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pcos and infertility in women

Polycystic Ovary Syndrome (PCOS) and Infertility in Canada

According to the University of Saskatchewan, approximately 1.4 million Canadian women are diagnosed with polycystic ovary syndrome (PCOS), making it the most common endocrine disorders occurring in Canadian women.

Yet, despite how common it is, PCOS is often under or misdiagnosed by a lot of healthcare professionals because the symptoms are so commonly associated with other health conditions.

Have you been diagnosed with PCOS and are trying to get pregnant? Here’s what you need to know about how to navigate PCOS and infertility.

What Is Polycystic Ovary Syndrome (PCOS)?

During a typical menstrual cycle, the ovaries produce a number of tiny follicles inside which eggs develop. Follicles are essentially miniscule sacs that are filled with fluid and release eggs during ovulation. Once a chosen egg is fertilized, the rest of the follicles disintegrate or break down naturally.

Women who have PCOS, however, experience their menstrual cycles and ovulation a little differently. Instead of releasing an egg to be fertilized during ovulation, the ovaries withhold the egg, and the follicles don’t disintegrate—they fill up with fluid and become benign cysts that rest on top of the ovaries. Even though the cysts are benign, they sit on top of the ovaries and cause hormonal imbalances. If left untreated, ovarian cysts can lead to major infertility issues, not to mention a series of uncomfortable and sometimes even painful symptoms.

What Are the Four Types of PCOS?

PCOS can be a by-product of many different conditions, namely hormonal imbalances, excessive androgen production in the ovaries, thyroid disease, genetics, insulin resistance caused by diabetes, and inflammation. Many of these conditions, however, can be linked to a number of other health conditions, which explains why the jury is still out on the exact cause of PCOS.

Speak to your doctor or fertility specialist immediately if you suspect you might have any of the following types of PCOS or are experiencing any of the associated symptoms. PCOS treatment options and approaches vary depending on the type that you have.

Insulin-Resistant PCOS

High insulin or insulin resistance is also referred to as pre-diabetes or metabolic syndrome in which your body is incapable of processing or absorbing insulin and glucose from your blood. An exorbitant surplus of insulin in your system can hinder your chances of conceiving as it typically causes the ovaries to produce androgens (male hormones) such as testosterone and reduce the amount of female hormone production. While some testosterone production in females is perfectly normal, an overabundance of it can lead to male attributes such as growing facial hair and the inability to get pregnant.

Diabetic and overweight women (BMI of 25-30) are at a much higher risk of developing insulin-resistant PCOS. A simple blood test that measures your glucose levels can determine if you’re diabetic or pre-diabetic. Once you’ve been diagnosed, you can work out a suitable treatment and management plan with your doctor. It’s important to note that insulin-resistant PCOS is the most common form of PCOS and if diagnosed early, it’s completely manageable.

Birth Control-Induced PCOS

Birth control, whether it’s in pill or injection form, alters your body’s hormone production by actively subduing ovulation to prevent pregnancy. Of course, there are tons of other reasons women take birth control, but avoiding reproduction is one of the main ones. The effects of birth control typically wear off once birth control treatment has stopped. Most women will usually resume ovulation shortly thereafter. For some women, however, it can take a lot longer than others to get to that stage again.

If you’re having a hard time getting pregnant after a certain period of time has passed since you ceased birth control treatment, then you should consider consulting an infertility counselling specialist in your area.

Inflammatory PCOS

Inflammation can be a symptom of a number of different medical conditions or even a side effect of certain medications. In some cases, inflammation can even be caused by certain foods in your diet (e.g., excess sugar). Unfortunately, it can also lead to mild or severe hormonal imbalances that stimulate the ovaries to produce androgens, particularly testosterone. This can make it a lot harder to get pregnant or prevent pregnancy altogether.

Once you’ve figured out the source of the inflammation, you can take the necessary steps to reduce or even eliminate it and better manage your PCOS.

Hidden PCOS

PCOS is one of those elusive conditions that can sometimes be difficult to diagnose right away. That’s because many of the symptoms are common with other physical conditions. As a result, your doctor may need to run multiple tests to rule out other possible health issues before firmly and confidently diagnosing you with PCOS.

Diagnosis isn’t even the hardest part. Once it’s determined that you have PCOS, it’s important to determine what’s causing it as it could be a symptom or side effect of another condition or medication.

Possible causes of PCOS

Possible causes of PCOS include iodine deficiency (which can prevent ovaries from producing healthy eggs), thyroid disease, zinc deficiency (often associated with vegetarian diets), and consuming too many artificial sweeteners or sugar in your diet.

How Can You Test for PCOS?

Healthcare professionals in Canada use a number of different PCOS diagnosis methods. Starting with a physical exam, they’ll then ask about your personal and medical family history. Next, they’ll inquire about your menstrual cycle and potential irregularities. Your doctor will also check your weight and look for specific symptoms that indicate potential hormonal imbalances such as excessive facial hair, dark spots on your skin, and acne on the lower half of your face.

Additionally, they might also do a pelvic exam and order an ultrasound to look for cysts on your ovaries and check for thickening on the endometrium wall of your uterus. Lastly, your doctor might also order a blood test to check the glucose levels in your blood. If you’re pre-diabetic, then this could cause PCOS symptoms.

What Are Some Complications from PCOS?

Common PCOS-related complications include:
  • Endometrial cancer (cancer of the uterine lining)
  • Infertility and inability to get pregnant
  • Abnormal bleeding in the uterus
  • Gestational diabetes
  • Pregnancy-induced high blood pressure
  • Sleep apnea
  • Depression
  • Anxiety
  • Eating disorders
  • High risk for miscarriage or premature birth
  • Prediabetes or Type 2 diabetes
  • Non-alcoholic steatohepatitis
  • Metabolic syndrome

What Fertility Treatments Are Available for PCOS?

Clomifene is typically the leading medication that’s recommended and prescribed for women who are experiencing PCOS-related infertility issues. This drug contains active medicinal ingredients that promote healthy egg production from the ovaries.

Metformin, which is typically used as a treatment for Type 2 diabetes, can also be prescribed if Clomifene treatments don’t work. A positive aspect of this medication is that it also helps to manage blood sugar and insulin levels in women who are living with PCOS.

Fertility Treatment at ONE Fertility Kitchener Waterloo

If you think you might be suffering from PCOS-related infertility, know that you don’t have to go through it alone. At ONE Fertility Kitchener Waterloo, our staff is completely committed to providing in-depth and compassionate PCOS fertility treatment. At our fertility clinic in Ontario, we provide a wide range of infertility treatment options including IVF treatment and IUI treatment, based on your needs. Book your consultation today.

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