Does polycystic ovary syndrome affect fertility?

Kelly Brier San Miguel, MD

Obstetrics and Gynecology

Polycystic ovary syndrome (PCOS) is more common than it sounds, and many women don’t even know they have it until they start trying to become pregnant.

OB/GYN specialist Kelly Brier San Miguel, MD, explained what to do if you show symptoms of PCOS and how this condition can affect your health and future fertility.

What causes PCOS?

“Polycystic ovary syndrome, usually referred to by the acronym PCOS, isn’t exactly a disease, it’s classified as a disorder,” said Dr. San Miguel. “It’s a hormonal condition that occurs primarily during the childbearing years.”

The cause of PCOS is not known. However, PCOS may be related to multiple internal factors working together that can cause other medical conditions as well, like insulin resistance.

What are the common signs and symptoms of PCOS?

“The most common symptom of PCOS is irregular menstrual periods,” said Dr. San Miguel. “This might mean not getting your period at all, having your period infrequently or far too frequently, or periods that come at their regular time but are unusually and consistently heavy.”

Other common signs of polycystic ovary syndrome include:

• Excess hair growth on the face, chest, abdomen or upper thighs, related to higher-than-normal levels of androgens, hormones that promote hair growth among other things.
• Severe acne or acne that doesn’t respond to treatment.
• Development of patches of thickened, darkened skin that has a velvety texture. This condition, called acanthosis nigricans, is a sign that the body is not responding to insulin and immediate medical care should be sought.
• Multiple small fluid-filled sacs in the ovaries, called cysts (the condition’s namesake symptom).
• Obesity or rapid weight gain.
• Infertility, as someone with PCOS may not ovulate at all, or may ovulate infrequently.
• Multiple miscarriages.

Does having PCOS cause other health risks?

“Polycystic ovary syndrome doesn’t just affect the reproductive system,” said Dr. San Miguel. “The condition affects the entire body, and it can have lifelong consequences far beyond fertility.”

Insulin resistance increases your risk of developing Type 2 diabetes and cardiovascular disease, which can both become severe if they go without regular treatment. Those with PCOS also have an increased risk of metabolic syndrome (a cluster of conditions that occur together and increase your risk of Type 2 diabetes, cardiovascular disease and stroke), as well as sleep-disrupting disorders like sleep apnea.

There is also an increased risk of endometrial hyperplasia, a condition where the lining of the uterus becomes too thick, which can then lead to an increased risk of endometrial cancer.

“Every affect from PCOS has the potential to cause more problems throughout the body,” said Dr. San Miguel. “Schedule an appointment with your gynecologist if you show any symptoms or suspect you might be struggling with PCOS.”

How is PCOS treated?

“There’s no magic treatment that fixes everything,” said Dr. San Miguel. “The treatments we use address the problems caused by PCOS and are personalized to every patient – we take into account symptoms, other existing health problems and whether or not the patient wants to get pregnant.”

For those who are obese or overweight, weight loss alone can help to regulate the menstrual cycle. Weight loss can also help to improve cholesterol and insulin levels, which can minimize or do away with excess hair growth and acne.

Another potential treatment involved combined hormonal birth control pills, best for those who do not want to become pregnant. Hormonal birth control helps to regulate the menstrual cycle and balance the hormonal imbalance causing acne and excess hair growth. Use of hormonal birth control also decreases the risk of developing endometrial cancer.

Birth control does carry its own risks, however, so be sure to speak with your doctor to find out if hormonal birth control would be an effective treatment for PCOS for you.

Can you still get pregnant with PCOS?

“Polycystic ovary syndrome can make it more difficult to become pregnant, but we can work toward successful ovulation, the first step to a successful pregnancy,” said Dr. San Miguel.

For some, weight loss may accomplish this goal. For others, medications can be used to cause ovulation.