Can PCOS Impact Fertility?

By: Dr. Kelsey Duncan, ND.

If you’ve been diagnosed with PCOS, polycystic ovarian syndrome, it’s possible you’ve been told that you may struggle to get pregnant when your time comes. 

Unfortunately, this is the truth. But the good news is there are natural ways to manage your PCOS and boost your chances of getting pregnant. 

When it comes to fertility and PCOS, it’s not that you have bad eggs or no eggs at all. The issue is that the great eggs you do have are not being released the way they should be. Often times women with PCOS only ovulate every few months, meaning your chances of getting pregnant go from 11-12 times per year to maybe 2-3 if you’re lucky. It’s quite common to have long cycles with PCOS, ranging anywhere from 40-70+ days. This is a sign that you aren’t ovulating as regularly as someone without PCOS who has a shorter cycle.

There are a few different pillars of PCOS, you may have one or a combination of all. Each can be intertwined and can negatively impact your fertility.

Insulin resistance is one of the most common causes of PCOS and contributes to infertility. Insulin is a hormone that binds to a receptor on cells, signaling that cell to take up the glucose floating around from your food. With insulin resistance, this signaling pathway is broken. Leaving extra glucose floating around telling your body you need more insulin. The truth is you don’t need more insulin, you need better cellular communication. This leaves your body with extra insulin, leading to poor ovulation, high androgens and weight gain.

When insulin is elevated, it tells your ovaries to produce more testosterone. The higher levels of testosterone signal back up to your pituitary that you don’t need to make anymore, which lowers your levels of LH and FSH. If you’ve downloaded our lab testing guide, you’ll know that FSH is important for egg maturation and LH is crucial for ovulation. When these hormones are turned down your body won’t move through the process of selecting, maturing, or releasing an egg. You may get a few different follicles start to mature and try to be released, but none of these will be able to be fertilized and often get trapped and form cysts on the ovaries.

Androgenic PCOS may also come from your adrenal glands. Your adrenals are responsible for your stress hormones. If they start pumping out high levels of DHEA, this can be converted to testosterone in your body and cause the same problems with ovulation that testosterone coming from your ovaries does. High levels of androgens also leads to acne, hair loss and male patterned hair growth. 

Both insulin resistance and high androgens can be managed using natural therapies, including diet, lifestyle, and various supplements depending on where your symptoms are coming from. It’s important to get down to the root cause with a proper lab work up first.

Some labs you’ll want to ask for include:

• Fasting insulin and fasting glucose to assess for insulin resistance
• Free testosterone and total testosterone to assess androgen levels
• DHEA-S to assess for adrenal contribution to androgens
• Vitamin D, because deficiency is associated with higher rates of PCOS

It is possible to get pregnant with PCOS, but it’s important to improve your insulin sensitivity and reduce your androgens first. This will then improve your ovulation rates, regulate your cycles, balance your hormones and lower your miscarriage risk when you do get pregnant.

If you’re curious how Cared For Wellness can help you manage your PCOS, book a free Insight Session to learn about our virtual appointments today.