Does Polycystic Ovary Syndrome (PCOS) affect fertility?

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 23 May 2022

Polycystic ovary syndrome (PCOS) is a common health condition that affects around 1 in 10 women of reproductive age. PCOS causes hormonal imbalances and metabolism problems that can affect their overall health and even their appearance. This condition is a common cause of infertility, but it is treatable. Despite the name, women with PCOS don’t develop cysts on their ovaries.

If you’re worried about PCOS affecting you or a loved one’s fertility, we’ve covered everything you need to know about when to test for PCOS and why you shouldn’t worry.

Contents
 

What causes PCOS?

Unfortunately, the exact cause of PCOS isn’t currently known. Most experts think that many factors contribute to this condition, including genetics. Other health conditions that could potentially cause PCOS include:

  • High androgen levels
  • High insulin levels

Androgens are sometimes referred to as ‘male hormones’. However, small amounts are present in every woman. Androgens are responsible for a range of male traits like male pattern baldness. Many women with PCOS have been reported to have higher androgen levels, which can prevent ovulation. This can lead to acne and extra hair growth.

Insulin is a hormone that controls your blood sugar and how the food you eat turns into energy. Some people can become resistant to insulin, which will cause their blood sugar levels to become higher than normal. Many women who suffer from PCOS have insulin resistance, which can lead to type 2 diabetes over time.

Symptoms of PCOS

There are many symptoms associated with PCOS. These can vary between individuals, but in general they will usually include a variety of the following.

  • Acne, as well as oily skin that usually appears on the face, the chest and the upper back.
  • Darkening of the skin: this is most common along neck creases, under the breasts and in the groin.
  • Excess hair growth (hirsutism) affects 70% of women with PCOS and is often seen on the face, chin, chest, stomach and back.
  • Irregular periods: periods will usually decrease, while some women stop having menstrual periods at all.
  • Infertility: an irregular menstrual cycle can lead to infertility. While it’s common, it’s also treatable.
  • Polycystic ovaries: when your ovaries become enlarged and develop fluid filled sacs, called follicles.
  • Skin tags: small excess flaps of skin that develop on the neck area or in the armpits.
  • Thinning hair or hair loss on the scalp, would be classed as female pattern baldness.
  • Weight gain: this will often occur around the belly (abdomen) and can become difficult to shift.

Effects of PCOS on fertility

Having PCOS doesn’t mean you won’t be able to have children. PCOS is a common cause of infertility in women but it’s also very treatable. Women with PCOS have hormonal imbalances which will interfere with the growth and release of an egg from their ovaries. This is called ovulation and if you don’t ovulate, you can’t get pregnant.

However, if you have PCOS, and you’re struggling to get pregnant or you’re worried about your fertility, then you should speak to your doctor. They will be able to figure out ways to help you ovulate. You can also track your menstrual cycle using an ovulation calculator to see if the methods your doctor prescribes are working.

Treatment options to boost fertility

If you have PCOS, your doctor will figure out the best course of treatment to help you get pregnant. To help you gain a better understanding, here are some of the treatment options.

Weight loss

If you’re overweight or obese, then losing weight by changing your diet and lifestyle can boost your fertility. Healthy eating and regular activity could improve the regularity of your menstrual cycle. You should speak to your doctor or a nutritionist about creating a personalised eating plan to improve your diet.

Medication

Once other causes of infertility have been ruled out, your doctor may recommend starting you on medication. This will usually consist of clomiphene (Clomid), which is a prescription medication that helps you ovulate. These ovulatory stimulants work in a similar way to oestrogen, which is the female hormone that develops and releases eggs.

In vitro fertilisation (IVF)

IVF will be the next option if the medication doesn’t work. This treatment works by fertilising an egg with a partner’s sperm in a laboratory. The successful embryos will be implanted into the uterus to develop. You’re more likely to get pregnant using IVF compared to taking medicine alone.

Surgery

If any of the above doesn’t work, then the final option will be surgery. The cortex which is the outer shell of the ovaries is thicker in women who have PCOS and is thought to play a role in ovulation. Ovarian drilling consists of the doctor making holes in the ovary surface using a fine heated needle or lasers. This temporarily restores ovulation for 6 to 8 months.

How does normal ovulation work?

During normal ovulation, a mature egg is developed and released from the ovary. Once the egg is released, it will move down the fallopian tube where it will remain for 12 to 24 hours waiting to be fertilised by sperm. If left unfertilised, the egg will disintegrate and will be disposed of when your uterine lining is shed during your period.

If you have PCOS, your polycystic ovaries will contain eggs. However, these follicles often don’t mature or develop properly, which leads to no release of eggs or ovulation. If you want to check if you have PCOS or you want to track your ovulation and fertility, then you can request a fertility test from ZAVA.

Do I have PCOS?

There isn’t a single test to diagnose PCOS. For this reason, a doctor will carry out several tests and physical exams and talk to you about your medical history to rule out other health issues that could be triggering your symptoms.

Testing

Home PCOS blood tests: these tests can check your levels of testosterone and sex hormone-binding globulin (SHBG) which are both androgens. If your result shows a high level of androgens, then you should contact your doctor for further tests. Request a home PCOS test and advice from a ZAVA doctor from the comfort of your own home.

Other blood tests: a blood test can be used to check your androgen hormone and insulin levels. Your doctor can also check for other hormones that are linked to common health problems that are often mistaken for PCOS, like thyroid disease and Cushing’s syndrome. You may also get tested for high cholesterol and diabetes.

Exams

A physical exam will consist of your doctor testing your blood pressure, your BMI (body mass index) and waist size. They will also examine your skin for extra hair, acne and discolouration. Your doctor may look for any hair loss alongside signs of conditions with similar symptoms, like an enlarged thyroid gland.

A Pelvic exam is carried out to look for signs of extra male hormones, such as an enlarged clitoris. They may also check if your ovaries feel large or swollen.

A Pelvic ultrasound uses sound waves to examine you internally. The doctor will check your ovaries for cysts and the endometrium (lining of the womb) for abnormalities.

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Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 23 May 2022




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