Many women quickly assume that PCOS and infertility go hand-in-hand. According to the Centers for Disease Control and Prevention (CDC), PCOS impacts about 6% to 12% of women and is actually one of the most common reasons for female infertility.
However, IVF offers women with PCOS an opportunity to expand their family and achieve their baby dreams, despite their diagnosis. So, what is PCOS? How does it impact fertility? In this article, we’re going to explore PCOS and infertility, as well as the IVF process for women diagnosed with PCOS.
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder where the body produces a higher level of androgens, male sex hormones. As a result of this condition, small cysts, fluid-filled sacs, are found on the ovaries, which can cause issues with ovulation.
Other PCOS symptoms may include:
- Irregular or skipped periods
- Enlarged ovaries
- Excess body hair
- Hair thinning
- Weight gain
Surprisingly, experts aren’t entirely sure what causes PCOS. Yet, it’s theorized that genetics might play a big role since in many cases female relatives also have PCOS.
How Does PCOS Affect Fertility?
With PCOS, the hormonal imbalances often impact a woman’s ability to ovulate. If ovulation doesn’t happen, pregnancy can’t occur.
In cases where ovulation does occur, further issues might arise. These hormonal imbalances may also deter the uterine lining from developing properly, which can impact implantation of a fertilized egg. Additionally, irregular or missed periods can make getting pregnant difficult.
Yet, this doesn’t mean pregnancy is impossible with PCOS. In the following section, we’ll take a look at PCOS fertility treatments.
Fertility Treatment for PCOS – Ovulation Induction
Depending on what exactly is causing your infertility, your PCOS fertility treatment may vary. At the same time, many of these treatment methods involve using medications or synthetic hormones to stimulate ovulation, which frequently is absent or irregular in women with PCOS.
Metformin for PCOS
Surprisingly, a large majority of women with PCOS also have insulin resistance. This means your body’s cells don’t respond as well to insulin, leading to poor uptake of glucose and high blood sugar levels.
Metformin helps your body become more sensitized to insulin. Research further states that, “Metformin is an effective ovulation induction agent for non-obese women with PCOS and offers some advantages over other first-line treatments for anovulatory infertility such as clomiphene.” It’s also thought that metformin may reduce the risk of ovarian hyperstimulation syndrome, which causes the ovaries to become swollen and painful. Thus, your doctor or fertility team may prescribe metformin to address the above issues and to aid in your fertility journey.
Clomid for PCOS
For ovulation induction in PCOS, clomid blocks the estrogen receptors, which signals to the brain that estrogen levels are low. In turn, this causes the pituitary gland to increase the production of the luteinizing hormone and the follicle-stimulating hormone. These two hormones are responsible for ovulation and egg maturation, which can increase your chances of getting pregnant.
Letrozole for PCOS
Letrozole is another PCOS fertility option that can help improve your chances of conceiving. Letrozole suppresses the enzyme, aromatase, which halts estrogen production. This means, similar to clomid, that the body begins producing more of the luteinizing and follicle-stimulating hormones. These hormones, then, encourage the development of follicles and help stimulate ovulation. In fact, research indicates that clomid and letrozole produce very comparable ovulation rates. Yet, letrozole had improved pregnancy rates when compared to clomid.
Gonadotropins or Injectable Fertility Drugs for PCOS
Gonadotropins for PCOS, again, help stimulate ovulation. They help multiple eggs mature, which is ideal for IVF or IUI. Typically, injectable fertility drugs are used after oral medications, such as letrozole and clomid, have failed to work. This type of injection is also used in the IVF process and is known as a “trigger shot.”
IVF for PCOS
For PCOS, IVF, in vitro fertilization, is one of the most common fertility treatments. IVF involves combining the man’s sperm and woman’s egg in a laboratory. The embryo is, then, transferred to the woman’s uterus. According to studies, this line of treatment is frequently used when all other treatment options haven’t worked.
Fertility Treatment for PCOS – Risks and Side Effects
Most fertility treatments come with some risks and potential temporary side effects. Many fertility drugs can cause bloating, breast tenderness, headaches, mood swings, and hot flashes. In fact, these are the most common side effects of fertility treatments which are consistent with what any woman can feel at least once a month during menstruation. Less common side effects include ovarian hyperstimulation syndrome and multiple pregnancies, which we explore in more detail below.
PCOS and Ovarian Hyperstimulation Syndrome (OHSS)
OHSS happens when the ovaries become swollen and painful. Usually, OHSS involves minor symptoms, such as nausea, bloating, diarrhea, and loss of appetite. In more severe cases, someone might experience severe abdominal pain, shortness of breath, decreased urination, weight gain, and low blood pressure.
Basically, OHSS is an overstimulated response to hormones taken during fertility treatments. Typically, it happens from injectable medications. Yet, OHSS in women with PCOS is more common than in women without PCOS. At the same time, many cases are mild and only cause temporary discomfort, which usually resolves within a week or 10 days. For severe OHSS, it may take four to six weeks to fully recover.
PCOS and Multiple Pregnancies
With PCOS fertility treatment, as with any fertility treatment, multiple pregnancies are also always a risk. This can happen due to IVF if more than one embryo is transferred (which can be done to increase the odds that pregnancy will occur). Fertility medications can also increase this risk.
IVF Treatment for PCOS at Elite IVF
At ELITE IVF, our team consists of some of the top fertility specialists in the world. We are committed to creating a growing community where you get the support you need as you undergo your fertility journey. ELITE IVF has a 72% pregnancy success rate, helping countless couples grow their family. With over 17 years of experience, we understand the difficulties regarding infertility and PCOS. At the end of the day, our ultimate goal is to help each of our patients achieve their baby dreams. So, what does this look like when it comes to PCOS and IVF?
IVF Success with PCOS
Research indicates that women with PCOS experience similar IVF outcomes to women without PCOS. However, ICF success with PCOS also depends on age and other factors. For instance, with increased age, especially for women 35 and above, IVF success rates tend to decline.
The Society for Reproductive Technology (SART) indicates that for women under 35, the percentage of live births via IVF is 55.6%. It’s important to note that this statistic involves women using their own eggs as opposed to donor eggs.
IVF Protocols for PCOS
At ELITE IVF, the whole process starts with us simply listening to your needs and gaining a better understanding of your current situation. IVF protocols for women with PCOS follow similar protocols for those without PCOS.
Once we understand your specific needs, we will start the process of ovarian stimulation, which may involve prescribing progesterone, estrogen, DHEA, clomid, or letrozole. These entities help stimulate the ovaries and maturation of the follicles. From there, we perform an egg retrieval where the hormone, HCG, is injected two days prior to further trigger their maturation. The entire egg retrieval procedure only takes about 30 minutes.
In a laboratory, the egg is fertilized via the use of the man’s sperm or donor sperm. The egg is carefully monitored throughout this process. After about five days, these eggs become embryos, which are transferred into the mother’s uterus. Two weeks later, a pregnancy test is taken to confirm that implantation has taken place.
It’s important to note that it often takes about 2-3 IVF cycles for a successful pregnancy to occur. However, IVF, as previously mentioned, is a very common fertility treatment for those with PCOS.
If you’re ready to begin your fertility journey and take those first steps toward creating the family you’ve always dreamed of, contact the ELITE IVF team today. We can help you find your fertility solution.