Getting Pregnant With PCOS By Dr. Ritu Hinduja, Fertility Consultant, Nova IVF Fertility, Mumbai


Polycystic Ovarian Syndrome, also known as PCOS, is a reproductive metabolic syndrome and imbalance or an endocrine metabolic problem. Women having PCOS may have infrequent or prolonged menstrual periods Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes them to skip menstrual periods, as no egg is released from the ovary and this makes it harder for them to conceive.

In PCOS, many small, fluid-filled sacs grow inside the ovaries. The word “polycystic” means “many cysts.” These sacs are actually follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation. The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Estrogen and progesterone levels are lower than usual, while androgen levels are higher than usual. Extra male hormones disrupt the menstrual cycle, so women with PCOS get fewer periods than usual.

Doctors don’t know exactly what causes PCOS. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally. Genetics, insulin resistance, and inflammation have all been linked to excess androgen production. Insulin is a hormone the pancreas produces to help the body use sugar from foods for energy. When cells can’t use insulin properly, the body’s demand for insulin increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones, which not only disrupts ovulation but also causes hirsutism and acne. Women having PCOS also tend to experience a low-grade inflammation that stimulates polycystic ovaries to produce androgen, which can invite heart and blood vessel problems in the future.

Know how PCOS affects your fertility?

It is a well-established fact that women suffering from PCOS take a longer time to get pregnant. The reason can be due to irregular periods which means they don’t ovulate every month. PCOS patients tend to have a poor quality of the egg, compared to that of a non-PCOS woman. This could imply that a PCOS patient has a lower pregnancy potential compared to a non-PCOS patient of the same age. Also, being overweight reduces fertility and can contribute to women with PCOS taking longer to conceive. This is how women with PCOS improve their chance of pregnancy. One needs to adhere to a healthy lifestyle and medications in order to increase the chances of getting pregnant. Here are some healthy lifestyle changes that should be opted for:

• Adding fibre to your diet helps lower the insulin levels and enhance the health of your gut. Eat seeds, berries, legumes, flax seeds, and whole grains.
• Eat more of lean protein but speak to your expert about the quantity in which you should eat. Include grilled chicken, salmon, fish, beans, tofu, shrimp, and tuna.
• Eat antioxidant-rich foods by opting for olive oil, avocado, quinoa, brown rice, kale, and spinach to stay healthy.
• Women with PCOS are at a higher risk of type-2 diabetes. A low-GI diet can help in weight loss as well as improve insulin sensitivity. Eat nuts, seeds, fruits, starchy vegetables, and other unprocessed, low-carbohydrate foods.
• Say no to white bread, pizza, pasta, and white rice. Too much sugar intake is linked to weight gain. So, do not eat sweets or pastries or drink juice, aerated drinks, or smoothies.
• Processed foods contain harmful chemicals, not only are poor for weight loss but can also destroy the gut microbiome. Bid adieu to ice creams, candies, and cookies.
• Saturated fats can be pro-inflammatory so don’t eat fast food and red meat. Avoid eating doughnuts, French fries, frozen pizza, junk, oily and spicy food.
• Similarly, smoking and alcohol is a strict no-no.

Fertility treatment can also be helpful: IVF is the most common treatment for women with PCOS who are not able to conceive naturally. In severe cases of PCOS, even after incorporating lifestyle changes, some women still experience infrequent ovulation, making it difficult for them to conceive. In these cases, women may choose to undergo IVF treatments to help with conception. In Vitro Fertilization (IVF) is one of the types of assisted reproductive technology (ART) that works using a combination of medicines and surgical procedures in order to help sperm fertilize an egg after which the fertilized egg is implanted in the uterus. First, a woman is prescribed medication to make her eggs mature and ready for fertilization. Next, the doctor performs a procedure called egg retrieval, post which, the sperms and the eggs are fertilized in the IVF lab. After that 1 fertilized eggs (embryos) of good quality is transferred into a woman’s uterus and the woman may become pregnant if the embryo implants itself in the lining of the uterus.