Polycystic ovarian syndrome (PCOS) is a complex hormonal condition that is characterised by long-term absence of ovulation. The typical signs of PCOS include irregular menstrual cycles, excessive hair growth (hirsutism), and weight gain. It can have a significant impact on fertility due to various hormonal imbalances and associated symptoms.
Infertility is most frequently caused by Polycystic Ovary Syndrome (PCOS), which is the most prevalent hormonal disorder afflicting women, according to the Ministry of Science & Technology (https://pib.gov.in/). It has a global prevalence ranging from 6-26%, whereas in India it affects 3.7-22.5% of women.
If we see other stats & facts from WHO (World Health Organization),
- Polycystic ovarian syndrome (PCOS) impacts around 8-13% of women in their reproductive years.
- Worldwide, a significant proportion of women, up to 70%, go untreated.
- Polycystic ovary syndrome (PCOS) is the most prevalent reason for anovulation, which is the absence of ovulation, and is a primary contributor to infertility.
Here’s how PCOS affects fertility in women, explained by Dr. Puneet Rana Arora, a renowned IVF expert at CIFAR Fertility Centre in Gurgaon.
Menstrual irregularities :
Menstrual irregularities are common in women with PCOS, including irregular cycles or the complete absence of periods (amenorrhoea). Anovulation or irregular ovulation hinders conception by causing unpredictable release of eggs required for fertilisation.
Ovulation Problems:
Polycystic Ovary Syndrome (PCOS) often leads to anovulation, a condition when the ovaries do not release eggs on a regular basis. Irregular ovulation can result in infertility since it prevents the release of eggs necessary for fertilisation.
Hormonal Imbalances:
PCOS is distinguished by heightened amounts of androgens (male hormones) like testosterone, which can disrupt regular ovulation. Elevated insulin levels can also disturb the equilibrium of hormones, hence contributing to problems with fertility.
Ovarian Cysts:
Although not all women with Polycystic Ovary Syndrome (PCOS) experience the formation of ovarian cysts, some may develop numerous tiny cysts on their ovaries. These cysts are basically multiple small antral follicles, which have the potential to impact hormone synthesis and interfere with the process of ovulation.
Endometrial alterations:
Women with Polycystic Ovary Syndrome (PCOS) may have irregularities in the uterine lining (endometrium), which might impact the successful attachment of a fertilised egg. This can reduce the likelihood of a successful pregnancy.
Increased Risk of Miscarriage:
Those diagnosed with Polycystic Ovary Syndrome (PCOS) are at an elevated risk of experiencing a miscarriage in comparison to those who do not have this disorder. PCOS might elevate the risk of pregnancy loss due to hormonal abnormalities and other related issues.
Additional Factors:
Polycystic ovary syndrome (PCOS) is frequently linked to other medical conditions including obesity, insulin resistance, and metabolic syndrome, which might exacerbate difficulties in achieving pregnancy. These disorders have the potential to impact the levels of reproductive hormones and the general health of the reproductive system.
What do you need to do in the case of PCOS conditions?
It’s important to remember that while PCOS can significantly impact fertility, many women with the condition are able to conceive with appropriate medical treatment.
At CIFAR Fertility Centre, Dr. Puneet Rana Arora provides fertility treatments such as ovulation induction medications, assisted reproductive technologies (ART) like in vitro fertilisation (IVF), and lifestyle changes such as weight management and diet modifications that can help improve fertility outcomes for women with PCOS.
Conclusion:
Dr. Puneet suggests that every woman who is suffering from PCOS and who is trying to conceive work closely with their healthcare providers to develop a personalised treatment plan.