make it more challenging to conceive as the woman gets older.

Women with PCOS trying to conceive should consult a healthcare professional to explore appropriate treatment options and improve their chances of getting pregnant.

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Common Signs of PCOS in Women

The signs and symptoms of polycystic ovary syndrome can vary from person to person, but there are some common signs to look out for. These include:

Irregular Periods

Irregular menstrual cycles are one of the characteristic symptoms of Polycystic Ovary Syndrome. This means that a woman’s periods may occur infrequently or become completely absent. This is due to the hormonal imbalances that occur in women with PCOS. These imbalances can prevent the ovaries from releasing an egg during each menstrual cycle, leading to irregular periods.

Excessive Hair Growth

Another common symptom of PCOS is hirsutism, which is the development of excess hair growth on a woman’s face, chest, stomach, or back. This occurs due to the overproduction of androgens, which are male hormones usually present in women in small amounts.

When there is an excess of androgens in the body, it can cause unwanted hair growth, which is a common scenario when dealing with PCOS and infertility.

Acne

Women with PCOS may experience persistent acne, especially around the jawline. This occurs due to the overproduction of androgens, which can cause the sebaceous glands to produce more oil than necessary, leading to the formation of acne.

Weight Gain

Women with PCOS may gain weight, especially around their midsection. This is due to the insulin resistance that can occur in women with PCOS. When the body becomes insulin resistant, it can cause the body to store more fat, particularly in the abdominal area.

Hair Loss

Women with PCOS may experience hair thinning or hair loss on their scalp. This can occur due to hormonal imbalances in women with PCOS. The excess androgens in the body can cause hair follicles to shrink, leading to hair thinning or hair loss.

Darkening of Skin

If one wonders, “does PCOS cause infertility,” it is essential to know about the signs of PCOS. Women with PCOS may notice a darkening of their skin, especially around their neck, underarms, or groyne. This occurs due to insulin resistance, which can cause the skin to produce more pigment.

Ovarian Cysts

Women with PCOS may have enlarged ovaries that contain multiple small cysts. These cysts are not harmful, but they can cause hormonal imbalances, leading to PCOS symptoms.

It is important to note that not all women with PCOS will experience all of these symptoms. In fact, some women with PCOS may not have any outward signs or symptoms. If you suspect that you may have PCOS, it is important to consult your healthcare provider for proper diagnosis and management.

Fertility Treatments For Women with PCOS

Treatments for improving PCOS in women depend on the severity of one’s condition. These procedures tend to take time before conception becomes easy for a woman. However, there are several fertility treatments available for women with PCOS. Here are some of the most common treatments:

Medications to Induce Ovulation

Women with PCOS and infertility often have irregular ovulation or don’t ovulate at all. Medications like letrozole can help regulate ovulation and increase the chances of pregnancy. 

  1. ​​Clomiphene Citrate: This medication is a selective oestrogen receptor modulator that works by blocking oestrogen receptors in the brain. This causes the brain to release more follicle-stimulating hormone (FSH) and luteinising hormone (LH), which can stimulate ovulation. 
  2. Letrozole: This medication is an aromatase inhibitor that reduces oestrogen production in the body. This can stimulate the production of FSH and LH and promote ovulation. Letrozole is taken orally for 5 days at the beginning of the menstrual cycle.
  3. Metformin: This medication is commonly used to treat type 2 diabetes, but it can also be helpful for women with PCOS. Metformin works by reducing insulin resistance and lowering insulin levels in the body. This can improve hormonal balance and promote ovulation.
    Metformin is typically taken orally daily.

Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is a fertility treatment that can be used to help women with PCOS conceive. IUI involves placing specially prepared sperm directly into the uterus using a thin catheter. Here’s how IUI can help treat PCOS:

  1. Controlled Ovarian Hyperstimulation (COH): Before the IUI procedure, women with PCOS may be given medications to stimulate the ovaries to produce more eggs. This is known as Controlled Ovarian Hyperstimulation (COH).
    COH can help improve the chances of ovulation and increase the number of mature eggs available for fertilisation.
  2. Timing of Insemination: The timing of the insemination is critical to the success of IUI. In women with PCOS and infertility, ovulation can be unpredictable, so careful monitoring is necessary to determine the best time for insemination.
    Ovulation can be triggered with medications such as human chorionic gonadotropin (hCG) to ensure that the insemination occurs at the optimal time.
  3. Increased Chance of Pregnancy: By placing the sperm directly into the uterus, IUI bypasses the cervix and places the sperm closer to the egg, increasing the chances of fertilisation. For women with PCOS, IUI can be an effective fertility treatment option.

In Vitro Fertilisation (IVF)

In vitro fertilisation (IVF) is another fertility treatment option for women with PCOS who have not achieved pregnancy with other treatments or who have more severe PCOS symptoms.

IVF involves stimulating the ovaries to produce multiple eggs, which are then retrieved and fertilised with sperm in a laboratory dish. The resulting embryos are then transferred into the uterus.

IVF can be particularly effective for women with PCOS because it allows for precise control of ovulation and can increase the chances of fertilisation and implantation. Additionally, IVF can help bypass any issues with blocked or damaged fallopian tubes, which can be a concern for women with PCOS.

Surgery

Surgery may be recommended for PCOS in rare cases where other treatments have been unsuccessful or if the patient has a specific underlying condition that needs to be addressed.

The most common type of surgery for PCOS is ovarian drilling, which involves making tiny punctures in the ovaries using a laser or heat probe.

Ovarian drilling aims to reduce the production of androgens (male hormones) by the ovaries, often elevated in women with PCOS and infertility. By reducing androgen production, ovarian drilling can help regulate ovulation and improve fertility. Ovarian drilling is usually performed as a laparoscopic procedure, which involves making a small incision in the abdomen and inserting a laparoscope to view the ovaries.

Another type of surgery that may be recommended for PCOS is a hysterectomy or removal of the uterus. This is only recommended in cases with a significant risk of cancer or other severe conditions affecting the uterus.

It is important to note that surgery is not typically the first line of treatment for PCOS and is usually reserved for cases where other treatments have been unsuccessful or if there is a specific underlying condition that needs to be addressed. 

Additionally, like any surgical procedure, there are risks and potential complications associated with ovarian drilling and other surgeries for PCOS. Patients should discuss the risks and benefits of surgery with their healthcare provider to determine if it is the best course of action for their individual needs.

Exercise

Regular exercise can be a beneficial treatment option for women with PCOS. Exercise can help improve insulin sensitivity, aid weight loss, reduce inflammation, improve mood, and increase fertility.

One of the most significant benefits of exercise for women with PCOS is its ability to improve insulin sensitivity. By improving insulin sensitivity, regular exercise can help regulate blood sugar levels and reduce the risk of developing type 2 diabetes.

Regular exercise has been shown to improve mood and reduce symptoms of anxiety and depression, which are more common in women with PCOS. In addition, regular exercise can help regulate menstrual cycles and increase fertility in women with PCOS and infertility.

To see benefits, it is recommended that women with PCOS engage in at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week.

Activities such as brisk walking, jogging, cycling, swimming, or strength training can be included in the exercise regimen. It is always important to consult a healthcare provider before starting any new exercise regimen.

Diet

Dietary modifications can play a crucial role in managing PCOS and improving fertility outcomes. Here are some ways a healthy diet can help treat PCOS:

  1. Managing Insulin Resistance: Many women with PCOS have insulin resistance, which can lead to weight gain and worsen symptoms. Eating a low glycemic index (GI) diet that is rich in fibre, whole grains, lean protein, and healthy fats can help manage insulin resistance and improve fertility.
  2. Reducing Inflammation: PCOS is associated with chronic low-grade inflammation. Consuming foods rich in antioxidants, such as fruits, vegetables, nuts, and seeds, can help reduce inflammation and improve fertility outcomes.
  3. Regulating Hormone Levels: A healthy diet can also help regulate hormone levels in women with PCOS and infertility. Consuming foods that are rich in phytoestrogens, such as soy products, can help regulate oestrogen levels.
    Eating foods that contain zinc, magnesium, and B vitamins can also help regulate hormone levels.
  4. Promoting Weight Loss: Weight loss can improve insulin resistance and regulate hormone levels in women with PCOS. A diet that is low in calories and carbohydrates but high in protein and fibre can help promote weight loss and improve fertility outcomes.

It’s important to note that each woman’s experience with PCOS and fertility is unique, and the best treatment approach will depend on individual circumstances.

Women with PCOS who are struggling with fertility should consult with a reproductive endocrinologist or fertility specialist to determine the best course of treatment for their specific needs.

When To See a Doctor?

When dealing with PCOS and infertility, it's important to seek medical attention promptly. A doctor can diagnose PCOS and assess the possible causes of infertility, recommending lifestyle changes, medication, and fertility treatments such as IVF. 

Seeking medical advice is crucial as PCOS may have long-term health implications, including increased risks of diabetes and heart disease. Early treatment can help manage these risks effectively.

Takeaway

PCOS is a common endocrine disorder that can lead to infertility in women. However, with proper diagnosis and treatment, women with PCOS can increase their chances of conceiving and carrying a healthy pregnancy. Fertility treatments, such as medications, surgery, and assisted reproductive technologies like IVF and IUI, can be effective in helping women with PCOS achieve pregnancy. 

Additionally, lifestyle changes such as a healthy diet, regular exercise, and stress management can improve fertility in women with PCOS. It is important for women to seek medical advice and follow a personalised treatment plan to manage PCOS and achieve their fertility goals. This is where we at HexaHealth can help you better manage your reproductive health and conceive easily. 

Get in touch with our professionals today and take your first step towards a growing family!

Frequently Asked Questions

Does PCOS cause infertility?

Yes, PCOS can cause infertility in women. However, the extent and severity of the condition are dependent on your health, age, weight and overall lifestyle. Nonetheless, you can effectively treat your infertility with dedicated treatments.

What is the relation between PCOS and infertility?

PCOS can affect fertility by disrupting ovulation and causing hormonal imbalances. Some women may find it difficult to conceive due to PCOS, alongside having other visible signs like facial hair.

How can PCOS cause infertility?

PCOS can cause infertility by preventing regular ovulation, leading to irregular periods, and preventing the release of mature eggs. Treatments for controlling PCOS aim at regulating your cycles and ensuring regular ovulation for improving the condition.

Why does PCOS cause infertility?

PCOS causes infertility due to the hormonal imbalances it creates in the body. Many times, you may experience trouble getting pregnant because of imbalances in the hormones that disturb your menstrual cycles.

Can PCOS make you permanently infertile?

PCOS does not make you permanently infertile, but it can make it more difficult to conceive without treatment. It is best to speak with your doctor and know your exact condition to find the most appropriate treatment.

Can I get pregnant with PCOS naturally?

Yes, it’s possible to get pregnant with PCOS naturally, but it may take longer due to irregular periods. Maintaining a balanced diet and doing regular exercises can help improve your PCOS.

Is it difficult to get pregnant with PCOS?

It can be more difficult to get pregnant with PCOS due to irregular ovulation and hormonal imbalances. You may need to opt for a dedicated treatment and control your hormones to make conception easier.

How do you fix PCOS infertility?

PCOS infertility can be treated with medications, lifestyle changes, and fertility treatments such as IUI and IVF. You must consult with your doctor and understand the most appropriate line of treatment for you.

What is the percentage of getting pregnant with PCOS?

The percentage of getting pregnant with PCOS varies based on individual factors, but with treatment, many women with PCOS can conceive and have a healthy pregnancy. It is highly dependent on the extent of PCOS impacting a woman.

How do I get pregnant fast with PCOS?

Maintaining a healthy weight, tracking ovulation, and reducing stress can help increase the chances of getting pregnant fast with PCOS. You can also start with dedicated medication to enhance ovulation.

What are the Fertility treatments for women with PCOS?

Fertility treatments for women with PCOS include medications like Clomid, Letrozole, and Metformin and assisted reproductive technologies like IUI and IVF. In certain cases, surgery may be the best option to improve the condition.

What is diet and lifestyle’s role in treating PCOS infertility?

Diet and lifestyle changes can play a significant role in treating PCOS infertility. A healthy diet, regular exercise, and stress management techniques can improve fertility outcomes.

When does fertility decline PCOS?

Fertility decline in PCOS is gradual and varies from person to person. Age-related decline in fertility can also compound the effects of PCOS on fertility.

Updated on : 16 March 2023

Reviewer

Dr. Arti Sharma

Dr. Arti Sharma

MBBS, DNB Obstetrics and Gynaecology, Diploma In Cosmetic Gynaecology

8 Years Experience

Dr Arti Sharma is a well-known Obstetrician and Cosmetic Gynaecologist currently associated with Aesthetica Veda in Bengaluru. She has 8 years of experience in Obstetrics and Cosmetic Gynaecology and worked as an expert Obstetrician...View More

Author

Charu Shrivastava

Charu Shrivastava

BSc. Biotechnology I MDU and MSc in Medical Biochemistry (HIMSR, Jamia Hamdard)

2 Years Experience

Skilled in SEO and passionate about creating informative and engaging medical content. Her proofreading and content writing for medical websites is impressive. She creates informative and engaging content that educ...View More

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