Polycystic ovary syndrome (PCOS) is a common endocrine disorder that primarily affects women of reproductive age, with hormonal imbalances that can significantly impact fertility. As its prevalence continues to rise globally, PCOS is becoming a growing concern for women’s health. C. Let’s explore the factors contributing to PCOS and how it affects fertility.
Contributing Factors to PCOS
Dr Kshitiz Murdia, CEO and Co-founder, Indira IVF highlights that lifestyle and environmental factors play a significant role in the development and severity of PCOS. One of the most prominent risk factors is obesity, with about 50% of women diagnosed with PCOS reported to be obese. Poor dietary habits, especially those high in refined carbohydrates and sugars, contribute to weight gain, which further exacerbates the hormonal imbalances linked to PCOS. In addition, a lack of physical activity worsens weight issues and insulin resistance, which are key factors in the hormonal disruptions that characterize the condition.
Women with higher body mass indices (BMI) are more likely to experience irregular hormone levels and insulin resistance, leading to disrupted ovulation. Stress and mental health challenges such as anxiety and depression are also recognized as contributors to PCOS. Dr Murdia explains that the hormonal fluctuations typical of PCOS can create a vicious cycle where stress exacerbates these imbalances, worsening symptoms and negatively affecting quality of life.
How Does PCOS Affect Fertility?
PCOS is one of the most common causes of infertility in women, and the hormonal imbalances associated with the condition can severely disrupt normal ovulation. As Dr Murdia explains, elevated levels of androgens, such as testosterone, prevent the ovaries from releasing mature eggs, reducing the chances of conception. Many women with PCOS experience irregular menstrual cycles and anovulation (absence of ovulation), which makes it difficult to predict fertile periods and plan for pregnancy.
PCOS can also affect the uterine lining, which is crucial for a successful pregnancy. Even when ovulation occurs, hormonal imbalances can prevent the uterine lining from developing properly, decreasing the likelihood of successful implantation of a fertilized egg. Without proper treatment, these issues can create significant challenges for women trying to conceive.
The Role of Hormonal Imbalance and Ovulation
Dr Arati Adhe, Consultant in IVF, Obstetrics & Gynaecology, P.D. Hinduja Hospital & MRC, Khar adds that PCOS often affects the function of the ovaries, making ovulation unpredictable. In a normal female without PCOS, ovulation typically occurs on a regular cycle. However, in women with PCOS, ovulation can be delayed for months at a time, which is a major contributor to infertility. If sexual intercourse does not coincide with the rare times of ovulation, fertilization cannot occur, and the egg will degenerate.
Another challenge is that PCOS often leads to a non-receptive endometrium due to hormonal imbalance. The endometrium is the inner lining of the uterus, where a fertilized egg, or embryo, must implant in order for pregnancy to continue. In women with PCOS, hormonal issues can prevent the endometrium from properly preparing for implantation, further complicating efforts to conceive.
The Rise of Male Hormones and Its Effects
One of the more visible symptoms of PCOS is the increase in male hormones, particularly testosterone. Dr. Adhe notes that this hormonal shift can result in masculine features such as excessive facial hair growth, acne, darkening of the skin, and scalp hair loss. These symptoms not only affect physical appearance but also contribute to the overall hormonal imbalance that makes conception difficult.
In addition to affecting fertility, PCOS is associated with more severe systemic health conditions, including type 2 diabetes, hypertension, high cholesterol, and heart disease. Women with PCOS also face an increased risk of developing endometrial cancer. If left unmanaged, PCOS can also increase the likelihood of developing diabetes during pregnancy, which presents further complications for both mother and child.
Managing PCOS and Improving Fertility
Despite its challenges, PCOS can be managed, although it cannot be cured. Both Dr Murdia and Dr Adhe emphasize the importance of lifestyle modifications in managing the condition. Maintaining a healthy weight through regular exercise and a balanced diet can help improve hormonal balance and restore ovulatory function, increasing the chances of conception.
Fertility treatments are also available for women with PCOS. Dr. Murdia highlights that medications that induce ovulation, as well as assisted reproductive technologies like in vitro fertilization (IVF), can significantly enhance the chances of pregnancy. These treatments, combined with proactive management of PCOS symptoms, offer hope for women looking to achieve their fertility goals.
In conclusion, PCOS is a complex and multifaceted condition that affects millions of women globally. While it can significantly impact fertility by disrupting ovulation and hormonal balance, lifestyle changes and medical interventions offer effective ways to manage these challenges. With proper care, women with PCOS can take control of their reproductive health and improve their chances of conception.
