How PCOS Can Affect Your Fertility

PCOS, Kelly Morales, OB/GYN

Polycystic ovary syndrome (PCOS) can develop at any age. In fact, you may develop the signs and symptoms of PCOS when you first begin menstruating. But most women don’t get diagnosed with PCOS until their 20s and 30s when they’re having difficulty getting pregnant and turn to their OB/GYN for answers.

The good news is, PCOS is treatable, and women’s health experts like Dr. Kelly Morales here in San Antonio, Texas, can help you figure out the best treatment to improve your fertility. Knowing how PCOS affects your fertility may help you understand the specific treatments that are prescribed to improve your chances of pregnancy.

PCOS and your hormones

PCOS develops from an imbalance in reproductive hormone levels. Your menstrual cycle is regulated by the interaction of your hormones, including estrogen and progesterone, which are your female sex hormones.

If you have PCOS, you may produce excess amounts of androgens, which are male sex hormones that can affect your menstrual cycle and ovulation. High amounts of androgens in your body may also cause other symptoms, such as male-pattern baldness, facial hair, or acne.

Many women with PCOS also have elevated insulin levels. Insulin is a hormone made in your pancreas that carries glucose — your body’s preferred source of fuel  — from your bloodstream into your cells. If your cells become resistant to insulin, the glucose continues to circulate in your blood, but your pancreas continues to secrete more and more insulin, resulting in elevated blood levels. Too much insulin in your blood triggers your body to up its production of androgens, which further compounds the hormonal effects on your menstrual cycle.

Problems with ovulation

The hormonal imbalance created by the high levels of androgens affect your ovulation. Every month, your body releases an egg for fertilization. This is referred to as ovulation and occurs about midway through your menstrual cycle. High levels of androgens may affect the health and release of your eggs. If you don’t release an egg, then you can’t get pregnant.

One of the primary symptoms of PCOS is an irregular menstrual cycle. You may notice that your cycle is either very short (21 days) or very long (35 days). Women with long cycles may only release 8-9 eggs a year, and some women with PCOS don’t menstruate or ovulate at all.

Ovulation problems are one of the most common causes of infertility in women, and PCOS is very often the underlying condition leading to the ovulation issues.  

Weight gain and fertility

Unfortunately, the high androgen levels also lead to weight gain or make it very difficult for you to lose weight. And because it’s a male hormone, most of the excess weight is in the abdominal area. Being overweight also increases your risk of insulin resistance, which lead to an increase in androgen production, affecting both fertility and weight.

Treating PCOS and improving fertility

Having PCOS doesn’t mean you can’t get pregnant. In fact, PCOS is one of the most treatable causes of infertility in women. Initially, hormonal birth control pills may be recommended to help regulate ovulation and control some of your symptoms. However, you can’t get pregnant when taking birth control pills.

If you’re overweight, following a healthy diet and exercise program may help improve your hormone balance by decreasing both insulin and androgen levels to help regulate ovulation and improve your chances of pregnancy. Losing weight before you get pregnant may also make for an easier pregnancy and delivery.

You may also need medications that increase your ovulation to help for improve your fertility, such as clomiphene or gonadotropins.

PCOS can affect fertility, but that doesn’t mean you can’t get pregnant. Dr. Morales specializes in the diagnosis and management of PCOS and can provide treatment to reduce your symptoms and improve your fertility. Call our office today or request an appointment online.

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