PCOS and Fertility

At London Women's Clinic, we understand the challenges and complexities that PCOS can present when it comes to achieving a successful pregnancy. Here, we will delve into the relationship between fertility and PCOS, exploring the available treatment options and the support we provide to help women with PCOS on their journey to parenthood.

What is PCOS?

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women of reproductive age, affecting approximately in one in seven women, although the worldwide prevalence of PCOS ranges from 4-21%, depending on the diagnostic criteria used.

The term Polycystic Ovary Syndrome is actually a misleading term and is currently being reviewed by experts, as there are no cysts in the ovaries requiring surgical removal.

At London Women's Clinic, we understand the challenges and complexities that PCOS can present when it comes to achieving a successful pregnancy. In this article, we will delve into the relationship between fertility and PCOS, exploring the available treatment options and the support we provide to help women with PCOS on their journey to parenthood.

Common symptoms of PCOS

The development of PCOS is influenced by genetic, hormonal, and environmental factors, and has a broad spectrum of clinical presentations, which may include:

• menstrual disorders with sparse but heavy periods due to thickened lining of the womb or occasionally lack of spontaneous menstruation
• obesity
• Increased facial or body hair caused by a hormonal imbalance of excess androgen (male hormone)
• acne prone oily skin
• fertility issues due to lack of regular ovulation

Not all women who suffer from PCOS are overweight, and some can belong to the ‘lean PCOS’ category. There may be associated metabolic disorders caused by excess of the androgens, as well as Insulin resistance resulting in Type 2 Diabetes, coronary heart disease and increased risk of pregnancy complications such as Diabetes in pregnancy (gestational diabetes) and adverse pregnancy outcomes such as miscarriages.

PCOS and fertility issues

Approximately two thirds of women with PCOS will have irregular or no ovulation – dysfunctional ovulation - and will likely require fertility treatment if trying to conceive..

Many women check for ovulation at home when trying for a baby naturally using the urine dipsticks available commercially, which quite reliably reflect the preovulatory Luteinising Hormone surge. But this hormone peak may not happen in dysfunctional ovulation due to PCOS, when the ovaries fail to release eggs regularly or at all. This is why, without ovulation, the chances of conception naturally decrease.

Your GP may offer a blood test called Serum Progesterone at a certain time of your menstrual cycle to confirm ovulation, or lack of it.

The good news in PCOS is that women have high egg reserve, i.e. the ovaries are replete with high numbers of dormant eggs, which are waiting to be used during fertility treatment!

Our dedicated team will assess your individual situation, provide a thorough evaluation, and discuss the most suitable treatment options available to you.

How can we help you at London Women’s Clinic

While PCOS may present challenges to fertility, it's important to remember that many women with PCOS can still conceive and have healthy pregnancies. We specialize in providing personalised fertility treatment options tailored to your specific needs.

Lifestyle Modifications: Our experts will give you appropriate advice about lifestyle changes and weight management, which can sometimes help in spontaneous resumption of ovulatory cycles. These may include adopting a healthy diet, regular exercise, and managing stress levels.

Ovulation Induction: Stimulating the ovaries with medication to promote regular ovulation is usually offered to women with PCOS who are trying to conceive, if there are no other fertility issues. Medications such as clomiphene citrate or letrozole are often used as first line to help induce ovulation .The goal of ovulation induction is the development of a single ovulatory follicle and the avoidance of a multiple gestation. Therefore, during ovulation induction, ultrasound scans are carried out to monitor the developing follicles in your ovaries leading to ovulation.

If oral medications are not effective, hormonal injections (gonadotrophins) are sometimes used to induce ovulation, along with close ultrasound monitoring. This is usually second line treatment for ovulation induction.

Intrauterine Insemination (IUI): IUI involves the introduction of prepared sperm into the uterus during ovulation, increasing chances of fertilization. This procedure is provided alongside ovulation induction, as our data and research studies show that it is more effective in achieving a live birth, in comparison to ovulation induction on its own.

In vitro Fertilization (IVF): For women with PCOS who are unresponsive to or have no success with ovulation induction treatment, or have additional indications, IVF may be recommended. IVF involves ovarian stimulation with hormonal injections for a few days along with ultrasound scan monitoring, retrieval of the mature eggs from the ovaries and fertilization in the laboratory using the partner’s sperm or donor sperm, and transferring the best embryo into the uterus to achieve a pregnancy. Some women with PCOS may be at greater risk of over responding to hormonal treatment, leading to a clinical scenario called ‘Ovarian Hyper Stimulation Syndrome’ (OHSS). At London Women’s Clinic we tailor your treatment protocol to your clinical parameters and closely monitor you to prevent this condition, which is therefore rare

Extra medication: Your doctor may sometimes prescribe additional medication such as Metformin or Myo Inositol, which can improve insulin resistance in PCOS and may help any metabolic dysfunction. There is evidence that Metformin therapy during IVF treatment in PCOS can reduce the risk of developing OHSS and prevent miscarriages in pregnancy.

Support and Guidance at London Women's Clinic

At London Women's Clinic, we understand that PCOS can be a challenging condition to navigate, both emotionally and physically. Our team of experienced fertility specialists, nurses, and counsellors are here to provide empathetic care, guidance, and support throughout your fertility journey. We believe in a holistic approach to fertility treatment, ensuring that you have access to the latest advancements in reproductive medicine and personalized care that addresses your unique needs.

Our state-of-the-art facilities, cutting-edge technologies, and a comprehensive range of fertility treatments make us a leading choice for women with PCOS seeking to achieve their dream of starting or expanding their family.

Take the First Step Towards Parenthood

If you have been diagnosed with PCOS and are concerned about your fertility, we encourage you to schedule a MOT at London Women's Clinic.

Our dedicated team will assess your individual situation, provide a thorough evaluation, and discuss the most suitable treatment options available to you. With our expertise and support, we are committed to helping you navigate the challenges of PCOS and increase your chances of successful conception