Polycystic ovarian syndrome (PCOS) is one of the most commonly diagnosed endocrine disorders in women of child-bearing years. PCOS can present with several different symptoms and unfortunately can make it more difficult to conceive. As it is a syndrome to be diagnosed, you need to present with two of the following three criteria:
- Irregular, heavy or absent menses (period) indicating that regular ovulation isn’t occurring.
- Cystic activity on their ovaries – seen with transvaginal ultrasound at least 12 developing follicles on each ovary
- Elevated androgens – higher levels of male hormones for example testosterone
If you meet these criteria, then often PCOS is confirmed.
Can You Get Pregnant with PCOS?
The answer to this question is a resounding yes!
Are there things you can do to improve your chances of a successful outcome? Again, the answer is yes!
There are a few different areas we can focus on to improve the chance of conception.
We want to work on:
- Regulating ovulation
- Improving egg quality
- Reducing elevated androgens
- Addressing potential concerns with blood sugars and cortisol
- Maintaining a healthy weight
One of the concerns that occurs in women with PCOS is the development of many follicles (eggs) that don’t reach maturity - therefore don’t ovulate or won’t be able to develop into a healthy embryo. This is caused by the imbalance of testosterone and estrogen. There are estrogen receptors on developing eggs that stimulate growth. If there is too much testosterone this process can be blocked resulting in immature eggs.
There is a nutrient called myo-inositol that has some great research supporting several areas of PCOS. One of the ways it works is by making hormone receptors more sensitive so that circulating hormones can bind to them. This in turn helps the hormonal signaling cascade regain balance. With myo-inositol we can see changes such as testosterone lowering, regular ovulation, improved blood sugar regulation and improvements in egg development in terms of size and quality.
Exercise is also an amazing way to help support regulating ovulation, blood sugars, cortisol and healthy weight. Exercise can mean a variety of different things depending on your baseline health. The most important part is to move your body everyday. This could be walking, dancing in your living room, weights at the gym or anything you enjoy that moves your body. Doing something for at least 20 minutes a day can have a huge impact on symptoms that you might be experiencing. One of the important things to watch for is how you feel after you finish exercising. If you feel invigorated and have good energy the rest of the day, then that exercise is great for you. If, however, after you finish you are exhausted and feel like you need a nap – then that particular exercise is too much for you and you should choose something lower intensity.
Your diet also plays an extremely important role when it comes to helping regulate blood sugars as well as other hormones in your body. There is no one size fits all diet for PCOS but, generally speaking, following a Mediterranean style of eating has the best research when it comes to fertility. This would include eating 7-10 servings a day of fruits and vegetables, eating good amounts of lean proteins such as fish, chicken, turkey or vegetarian protein sources such as beans, lentils and soy and some healthy fats, such as olive oil and avocado.
Protein consumption is especially important with PCOS as protein will help you feel more satiated and slow the release of sugars into the blood stream. For most women with PCOS I recommend somewhere between 80-100g of protein per day and see great results with this. You also want to focus on limiting your refined sugars. These are sugars or foods made from white flour such as muffins, cookies, candy, cakes etc. When you eat these types of foods your pancreas responds by secreting a hormone called insulin. Insulin moves sugars out of your blood stream into your cells but oftentimes women with PCOS secrete more insulin then average to have this system work properly. Insulin, unfortunately, is also very inflammatory. We know that inflammation can impact both egg quality and implantation. Therefore, the less insulin you need to secrete, the better you will be.
PCOS is a syndrome - meaning symptoms can improve, along with being responsive to diet and lifestyle changes. There is significant research on several different supplements as well as on myo-inositol which was discussed above. If you have been diagnosed or think you may have PCOS please reach out to your health professional or a Naturopathic doctor who focuses on hormonal health, to help you navigate which interventions are going to be the best for you. In the meantime, implementing ideas discussed here will start you on the path to improving both your fertility and your overall health.