How does PCOS affect fertility?

20 August 2024

Dr Ewa Goncikowska

What is PCOS and how does it affect fertility?

If a woman has PCOS, this means she has ovaries containing a large sum of tiny cysts triggered by an imbalance of reproductive hormones. These harmless follicles, or underdeveloped sacs, are up to 8mm in size and are filled with fluid where eggs develop. PCOS prevents the sacs from releasing the eggs, subsequently preventing ovulation. 

Due to the fact that it’s a hormonal condition, PCOS can also have a serious effect on your fertility. When you’re struggling to get pregnant it can be incredibly frustrating and stressful.

We asked Dr Ewa Goncikowska to explain how PCOS can affect fertility, and what you can do about it. As well as IVF and fertility preservation.

How do I know if I have PCOS?

While it may be incredibly common, PCOS manifests in many different ways. Some people notice that their periods become irregular or stop altogether. Other people report weight gain or excessive hair growth.

 PCOS has 3 main characteristics:

• Irregular or infrequent periods
• High levels of male hormones, which may cause physical signs such as excess hair (usually on the face, chest or back)
• Polycystic ovaries: ovaries containing many fluid-filled sacs (follicles) that surround the eggs

Your doctor will request a blood test to check your testosterone levels and a scan to check for polycystic ovaries. You may also have other signs and symptoms of PCOS:

• difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
• thinning hair and hair loss on the head
• weight gain
• oily skin or acne

How can PCOS affect fertility?

PCOS affects both ovulation and hormones, therefore making it one of the most common reasons why people struggle to conceive.

PCOS causes your body to produce higher levels of androgens testosterone and androstenedione. Normally, most of the testosterone in women is converted in the ovarian follicle to oestrogen. But too much testosterone and androstenedione can interfere with ovulation as they cause hormone imbalances that lead to an egg not being released.

Your ovaries are designed to release an egg each month to either be fertilised – leading to pregnancy or pass as a period. But due to hormonal imbalances, if you have PCOS, an egg may either not develop or not be released during ovulation as it should. 

This is why you may also notice that your period is irregular, or you miss it altogether.

What causes PCOS?

There’s no definitive answer as to what causes PCOS. While some research highlights the importance of lifestyle and diet, other studies have said that genetics could play a big part in the likelihood that you’ll be diagnosed with it.

How can PCOS be treated?

Lifestyle changes are important to avoid the long-term consequences of PCOS, such as diabetes, high blood pressure, cholesterol, triglycerides, and endometrial cancer. Lifestyle is listed as a key factor. If your doctor considers your BMI to be too high as a result of your PCOS they may ask you to lose weight through exercise and changing your diet.

However, if you’re trying to get pregnant, your PCOS may be treated in a combination of ways.

Studies suggest a weight loss of just 5% can lead to significant improvement in PCOS. This can be achieved by exercising regularly and eating a healthy balanced diet. Daily food intake should include at least five portions of fruit and vegetables, whole foods, lean meats, fish and chicken.

If you’re not trying to conceive with PCOS, or you’ve finished your fertility journey, looking after yourself when you have PCOS is equally as important as when trying to get pregnant. Our consultants are happy to meet with you, help you understand the condition more and what to do about it to help your long-term health.

Can I get pregnant with PCOS?

PCOS can make it more difficult to get pregnant. However, the diagnosis isn’t a confirmation that you won’t conceive. If you are diagnosed with PCOS and are thinking of having a baby, you should speak to your doctor about the best course of action.

PCOS is the most common hormonal condition affecting fertility. Although some people may need IUI or IVF, for most women, lifestyle change, weight loss and tracking ovulation for timed intercourse is enough to help them get pregnant.

At The Evewell we pride ourselves on identifying the root cause and reason why you can’t get pregnant, often making recommendations for the least invasive treatment to achieve a successful pregnancy.

How does IVF help PCOS?

If you are unable to get pregnant after making lifestyle changes, your doctor may recommend ovulation induction (IUI), if sperm function is normal often a cause of not conceiving is simply not ovulating, or IVF.

Women with PCOS undergoing IVF are at significant risk of ovarian hyperstimulation syndrome but we will take all the necessary measures for this to be avoided. 

How can The Evewell help me get pregnant with PCOS?

Here at The Evewell, not only are our fertility consultants also gynaecologists, with specialised interests in providing holistic female healthcare, but we are also leading the way in new endoscopic techniques for the treatment of ovarian cysts. 

We offer a comprehensive and state-of-the-art fertility service enabling us to design an individualised care plan to reduce the effects of polycystic ovary syndrome. Our team of experts have a wealth of experience in PCOS treatment, for women who desire to become pregnant now and in the future.