PCOS: How does it impact women’s fertility – Health shots


Polycystic ovary syndrome (PCOS) is a hormonal disorder that presents itself in different ways among women of reproductive age and can have a serious impact on health if not treated in time. Obesity due to an unhealthy diet and lack of exercise, family history, and insulin resistance are the major causes of PCOS. It is triggered by hormonal imbalance and manifests itself with infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. It often leads to the ovaries developing numerous small collections of fluid (follicles), which results in a failure to regularly release eggs. That’s why pregnancy in women with PCOS is tough.
The syndrome may lead to excessive hair growth, baldness, weight gain, Type-II diabetes, heart disease, high blood pressure, and stroke. An estimated 20 percent of Indian women suffer from PCOS. If not treated in time, PCOS can seriously impact health. Let’s talk about fertility and understand how PCOS can affect fertility in a woman.
Due to its link with infertility, PCOS has been a topic not widely spoken about widely until recently. It triggers changes in the ovaries, which become larger and may also develop numerous fluid-filled sacs called cysts inside. These sacs are follicles that contain an immature egg each. Both of these cause the body to produce a higher level of androgen. Due to the higher level of androgens, the eggs don’t mature enough to trigger ovulation, leading to the absence of periods. PCOS prevents the regular release of a mature egg, which makes it difficult for women with the syndrome to conceive.
PCOS can lead to several complications during pregnancy. Among them is preeclampsia, a dangerous condition marked by a sudden onset of high blood pressure, usually after the 20th week of pregnancy. This condition has a chain reaction and affects organs like the kidney and liver. If left untreated, the condition known as preeclampsia can also lead to death. There is also a higher likelihood of miscarriage.
Recent studies show that women with PCOS are three times more susceptible to miscarriage than their healthier counterparts. Excess androgens may be a reason for this. In addition to this, high insulin levels can also damage the uterus, leading to an early loss of pregnancy.
The risk of diabetes increases with pregnancy in women with PCOS. Though gestational diabetes is treatable, high insulin levels may continue after pregnancy due to PCOS. In extreme cases, uncontrolled gestational diabetes can even lead to stillbirth.
A rising number of teenagers now suffer from PCOS. Missing menstrual periods or having irregular periods may be the first signs of PCOS. Those affected by it need to get a proper diagnosis, which can make a big difference in the treatment and help cope with and manage PCOS in a better way. A timely and thorough diagnosis also helps women to tackle the issue in a healthier manner and to remain mentally and emotionally stable.
In the case of early signs of PCOS, teenagers can consult a doctor and start treatment early to regularize the menstrual cycle, which will eventually help them later in life with pregnancy. In the case of overweight conditions, weight loss can reduce insulin and androgen levels and may restore ovulation. PCOS can also be controlled with high-intensity interval training (HIIT), pilates, resistance training/weight training, aerobics, and a balanced diet of low-carbohydrate, high-protein.
Dr Aastha Gupta, Obstetrician-Gynecologists, Infertility/IVF Consultant, and Adv.Gynae Endoscopy Surgeon, Delhi IVF and Fertility Research Centre
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