As a midwife, I have had the privilege of working closely with women from all walks of life, each with their own unique set of challenges. One of the most prevalent issues I have encountered over the years is the complex relationship between Polycystic Ovary Syndrome (PCOS) and infertility. It’s a topic that has become increasingly relevant in my consultations with my patients.
PCOS is a hormonal disorder that affects up to 1 in 10 women of reproductive age. It can cause a wide range of symptoms, including irregular periods, excessive hair growth, acne and weight gain. But the symptom that often brings my PCOS patients to my office is their difficulty conceiving.
You see, PCOS can significantly impact a woman’s fertility. The hormonal imbalances associated with PCOS can disrupt ovulation, making it difficult for the ovaries to regularly release mature eggs. This, in turn, makes it harder for women with PCOS to get pregnant naturally.
The most common fertility-related issues associated with PCOS include:
- Irregular or absent ovulation: PCOS can prevent the ovaries from regularly releasing mature eggs, a process known as anovulation. Without ovulation, the chances of conception are significantly reduced.
- Insulin resistance: Many women with PCOS experience insulin resistance, which can lead to the overproduction of androgens (male hormones). This hormonal imbalance can further disrupt the ovulation process.
- Increased risk of early pregnancy loss: Studies have shown that women with PCOS have a higher risk of experiencing early pregnancy loss due to the hormonal imbalances associated with the condition.
I will never forget the first time I sat down with a young woman in my facility. She had been trying to conceive for over a year, and she was becoming increasingly frustrated and disheartened. It was during our consultation that we uncovered her PCOS diagnosis. A condition she had been unaware of until that point.
She was understandably overwhelmed. She had so many questions and concerns about how this would affect her dream of starting a family. As her midwife, I took the time to listen, to empathise and to provide her with the information and support she needed to go through this new reality.
I explained to her that while PCOS and infertility can be a challenging combination, there are treatments and strategies available to help women like her achieve their goals.
Managing PCOS and improving fertility
While PCOS can present challenges when it comes to fertility, there are several strategies that can be employed to improve the chances of conception:
- Lifestyle changes: Maintaining a healthy weight through a balanced diet and regular exercise can help to regulate insulin levels and reduce the effects of PCOS. This, in turn, can improve the chances of ovulation and conception.
- Medication: Your gynae may recommend the use of medications to help stimulate ovulation and improve fertility outcomes in women with PCOS.
- Assisted reproductive technologies (ART): In cases where lifestyle changes and medication are not effective, healthcare providers may recommend the use of ART, such as in vitro fertilisation (IVF) or intrauterine insemination (IUI), to assist with conception.
- Monitoring and tracking ovulation: Consistently monitoring ovulation patterns and tracking fertility signals can help women with PCOS identify the optimal times for conception.
Seeking professional guidance
If you have been diagnosed with PCOS and are experiencing fertility challenges, it is essential to work closely with a healthcare professional, such as a midwife, gynaecologist or a fertility specialist. They can provide personalised recommendations and develop a comprehensive treatment plan to address your specific needs and increase your chances of achieving a successful pregnancy.
In conclusion, PCOS can have a significant impact on fertility; but with the right strategies and professional support, many women with PCOS are able to overcome these challenges and conceive. You’ve got this!
