Can PCOS Cause Infertility? Here's What You Should Know

The term PCOS has become so common these days that you hear it from many women, especially those who experience irregular periods or have difficulty losing weight. So what is PCOS? Just a weight management issue? Not really! Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that affects many women of reproductive age. One of the biggest concerns surrounding PCOS is its potential impact on fertility, often raising the question, Can PCOS cause infertility?

In this blog, we’ll dive into what PCOS is, the symptoms, how it affects fertility, available fertility treatments, and when to seek medical help if you suspect PCOS is affecting your ability to conceive.

What is Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome is an endocrine disorder affecting 4-20% women of reproductive age. It is characterised by hormonal and metabolic issues which include insulin resistance and hyperandrogenism (excessive androgens (male hormones) in the body) which leads to chronic anovulation (inability to release an egg during the menstrual cycle) and like the name suggests polycystic ovaries. ^{1 2} 

Higher levels of androgens, or male hormones, are frequently seen in women with PCOS, which can disrupt ovulation, the normal release of eggs. PCOS is also frequently linked to insulin resistance, a disorder in which the body's cells do not react adequately to insulin. This insulin resistance can exacerbate PCOS symptoms by increasing the risk of type 2 diabetes and causing weight gain. ^{3 4}

The term "polycystic" refers to the presence of small cysts on the ovaries, though not all women with PCOS develop these cysts. The exact cause of PCOS is unknown, but it is believed to result from a combination of genetic and environmental factors. ^{3 4}

That said, let's understand the symptoms of PCOS before we answer the burning question– “Can PCOS cause infertility?”

Symptoms Of PCOS

Typically, PCOS symptoms may vary from one woman to another, which is why some get diagnosed early and some unfortunately very late. Few of the most common symptoms include:

• Irregular or Missed Periods: PCOS affects normal menstruation making women have infrequent, prolonged, or missed periods. Some experience excessive pain and heavy bleeding during periods. ⁴
• Excess Hair Growth: Also known as hirsutism, many women with PCOS experience increased hair growth on the face, chest, and back due to elevated androgen levels.⁴
• Weight Gain: For some people, PCOS contributes to obesity by making it harder to maintain or reduce weight.⁴
  Oily Skin & Acne: Hormonal imbalances can cause acne and other skin issues, especially on the face, chest, and upper back. ⁴
• Hair Thinning: Similar to male-pattern baldness, women with PCOS may have thinning hair on their scalps.⁴
  Enlarged Ovaries With Cysts: An ultrasound examination may reveal several tiny cysts that some women develop on their enlarged ovaries.⁴
• Darkened Skin: Insulin resistance, a typical symptom of PCOS, can be indicated by skin discolouration, which is frequently seen in places like the neck, groin, and under the breasts.⁴

These symptoms may lead to mental or psychological stress and make day-to-day living difficult. But for many women, the impact of PCOS on fertility is one of the most worrisome symptoms.

Let’s break it down for you. 

How Does PCOS Impact Fertility

Can PCOS cause infertility? Yes, PCOS can lead to infertility, but it does not mean every woman with this condition will be infertile. Individuals with PCOS experience chronic anovulation which leads to irregular or absent ovulation. This means that there is no egg available for the sperm to fertilise making it difficult for women to conceive, impacting their fertility. The excess male hormones in women with PCOS interferes with the normal development and functioning of the eggs leading to low quality immature eggs, again leading to infertility. ⁵

In short, Here’s how PCOS affects fertility:

• Irregular ovulation: Women with PCOS may not ovulate consistently or at all, which drastically lowers their chances of becoming pregnant.
• Hormonal imbalances: Normal follicular growth, which is necessary for ovulation, is inhibited by high levels of androgens.
• Problems with the endometrial lining: A fertilised egg may have trouble implanting if the uterine lining does not thicken appropriately. ^{5 6}

It's crucial to keep in mind that, with the correct care and lifestyle adjustments, many women with PCOS are nevertheless able to become pregnant in spite of these obstacles.

Fertility Treatments For Women With PCOS

There are many fertility treatments available for women wondering if PCOS can cause infertility. The severity of PCOS symptoms and each patient's unique situation determine how effective various therapies are. Some of the most common treatments include:

• Lifestyle changes: Making healthy lifestyle changes can increase a woman's chances of getting pregnant if she has PCOS. Even a 5–10% weight loss can improve menstrual cycle regulation and ovulation restoration. Insulin resistance and hormone levels can be improved with regular exercise and a balanced diet that emphasises foods low on the glycaemic index, which avoid insulin spikes. ^{7 8}
• Hormonal Birth Control: Hormonal birth control options include intrauterine devices (IUDs), vaginal rings, injections, patches, and pills. These techniques aid in menstrual cycle regulation, and some can also lessen excessive hair growth and treat acne. ⁴
• Metformin: This medication is frequently prescribed to women who have insulin resistance. When used in conjunction with other reproductive therapies, it can enhance ovulation and assist control insulin levels. ⁴
• Clomiphene Citrate: For women with PCOS who are attempting to conceive, clomiphene citrate is frequently the first course of treatment. It facilitates the release of eggs from the ovaries. ^{4 9}
• Letrozole: Originally taken to treat breast cancer, letrozole is also occasionally used to promote ovulation in women with PCOS. According to studies, it might work better for some PCOS-affected women than Clomiphene Citrate. ^{4 9}
• Gonadotropins: Injectable hormones that stimulate the ovaries to produce multiple eggs. These are often used when oral medications are not effective. 4
• IVF (In vitro Fertilisation): IVF might be suggested if medicine and lifestyle modifications are ineffective. In IVF, eggs are taken from the ovaries, fertilised with sperm in a laboratory, and then the fertilised egg (embryo) is placed into the uterus. Despite being more costly and invasive, IVF has a high success rate, particularly for PCOS-affected women who do not ovulate consistently.⁴
• Ovarian Drilling: Ovarian drilling is a last stop surgical operation done in order to decrease androgen production and re-establish normal ovulation. In this minimally invasive procedure tiny holes are created in the ovary. ¹⁰

Alternative Remedies for PCOS 

Some women who are aware that PCOS can cause infertility prefer alternative therapies like:

• Herbal Supplements: Inositol, vitex, berberine are some herbal supplements that are known to help regulate hormonal imbalances in women with PCOS. ^{11 12}
• Acupuncture: Women with PCOS may also benefit from acupuncture as a supplemental treatment for infertility. It might help balance hormone levels, enhance blood flow to the reproductive organs. ¹³
• Stress Management: Managing stress through practices like yoga, meditation, or mindfulness can help lower stress hormones, which may indirectly support hormone balance and improve reproductive health. ¹⁴

When To See A Doctor

If you have PCOS and are trying to get pregnant and are also wondering if PCOS can cause infertility, it is time for you to seek medical advice. Especially if ⁴:

You’ve been trying to get pregnant for over a year (or six months if you're over 35) without success.
Your periods are irregular or absent, which may be a sign that you're not ovulating regularly.
You experience other symptoms of PCOS, such as excess hair growth, acne, or weight gain, which may indicate hormonal imbalances.

Early intervention is key to managing PCOS related infertility. 

In Conclusion 

Can infertility result from PCOS? Indeed, by interfering with ovulation and hormonal balance, PCOS can affect fertility. It's crucial to remember, though, that with the correct care and lifestyle adjustments, many women with PCOS can become pregnant. There are several strategies to increase fertility and have a healthy pregnancy, including medicine, IVF, and complementary therapies. Do not be afraid to seek assistance from a healthcare professional who can direct you towards the best remedies if you are experiencing infertility as a result of PCOS. 

Also, check out LifeCell’s OvaScore–an at-home test that checks female fertility hormones & identifies potential red flags for you to be on top of your reproductive health! 

Despite fertility difficulties, there is hope because many women with PCOS go on to have healthy children with the right care! 

FAQs:

1. Does PCOS cause infertility?

Yes, PCOS can cause infertility in some women due to irregular or absent ovulation, making it difficult to conceive naturally.⁴

2. Can PCOS cause infertility in all women?

No, not all women with PCOS will experience infertility. While PCOS can lead to irregular ovulation, many women with PCOS can still conceive naturally or with the help of fertility treatments. ⁴

3. Can PCOS-related infertility be treated?

Yes, PCOS-related infertility can be treated. Treatment options include lifestyle changes, medications to stimulate ovulation, and In Vitro Fertilisation (IVF).⁴