How Polycystic Ovary Syndrome Affects Fertility

An estimated 6.6% of women in the United States have polycystic ovary syndrome (PCOS), one of the leading causes of female infertility. However, most women remain unaware they have this disorder until they try to get pregnant, making early treatment rare.

While PCOS can make it more difficult to get pregnant, if you have the condition, there are several treatment options available to help you restore your fertility and increase your chances of getting pregnant.

Dr. Michelle Starke, at The Center for Gynecology & Restorative Medicine in Coral Gables, Florida, is experienced at diagnosing and treating polycystic ovary syndrome and helping couples overcome issues of infertility. Dr. Starke and her team work closely with you to help you better understand how PCOS can affect your fertility.

Here is some basic information to get you started.

What is polycystic ovary syndrome?

Polycystic ovary syndrome has a wide range of symptoms and can be difficult to diagnose. Despite its name, not everyone who has it actually has cysts on their ovaries. However, you will be more likely to develop fluid-filled pustules on your ovaries as one of the symptoms of PCOS. These can be detected through either a manual exam or a sonogram.

Another important symptom of polycystic ovary syndrome is high levels of male hormones, called androgens, which can be detected with a blood test. The higher level of androgens often causes the more noticeable symptoms of weight gain and unwanted hair growth that accompany PCOS.

Other symptoms include irregular, skipped, or long and painful periods. It can be helpful to track your periods with a diary or period-tracking app on your smartphone to determine whether your periods are irregular.

If Dr. Starke suspects that you may have polycystic ovary syndrome, she will take your history, perform a physical exam, and order blood tests to confirm the diagnosis and help decide on the best course of treatment.

Three ways polycystic ovary syndrome affects fertility

Polycystic ovary syndrome interferes with your fertility in several ways, often making a multi-pronged approach in treatment necessary. These are three of the primary ways PCOS affects fertility:

1. High androgen levels prevent the release of an egg

This is the most common reason women with PCOS cannot get pregnant. Their ovaries simply do not release eggs. This can be due to androgens preventing the maturation and release of an egg or due to fluid buildup preventing the physical release of an egg.  

2. Low progesterone levels prevent implantation of an egg

With high androgen levels, you may have low progesterone levels. This can prevent your uterine lining from maturing, which means that if you are able to release an egg, it will not be able to implant in your uterus for a successful pregnancy.

3. Released eggs are damaged

Occasionally, an egg may be released but due to your hormonal imbalance, it may be damaged and unable to begin a pregnancy.

Your fertility with and without treatment

If you have polycystic ovary syndrome, you may still be able to get pregnant. Often, lifestyle changes including weight loss, exercise, and a reduction in smoking or drinking alcohol can help restore your hormone balance. In a recent study, nine of 11 women with PCOS who lost weight had a restored period, and five of those women became pregnant.

For some women, however, lifestyle changes on their own are not enough to restore fertility. In these cases, oral medication to induce ovulation or surgical interventions allow around 70% of women to get pregnant.

Finally, in vitro fertilization may present a way to achieve a healthy pregnancy. Depending on your age, health, weight, and medical history, Dr. Starke may suggest either a more natural or a more aggressive treatment plan to give you the best chance at becoming pregnant.

If you think you may have polycystic ovary syndrome or you’re having difficulty conceiving, make an appointment with Dr. Starke as soon as possible. Early diagnosis and treatment can increase your chances of becoming pregnant.

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