Q&A: Will PCOS hurt my chances of getting pregnant?

I have been diagnosed with polycystic ovarian syndrome and told I may have trouble conceiving. Could you explain?

Polycystic ovary syndrome (PCOS) is a condition that about one in 10 women have that can affect their ability to get pregnant. Women who have PCOS generally have high levels of male hormones (androgens) circulating, affecting their ability to ovulate and maintain regular cycles.

There is not one conclusive cause for PCOS, although researchers agree that heredity may play a big part. Another theory is tied to insulin production and regulation. Insulin, a hormone important in controlling and using circulating blood sugar, is thought to be high in women with PCOS. This high level of insulin is linked to increases in androgens.

Each month, in a woman who does not have PCOS, small sacs or follicles containing eggs fill with fluid as the eggs mature. When an egg is fully mature, the sac bursts and the egg travels into the fallopian tube and on to the uterus for possible fertilization. A woman who has PCOS, because of her hormone imbalance, does not experience the "burst" and as a result no egg is released for fertilization. These immature follicles remain on the ovaries as cysts.

Women with PCOS will generally present with many of these symptoms:

  • Irregular menstrual cycle
  • High blood pressure
  • High cholesterol
  • History of infertility
  • Overweight
  • Increased hair growth (facial, hands, arms)
  • Pelvic pain
  • Male pattern baldness
  • Sleep apnea
  • Acne or oily skin
  • Ovarian cysts
Though there is no cure, there are several treatments that may help.
  • Birth control pills: to regulate your menstrual cycle
  • Diabetes medication: to help control your insulin levels. The drug currently being used is called metformin (common trade name Glucophage). In addition to lowering insulin it can also lower testosterone, slow the rate of hair growth, and may bring the return of normal ovulation.
  • Fertility medication: to help stimulate ovulation. This can increase the chances of multiple births (i.e., twins or triplets)
Your doctor will help you decide which is the best course of treatment. (Read more about PCOS here.)

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