This article was contributed by the team at Fertility Family, offering advice on conception for those affected by PCOS
Polycystic ovary syndrome (PCOS) is very common, affecting 5-10% of women. The exact cause of PCOS is unknown, but it’s thought to be related to abnormal hormone levels and is often associated with insulin resistance. The presentation of the syndrome varies widely.
Some women may not be having a period and not ovulating or if they are ovulating, the quality of the egg and/or the endometrium may not be optimal. It is no surprise that many women with PCOS struggle to get pregnant.
Understand your menstrual cycle
If you are having periods, you can begin to understand when you’re ovulating and where your fertile window falls, so that you know when those few days in the month to try for a baby. Some women notice an ‘ovulation pain’ around mid-cycle and cervical mucus changes to become stretchy and clear. Using ovulation test kits to find out when the LH surge is happening will help pinpoint ovulation. These kits can be bought from your local pharmacy and work in a similar way to a pregnancy test. Make a note of when you ovulate each month so that you can find out how regular your ovulation is. If you find that you are not ovulating, book an appointment to see your doctor. It is important to seek medical advice of you have been trying to conceive for over one year.
If you are not ovulating/not having periods
Medications can be prescribed by your doctor that can induce ovulation, such as letrozole and Clomid (clomiphene). Metformin can be prescribed to improve the response to insulin resistance, best alongside exercise and a balanced diet. However, these medications do have side effects and potential risks; your doctor can give you more information.
Follow an anti-inflammatory and lower calorie diet
Diet plays a big part in fertility and with PCOS symptoms. Often women with PCOS have a tendency to put on weight. This in turn may exacerbate the hormonal imbalance (excess androgens) that occurs in PCOS. Women with PCOS can experience higher inflammation due to higher androgens which in turn encourage more insulin production. Higher insulin levels contribute to weight gain which only causes more inflammation — a vicious circle!
An anti-inflammatory (or ‘mediterranean) diet will nourish and heal your body by helping balance your hormones and blood sugar and help you to lose weight if needed. An anti-inflammatory diet amy include:
- Eating omega-3 rich fish several times a week (salmon or tuna for example)
- Reducing red meat
- Eating plenty of fruit and vegetables
- Avoiding sugar
- Including beans in your diet (at least once a week)
- Swapping your daily tea or coffee for green tea
- Using herbs and spices when cooking (ginger, cumin, fennel, bay leaves etc)
- Consuming unsaturated sources of fat (such as nuts, seeds, olive oil)
Reduce insulin resistance
Around 65-80% of PCOS women have problems with insulin resistance, which means that your blood sugar levels are elevated, as is your insulin level, this affects your hormone production and reduces your chance of conceiving. In the first instance, try cutting out sugar and refined carbs from your diet and making sure you get enough protein, fibre and healthy fats to help reduce your blood sugar and insulin levels. Myo-inositol has been proven effective in treating insulin resistance in some PCOS women, so it is worth trying this. Doctors may prescribe Metformin to help, although there are some undesirable side effects to consider.
Consider the right supplementation
In order to get pregnant with PCOS you need to ovulate with good quality eggs.
Women with PCOS who are not ovulating may consider 4000mg of myo-inositol per day, however, it is important to know that around 40% of women with PCOS cannot absorb myo-inositol effectively. Try to choose a myo-inositol supplement with alpha-lactalbumin; this helps reduce the inflammation associated with PCOS, increase the absorption of myo-inositol, and facilitate the release of melatonin which has been shown to be good for egg quality. Even if this does not result in success, it can help with egg quality should you need fertility treatment with ovulation induction using injectable hormones or even IVF.
Don’t forget about sperm
Regardless of PCOS, successful conception whether naturally of by IVF requires good quality sperm. There are various steps that can be taken to optimise sperm function or prevent damage to sperm.
And lastly but most importantly… De-stress
Your fertility depends on balanced hormones and nurtured adrenals, but the stress hormone, cortisol, produced by your adrenal glands affects all your hormones. So by actively reducing and preventing any stress you can increase your chances of getting pregnant. Try meditation, massage, yoga, exercise, spending time with animals or socialising — whatever makes you happy!
