PCOS: precautionary steps to be taken before pregnancy in PCOS
What are the precautionary steps to be taken before pregnancy in PCOS?
A woman always desires to have children. But women who are suffering from chronic health problems such as polycystic ovary syndrome (PCOS) usually have fear regarding conceiving a baby, including the fear of not getting pregnant.
Polycystic ovary syndrome (PCOS) is a complicated hormonal ailment that affects up to one in five females of reproductive age. Women with PCOS suffer from two major hormonal problems: there is a significant increase in the level of luteinizing hormone (a hormone that stimulates ovulation in females and the synthesis of androgen in males), and a significant decrease in the level of follicle replicating hormone (a hormone that promotes the formation of ova or sperm), which is majorly important for growth in teenagers. Women with PCOS produce fewer estrogens (“female” hormones) and produces extra androgens (“male” hormones). This forms minor cysts which appear in the ovaries.
Because of the hormonal imbalances, women with PCOS usually have irregular menstrual cycles. Therefore, women with PCOS have trouble conceiving a baby. They usually take longer to get pregnant and are expected to be more in need of fertility treatment than women who don’t have PCOS.
How to increase the chance of pregnancy for women with PCOS?
For all women, being in the best conceivable health before getting pregnant increases the chance of pregnancy. This also helps in ensuring the good health of the baby in most cases. According to the international guidelines, following a healthy lifestyle – which includes being in the healthy weight range, not smoking, avoiding alcohol, consuming a healthy diet, doing regular exercise and getting enough sleep – is the first step to improve the chances of getting pregnant and having a healthy baby for a woman with PCOS.
For women with PCOS who are obese or overweight, a certain reduction in weight periodically can result in regular ovulation, which increases the chances of pregnancy. For those women who know that they ovulate regularly, having intercourse during the “fertile window” boosts the chance of conception. Overall, women with PCOS have a similar number of chances of getting pregnant as women without PCOS.
Treatments for women with PCOS:
If you have tried to conceive a baby for 12 months without positive results, it is high time to seek medical guidance. If you have irregular or erratic periods, this is an indication that you are not ovulating or releasing an egg and need medical assistance to conceive a baby. The first step of medical treatment is ovulation initiation. This includes several doses of tablets or boosters to rouse the ovaries to produce an egg that can be fertilized, maybe during intercourse or through intrauterine insemination (IUI).
A woman can get pregnant only 2 days a month, and that is the time when a woman ovulates. Women who get their periods regularly have the chance of getting pregnant once every month. But for women whose periods are irregular, for example, once every three months, their chances of pregnancy are reduced. She can only produce the egg once every three months. Therefore, if you compare a woman who gets regular periods (she releases an egg every month that is 12 times a year), and a woman with PCOS who gets periods every three months, you will find that her chances of pregnancy are much lesser as she releases eggs only 4 times a year. So, the more erratic the period, the lesser are the chances of getting pregnant.
The chances of getting pregnant depend on the kind of problems faced by a woman with PCOS, be it erratic periods, an increase in male hormone, or other such problems. One of the major problems for women with PCOS is insulin resistance. In this condition, the insulin in the body is less able to regulate the sugar levels. As a result, the body keeps secreting more and more insulin to combat the level of sugar. The presence of high levels of insulin in the body is also a reason why a woman with PCOS cannot get pregnant easily. So, there are various hormonal issues and issues related to the release of the egg which can be a problem for a woman with PCOS.
In a year, on an average 85% of the women who do not use contraceptives get pregnant, and only 15% of the women are left without getting pregnant. That is because they have issues with infertility. For that 15 %, it is always recommended to see a doctor so that the problem can be curated.
Women with PCOS who have irregular periods face the problem of infertility due to the following reasons:
- High androgen levels
- Insulin resistance (leading to obesity)
- Hormonal dysfunction
Women facing the above difficulties are always suggested to see a doctor and get the issues corrected. But after doing so, a woman can still have irregular periods. In that case, oral medications can help a woman get pregnant. In extreme conditions where oral medications don’t help, the next step is to give injectable hormones to make a woman ovulate and get pregnant. And even after that if a woman does not conceive because of various factors then only assisted reproduction or IVF is suggested.
IVF comprises a sequence of injections to rouse the ovaries to release multiple eggs. When they mature, the eggs are retained in an ultrasound-guided technique under light anesthetic. Sperm is combined with the eggs in the lab for embryos to formulate.
After a few days, an embryo is placed in the uterus where it can be implanted and then it can further grow into a baby. If there is more than one embryo, these can be feezed for later use if there is no pregnancy. While IVF is considered to be safe in the hands of experts, there are some projectable health issues to be wary of, including ovarian hyperstimulation syndrome. This is an over-response to the fertility treatments that are performed to rouse the ovaries to release multiple eggs. This can be the main cause of abdominal pain, nausea and vomiting, quick weight gain and blood clots.
Lastly PCOS women have the best success rates in pregnancy which can be achieved only through timely diagnoses and treatment.