Sex & fertility

PCOS and fertility — Answers to your most important questions

by Marcelle Pick, OB/GYN NP & Marcy Homes, NP

• How does PCOS influence my fertility?
• If I have PCOS, what will increase my chances of getting pregnant?

“If I have PCOS, can I still get pregnant?” We hear this question all the time from women who have just learned they have polycystic ovarian syndrome (PCOS). And the answer is yes. Even though PCOS is the most common type of female endocrine (hormone) disorder and one of the leading causes of female infertility, there is certainly hope for women with PCOS.

At Women to Women, we have seen many women with this form of hormonal imbalance improve their fertility — and go on to experience healthy pregnancy!

Let’s look at some of the most common questions we hear about the effects of PCOS on fertility, and how a natural approach like ours can help.

How does PCOS influence my fertility?

When you have PCOS, it alters the hormonal mechanisms in your body that produce eggs and prepare the uterus for pregnancy. Here are the three most basic reasons why becoming pregnant, or staying pregnant may be more challenging for women with PCOS:

• Women with PCOS may not ovulate at all.
• Women with PCOS may have irregular periods rather than “textbook” monthly cycles with more predictable windows of fertility.
• When and if an egg is released, the endometrium (lining of the uterus) may not be able to support implantation and sustain pregnancy.

If you’d like to know more about the causes of PCOS, see our article on causes and symptoms of PCOS. The good news is that complicated hormonal imbalances can often be managed to increase your chances of conception.

If I have PCOS, how can I increase my chances of getting pregnant naturally?

There are a variety of treatment options — including both conventional and natural measures — that can tip the hormonal scales back toward normal and increase the potential for pregnancy.

At Women to Women, we have found that nutritional and lifestyle changes are almost universally necessary for women with PCOS who would like to have regular menstrual cycles and go on to become pregnant. Our approach includes the following natural measures:

• Follow a low-glycemic load diet. Long experience has taught us that this step is essential to limit insulin resistance, balance sex hormones, and increase fertility. By “low-glycemic load,” we suggest limiting carb intake to 16 g of complex carbs per meal, and 7 g per snack. But if you are very active or in a healthy weight range, you may need more carbohydrates. To keep the glycemic load down, pair your carbohydrates with fiber, protein, and/or healthy fats. We suggest eliminating all high-fructose syrups, sugar, white flour, white rice, white potatoes, and other highly processed, refined sugars and starches.

  The careful limitation of refined carbohydrates is so helpful to fertility because it reduces your insulin resistance, decreases androgens, and results in more regular ovulation. This is essentially what the insulin-sensitizing drug metformin accomplishes, too — the difference is that our approach does this naturally. For an in-depth explanation of how all this works, see our article on natural solutions for PCOS.

• Maintain a healthy weight and stay physically active. Any form of regular exercise will help reduce insulin resistance, as well as create a circle of positive influences on your mood, sleep, and stress levels. Exercise will also help you to maintain a healthy weight. Obesity is a problem for 35–60% of women with PCOS. A high waist/hip ratio is linked with the characteristic high insulin, androgen, and estrogen levels that disrupt normal ovulation and fertility. Even losing just 5% of your “extra padding” can lead to more regular menstrual cycles and ovulation. The carb-limited diet we outlined above can help you reach a healthy weight.

• Restore balance with nutritional and herbal support. If you can’t always eat perfectly, you may benefit from a pharmaceutical-grade multivitamin–mineral complex rich in antioxidants. Other micronutrients shown to help offset insulin resistance include vitamins B3 (niacin), B6, B9 (folic acid), B12, C, D and E; and the minerals vanadium, chromium, magnesium, and manganese. Taking a daily omega-3 supplement will help you counterbalance the systemic inflammation that often accompanies insulin resistance.

  For gentle endocrine support, helpful herbs include chasteberry, raspberry leaf, kudzu, red clover, and milk thistle, as well as traditional adaptogens such as ashwagandha. (The set of formulations we use in our Personal Program for Hormonal Imbalance contain these beneficial factors.)



• Reduce stress and create emotional health and well-being. It’s often overlooked that women with PCOS report higher-than-average rates of anxiety, and those who experience difficulty conceiving also report higher rates of depression. On-line and in-person support groups for women with PCOS exist, and we recommend you find one that suits you. We also suggest visiting web sites such as PCOS Diva, PCOS Challenge, and InCyst on the Best!, which offer information, support, suggestions, and tips for women with PCOS, whether you’re trying to conceive or not.

• Detoxify. Closely following our Nutritional and Lifestyle Guidelines will not only help with insulin regulation, but will promote optimal metabolism (detoxification) of sex hormones, too. You may also want to check your environment for the presence of endocrine-disrupting agents. For example, the ovaries have been shown to be sensitive to bisphenol A (BPA), a widespread industrial chemical found in polycarbonate plastics. One easy way to reduce your exposure to this and similar chemicals is to switch from plastic food and beverage containers to glass, ceramics, and stainless steel.

We can’t emphasize enough how important dietary changes can be. For most women we see at the clinic, eating low carb is the single most helpful piece of the puzzle. And we’ve had great success in helping women improve their chances of pregnancy just by using these steps.

In recent years there also have been many advances made in reproductive technology for women with PCOS. You can discuss your fertility treatment options with your practitioner or a qualified fertility specialist. But again, in over 25+ years, we have found that a woman’s fertility treatment outcome is brightest when she first makes the above-recommended changes to restore hormonal balance.

Yes, you can you heal your PCOS!

We often tell women to try all of the natural nutrition and lifestyle measures outlined above to support their body’s fertility for a period of at least four to six months. In our experience, this time period is necessary to address many issues with hormonal imbalance — by which point you may have commenced more regular periods, and can begin thinking about the next step in your journey to motherhood.

Related to this article:

References & further reading on PCOS and fertility

 

Last Modified Date: 11/10/2011
Principal Author: Marcelle Pick, OB/GYN NP & Marcy Homes, NP