PCOS & Fertility

If you have PCOS, are trying to build a family, and the condition isn’t under control, it’s quite possible that the disorder is preventing you from achieving pregnancy.

PCOS is a metabolic condition that causes irregularities in the hormones a woman produces.

If we look first at a woman without PCOS, we see that her hormones are regulated in a balanced way during her menstrual cycle, so that a mature egg is released from the follicle, thus allowing for ovulation to occur.

The menstrual cycle of woman with PCOS is completely different, as hormones become off-balance and can interrupt or even stop the process of ovulation. When this occurs, the ability to conceive is not possible.

Women with PCOS also become resistant to their own insulin, and this resistance in turn triggers the body to react and create even more insulin.

At this point, the body has such high levels of circulating insulin that the ovary attempts to regulate it and bring the levels back to balance by creating too much testosterone. This increased level of testosterone in the body will alter the level of other hormones and in turn, impair ovulation.

For women with PCOS, this same process is repeated each month in an attempt to ovulate, which creates more and more immature follicles on the ovary, since ovulation is not able to take place.

These immature follicles form cysts; hence the name Polycystic Ovary Syndrome.

PCOS, Body Weight, and Fertility

Body weight has an impact on fertility for all women but even more so for women with PCOS. Studies show that a high body mass index (BMI) of more than 30 significantly reduces a woman’s fertility. This is partly due to the higher insulin resistance that comes with a higher body weight, which affects a women’s reproductive hormones.

The good news is that even modest amounts of weight loss can have a positive effect on fertility. “Weight loss of as little as 10% to 15% will enhance a woman’s chances of conceiving by normalizing sex hormone levels,” says Boston IVF reproductive endocrinologist David Ryley, MD.

Nevertheless, maintaining normal reproductive function requires a complex balance of sex hormones. Being overweight can upset this balance – with or without PCOS – and contribute to infertility in several ways:

  • Excess abdominal fat can increase production of androgens, which are male sex hormones that are normally present in small amounts in normal women. Their levels need to stay consistent for normal ovulation to occur. If androgen levels soar, ovulation may be disrupted and conception cannot occur
  • Excess body fat can trigger imbalances of the hypothalamus and pituitary hormones in the brain that are needed for normal ovulation.
  • Even without a full diagnosis of PCOS, an obese woman can still have insulin resistance that leads to increased levels of circulating insulin. With more insulin in circulation, the balance of sex hormones in the ovaries can be disrupted, interfering with the delicate reproductive hormonal balance needed to trigger ovulation and contributing to infertility.

How Can I Manage PCOS ~ and Increase  My Chance for a Successful Pregnancy?

As discussed above and in our PCOS and Nutrition section ~ diet and lifestyle management are the primary modes of treatment for Polycystic Ovary Syndrome (PCOS).

Scheduling an appointment with a nutritionist is one of the first steps to take control of this disorder and help reduce your symptoms.

The Domar Center’s Director of Nutrition, Hillary Wright, MEd, RD, LDN has vast experience working with women suffering from PCOS and teaches the skills to use in your every day life that will help deal not only with weight management but with depression and self-image. Creating a healthy lifestyle is one of the first steps of managing PCOS and is a way for patients to take control of the syndrome and help treat it without relying on medications.