Are Ovulation Tests Accurate With Pcos? Top Answer Update

Polycystic ovary syndrome (PCOS) is a common but often undiagnosed condition in which certain hormones become imbalanced. These imbalances typically manifest themselves as irregular menstrual cycles, higher levels of androgens (a type of hormone including testosterone) in the body, and small cysts in the ovaries.

PCOS can cause excess facial and body hair, acne, and mood swings. Here are some answers to frequently asked questions about PCOS.

What is PCOS?

Is PCOS a Rare Disease?

Polycystic ovary syndrome (PCOS) is very common but goes undiagnosed and untreated in most sufferers. It can affect approximately 1 in 12 women and people with cycles of reproductive age (8% or ~6-13%), but this likely varies by population (1-5). Of those who have it, about 7 in 10 go undiagnosed (5,6).

Is PCOS just a disease of the ovaries?

No it is not. PCOS is an endocrine and metabolic disease that affects the body well beyond the ovaries. Not everyone with PCOS has ovarian cysts, and polycystic ovaries alone do not meet diagnostic criteria. There are clinical and research groups pushing for the disease to be renamed, arguing that the current name hampers research progress and creates confusion. A suggestion for a new name is “metabolic reproductive syndrome” (7).

Do We Know What Causes PCOS?

no It’s still not understood what causes PCOS, and the causes are likely different for different people. Genetics, behavior, lifestyle, and environment can all play a role.

PCOS Diagnosis

Is it important to get PCOS diagnosed and treated?

Yes. PCOS is underdiagnosed and undertreated. This may be because the symptoms can be mild or unrelated. But untreated PCOS can lead to a variety of more serious health conditions, and the symptoms of the condition can cause significant distress. Uncontrolled PCOS is associated with type 2 diabetes, infertility, cardiovascular disease, obesity, sleep apnea (difficulty breathing during sleep), non-alcoholic fatty liver disease, and depression (8-10). Early diagnosis and treatment can help reduce these risks significantly. Healthcare providers can often make a diagnosis after a brief assessment or simple tests.

Read here and here how different healthcare providers approach the PCOS diagnosis.

Does Everyone With PCOS Have Polycystic Ovaries?

no Not everyone with PCOS has small cysts in their ovaries — cysts are more of a symptom of PCOS than a cause. While they can contribute to hormonal imbalances, the cysts themselves are usually harmless (11).

PCOS cysts are different from the type of ovarian cysts, which grow, rupture, and cause pain.

If my menstrual cycle is irregular, does that mean I have PCOS?

no Infrequent or absent menstrual bleeding can be caused by other health problems or lifestyle factors, such as: B. a thyroid disorder (an overactive or underactive thyroid gland) or exercising too much without consuming enough calories. Hint author Dr. Shruthi Mahalingaiah wrote more about how she determines the causes of irregular periods.

Do you need an ultrasound to diagnose PCOS?

Not always. When you see your doctor, they’ll likely ask you questions about your symptoms, medical and menstrual history, and do a simple physical exam. If they think PCOS might be present, they may also: Ask questions about your full medical history, including medical and surgical history, social history, and family history. Do blood tests to check blood levels of hormones and sugars. The hormones they usually check for include: testosterone, thyroid hormone, prolactin, and glucose metabolism tests. Do a pelvic ultrasound (sonogram) of your ovaries and uterus

PCOS treatment

What medications are used to treat PCOS?

Several medications can be prescribed for PCOS. Contraception is not a cure, but is often prescribed as a first-line treatment after or with lifestyle changes. Other medications that may be prescribed for PCOS include antidiabetics and antiandrogen medications to help balance hormone levels.

Metformin is a drug sometimes prescribed to regulate blood sugar in some forms of PCOS. People trying to conceive may be prescribed a medication to help them ovulate (12-14). Antidiabetic drugs, which can improve the way the body uses insulin, are sometimes prescribed in combination with other weight management measures (15,16).

Are there things other than medication that can help treat PCOS?

Yes. Diet, exercise, and behavior changes can have a major impact on preventing and treating PCOS (17). Restoring regular ovulation helps with the symptoms and health effects of the condition. Limiting simple carbohydrates and sugars in the diet can help balance insulin and prevent inflammation, but there’s still no clear evidence that one diet is best for everyone (18-22).

Not smoking is also important as nicotine can increase androgenic activity and smokers tend to have more testosterone in their bodies (23). Smoking is associated with increased levels of free testosterone and fasting insulin in women with polycystic ovary syndrome, leading to increased insulin resistance (24).

Some people seek complementary medicine, including herbal treatments and dietary supplements, to help with their PCOS. More research is needed on the effectiveness of these approaches in PCOS.

PCOS and fertility

Do people with PCOS ovulate?

Not always. In people without PCOS, ovulation (the release of an egg from the ovary) usually occurs about once a month. People with PCOS may ovulate less frequently or predictably and may be more prone to miscarriage, making PCOS a common cause of infertility.

Can people with PCOS get pregnant?

Yes. For people trying to conceive, PCOS can make it harder to schedule sex on the fertile days of their menstrual cycle when ovulation occurs. It can also take longer to get pregnant if ovulation only occurs every few months.

People with PCOS are more likely to seek and need fertility treatments than people who don’t have them. However, research shows that both people with and without PCOS have a similar number of pregnancies and children over their lifetime (25,26). In fact, the majority of people with PCOS who are trying to conceive will conceive and give birth at least once in their lives without fertility treatment ( 26Trusted Source ).

If I have PCOS, do I still need to use birth control?

Yes, if you are having penis-vagina sex and want to avoid pregnancy. Some people with PCOS think they can’t get pregnant, but that’s not true. Ovulation can happen even if it doesn’t happen on a predictable schedule. It’s important that people with PCOS use some form of birth control if they don’t want to become pregnant and are having sex that could result in pregnancy.

Read more about PCOS, including stories about PCOS diagnosis, management, and experiences of transgender and non-binary people with PCOS.

Download Clue to track your cycle and symptoms.

PCOS is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne.

The cysts on the ovaries are not harmful and do not need to be removed.

Treatment for PCOS consists of a healthy diet, exercise, and medication. Important facts

PCOS is a common problem in teenage girls and young women. In fact, almost 1 in 10 women has PCOS.

What is PCOS?

Polycystic ovarian syndrome (PCOS) is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne. PCOS often begins in a girl’s teenage years and can be mild or severe.

What are the signs of PCOS?

Some of the most common signs of PCOS are:

Irregular periods that come every few months, not at all, or too often

Extra hair on the face or other parts of the body, called hirsutism (her-suit-is-em)

Treatment-resistant acne

Weight gain and/or problems losing weight

Patches of dark skin on the back of the neck and other areas called acanthosis nigricans (“a-can-thosis ni-gri-cans”)

Could I have PCOS?

If you have some or all of the above signs, you may have PCOS. There may be other reasons why you might have signs; However, only your doctor can say for sure.

What causes PCOS?

PCOS is caused by an imbalance in hormones (chemical messengers) in your brain and ovaries. PCOS usually occurs when a hormone called LH (from the pituitary gland) or insulin levels (from the pancreas) are too high, which then causes the ovaries to produce extra amounts of testosterone.

For a more detailed explanation, take a look at the image of the female reproductive anatomy:

The pituitary gland (pi-tu-i-tary) in your brain produces the hormones luteinizing (lu-tin-iz-ing) hormone (LH) and follicle (fall-i-call) stimulating hormone (FSH). After receiving the signal from the hormones LH and FSH, the ovaries produce estrogen (es-tro-gen) and progesterone (pro-ges-ter-own), the female sex hormones. All normal ovaries also produce some androgen testosterone (andro-gen tes-tos-ter-own), a male sex hormone. The pancreas (pang-cree-us) is an organ that produces insulin. High insulin levels can also cause the ovaries to produce more of the hormone testosterone.

Why are my periods so irregular?

Having PCOS means your ovaries are not getting the right (hormonal) signals from your pituitary gland. Without these signals, you won’t ovulate (make eggs) every month. Your period may be irregular or you may not have a period at all.

Let’s review a regular menstrual cycle.

The menstrual cycle begins when the brain sends LH and FSH to the ovaries. A large LH surge is the signal that causes the ovaries to ovulate, or release an egg. The egg travels down the fallopian tube and into the uterus. Progesterone from the ovary causes the lining of the uterus to thicken. If the egg is not fertilized, the lining of the uterus is shed. This is a menstrual period. After menstruation, the cycle starts all over again.

The left diagram shows a regular menstrual cycle and the right diagram shows a PCOS cycle without ovulation.

Now let’s look at what happens with PCOS during a menstrual cycle.

In PCOS, LH levels are often high early in the menstrual cycle. The LH level is also higher than the FSH level. Since the LH level is already quite high, there is no LH surge. Without this LH surge, ovulation will not occur and your periods will be irregular.

Girls with PCOS may ovulate occasionally or not at all, so periods may be too close together or more often too far apart. Some girls may not get their periods at all.

What types of tests does my doctor do to diagnose PCOS?

Your doctor will ask you many questions about your menstrual cycle and general health, and then perform a full physical exam. You will most likely need a blood test to check your hormone levels, blood sugar, and lipids (including cholesterol). Your doctor may also want you to have an ultrasound test. This is a test that uses sound waves to take a picture of your reproductive organs (ovaries and uterus) and bladder (where your urine is stored). In girls with PCOS, the ovaries can be slightly larger (often >10 cc in volume) and contain multiple tiny cysts.

Does PCOS mean I have cysts on my ovaries?

The term “polycystic ovaries” means that there are many small cysts or bumps in the ovaries. Some young women with PCOS have these cysts; others have few. Sometimes these cysts cannot be seen on ultrasound. Even if no cysts are seen on ultrasound, you may still have PCOS. If you have polycystic ovaries, they are not harmful and do not need to be removed.

Why am I getting acne and/or extra hair on my body?

Acne and extra hair on your face and body can appear when your body produces too much testosterone. All women produce testosterone, but when you have PCOS, your ovaries produce a little more testosterone than they should. Skin cells and hair follicles can be extremely sensitive to the small increases in testosterone that occur in young women with PCOS.

Why do I have dark skin spots?

Many teenagers with PCOS have higher levels of insulin in their blood. Higher insulin levels can sometimes cause patches of darker skin on the neck, under the arms, and in the groin (inside the thighs).

Will PCOS affect my ability to have children one day?

Women with PCOS have a normal uterus and healthy eggs. Many women with PCOS have trouble getting pregnant, but some women have no trouble at all. If you’re concerned about your future fertility (ability to get pregnant), talk to your doctor about all the new options available, including medications to lower your insulin levels or to support your monthly ovulation.

What can I do about PCOS?

The most important treatment for PCOS is working on a healthy lifestyle that includes healthy eating and daily exercise. There are also excellent medications to help you manage irregular periods, hair growth, and acne. Ask your doctor about the different treatment options.

What is the treatment for PCOS?

The most common form of treatment for PCOS is birth control pills; However, other types of hormone therapy may include the “vaginal ring” and the “patch.” Even if you are not sexually active, birth control pills can be prescribed because they contain the hormones your body needs to treat your PCOS. Birth control pills (either taken continuously or in cycles) can:

Correct hormone imbalance

Lower testosterone levels (which improves acne and reduces hair growth)

Regulate your menstrual flow

Reducing the risk of endometrial cancer (which is slightly higher in young women who do not have regular periods)

Prevent unplanned pregnancy if you are sexually active

Are There Other Medications to Treat PCOS?

A drug that helps the body lower insulin levels is called metformin. It’s especially helpful in girls with high insulin levels or those with prediabetes or type 2 diabetes. Some girls are treated with metformin and birth control pills at the same time

Ask your doctor about hair growth treatments. Only you and your doctor can decide which treatment is right for you. Options include bleaching, waxing, depilatories, spironolactone (Spi-Ro-No-Lac clay), electrolysis, and laser treatment. Spironolactone is a prescription drug that can reduce hair growth and make hair lighter and finer. However, it can take up to 6-8 months before an improvement is visible.

Ask your doctor about treating acne. There are several ways to treat acne, including birth control pills, topical creams, oral antibiotics, spironolactone, and other medications.

Ask your doctor about a weight loss plan if you are overweight. If you are overweight, losing weight can help relieve some of the symptoms of PCOS. Talk to your doctor or nutritionist about healthy ways to lose weight, such as eating. B. Getting more exercise and following a diet plan that helps control insulin levels. Eating a healthy diet can also keep your heart healthy and lower your risk of developing diabetes.

Weight Management Tips:

Opt for nutritious, high-fiber carbs over sugary or refined carbs

Balance carbohydrates with protein and healthy fats

Eat small meals and snacks throughout the day rather than large meals

Exercise regularly to control insulin levels and weight

What if I’m worried about having PCOS?

When you’ve been told you have PCOS, you may feel frustrated or sad. You may also feel relieved that there’s finally a cause and treatment for your problems, especially if you’ve been struggling to maintain a healthy weight or have excessive body hair, acne, or irregular periods. Having a diagnosis without a simple cure can be difficult. However, it is important for girls with PCOS to know that they are not alone. It is very important to find a healthcare provider who knows a lot about PCOS and who you are comfortable talking to. It’s also very important to keep a positive attitude and work on a healthy lifestyle, even if the results seem to take a long time! Many girls with PCOS tell us that talking to a counselor about their concerns can be very helpful. Other girls recommend online chats. The Center for Young Women’s Health offers a free and confidential monthly online chat for girls and young women with PCOS.

What else should I know?

It’s important to see your doctor regularly and make sure you’re taking any medications prescribed to help regulate your periods and reduce your chances of developing diabetes or other health problems. Because you’re at a slightly higher risk of developing diabetes, your doctor may suggest that you have your blood sugar tested once a year or have a glucose challenge test every few years. When you quit smoking (or don’t start in the first place), your overall health also improves. Because you’re at higher risk of developing diabetes, your doctor may suggest doing a:

This article was republished by The Conversation under a Creative Commons license.

Sara Holton, Deakin University and Karin Hammarberg, Monash University

Most women want and are expecting children. But women who have a chronic condition like polycystic ovary syndrome (PCOS) often have concerns about childbirth, including whether they can get pregnant.

PCOS is a complex hormonal disorder that affects up to one in five women of childbearing age. Most women with PCOS have elevated levels of a hormone called luteinizing hormone, which induces ovulation, and decreased levels of a hormone called “follicle-stimulating hormone,” which is essential for pubertal development and the function of the female ovaries and male testicles.

Women with PCOS also have an underproduction of estrogen (“female” hormones) and an overproduction of androgens (“male” hormones). This causes tiny cysts on the surface of the ovaries.

Because of these hormonal imbalances, women with PCOS often have irregular menstrual cycles because they don’t ovulate or ovulate only occasionally. Women with PCOS are therefore more likely to have problems conceiving than other women.

While most women with PCOS conceive, they often take longer to conceive and require fertility treatment more often than women without PCOS.

In a recent study by Monash University, women with PCOS participated in an online discussion group. They talked about their concerns about pregnancy and what they could do to improve their chances of conceiving, what kind of information they would like about fertility and PCOS, and when they would like to receive that information.

Their biggest concern was whether they might get pregnant. They also wanted to know how best to prepare for pregnancy and what to do before trying to conceive. They had trouble finding up-to-date, relevant and reliable information.

Read more: Explanation: What is Polycystic Ovarian Syndrome?

How to increase the chance of pregnancy

As with all women, having the best possible health before trying to have children increases the chances of pregnancy and gives the baby the best start in life.

According to the international evidence-based guideline for the assessment and treatment of PCOS, adopting a healthy lifestyle — including a healthy weight range, not smoking, avoiding alcohol, a healthy diet, getting plenty of regular exercise, and getting enough sleep — is the first thing to do to improve a woman’s chances of conceiving and having a healthy baby.

To get the right kind of advice and support, women planning a pregnancy should have a preconception health check with their GP. This is also an opportunity to discuss a plan of action in case PCOS is causing fertility issues.

In women with PCOS who are overweight or obese, a small amount of weight loss sometimes results in more regular ovulation, which increases the likelihood of pregnancy. For those who know they’re ovulating, having sex during the “fertile window” (the five days before and including ovulation) increases the chance of conception.

Overall, women with and without PCOS have similar numbers of children. john looy unsplash

Read more: Female fertility: does the egg timer test work and what other options are there?

What options do I have?

If you’ve been trying to have a baby for 12 months (or six months if you’re 35 and older) without success, it’s time to see a doctor. Your GP is your first port of call, but they can refer you to a fertility specialist.

If you have very irregular or sporadic periods, this is an indication that you are not ovulating and need medical help to have a baby. The first line of medical treatment is ovulation induction. This involves a series of pills or injections to stimulate the ovaries to release an egg that can be fertilized, either during intercourse or through intrauterine insemination (IUI).

If this doesn’t work, there may be other reasons why pregnancy cannot be achieved and may require more invasive treatments such as IVF.

IVF involves a series of injections to stimulate the ovaries to produce multiple eggs. When they are mature, the eggs are retrieved in an ultrasound-guided procedure under light anesthesia. Sperm are added to the eggs in the laboratory so that embryos can form.

A few days later, an embryo is placed in the uterus where it can implant and grow into a baby. If there is more than one embryo, these can be frozen for later use if there is no pregnancy.

While IVF is safe in the hands of specialists, there are some potential health implications to be aware of, including ovarian hyperstimulation syndrome. This is an overreaction to fertility drugs used to stimulate the ovaries to produce multiple eggs. This can cause abdominal pain, nausea and vomiting, rapid weight gain, and blood clots.

Read more: Better health and nutrition well before conception leads to healthier pregnancies

For more informations

Visit the Your Fertility website for more information on PCOS and fertility. The Center for Research Excellence in Polycystic Ovary Syndrome has also created a list of questions for women with PCOS to use in discussions with their healthcare provider and a fact sheet about PCOS, fertility and pregnancy.

Although fertility problems are common in women with PCOS, it is reassuring that women with PCOS and women without PCOS have a similar number of children overall. And while PCOS is associated with fertility issues, women with PCOS should also be aware that conception is possible and effective birth control is necessary to avoid unwanted pregnancy.

This article was co-authored by Louise Johnson, CEO of the Victorian Assisted Reproductive Treatment Authority (VARTA). Louise has no significant conflicts of interest.

Sara Holton, Research Fellow, Deakin University and Karin Hammarberg, Senior Research Fellow, Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University

This article was republished by The Conversation under a Creative Commons license. Read the original article.

PCOS fertility pregnancy

Share on Pinterest Polycystic ovary syndrome, or PCOS, is a hormonal condition that affects more than just your fertility, but you may first get a diagnosis when you’re trying to conceive. This is because it is a common — and treatable — cause of infertility in women. According to the Centers for Disease Control (CDC), up to 12 percent of women in the United States have trouble conceiving because of untreated PCOS. In reality, that number could be larger since nearly 50 percent of women with this syndrome are unaware they have it or are misdiagnosed. PCOS doesn’t mean you can’t get pregnant. It might just be a bit trickier and you might need some extra help. There is much you can do at home and with medical attention to keep PCOS symptoms at bay and increase your chances of having a healthy pregnancy.

Getting Started Conceiving with PCOS involves some of the same steps women without PCOS should take to have a healthy pregnancy. Have your doctor measure your weight and body mass index (BMI). Your BMI shows whether you are at a healthy weight and how much of your body composition is fat. If you’re carrying extra weight, talk to your doctor about how much weight you need to lose before you become pregnant. Start a healthy diet and exercise plan. Make a habit of choosing healthier foods and being more active. Use an ovulation calendar or app to track when you have your period. This will give you a better idea of ​​which days of the month you are more likely to become pregnant. Check your blood sugar level. See your doctor to make sure your blood sugar levels are balanced. Your blood sugar levels are important for conceiving, having a healthy pregnancy and even your baby’s future health.

Maintain a Healthy Weight Obesity is associated with PCOS, but many women who have the condition are not obese at all. However, if you carry extra weight, you can improve your fertility and reduce other PCOS symptoms by losing as little as 5 percent of your weight. Exercise daily by walking and getting into your steps. Use a standing desk instead of sitting down while you work. Lift light weights while watching TV as building more muscle will help reduce PCOS symptoms and improve your health.

Eat a healthy diet Any woman trying to conceive needs to be consuming the right amounts of nutrients. Swap sugary foods, simple carbohydrates and unhealthy fats for healthier choices including: fresh and cooked fruits and vegetables

Whole grains like brown rice, oats and barley

beans and lentils

chicken

Fish Certain vitamins and minerals are important for a healthy pregnancy and growing baby. Ask your doctor about the best nutritional supplements for you. Dietary supplements that may support fertility include: Folic acid (vitamin B9)

Vitamin B6

Vitamin B12

vitamin C

Vitamin D

vitamin E

Coenzyme Q10

Balance your blood sugar levels Your doctor will test your blood sugar levels if you are having trouble conceiving. PCOS sometimes leads to high blood sugar levels or type 2 diabetes. This can cause fertility problems. This happens because PCOS can change the way your body uses insulin. This important hormone transports sugar (glucose) from the blood to the muscles and cells, where it is burned for energy. PCOS makes your body less sensitive to insulin — making it harder for it to do its job. Balancing your blood sugar levels can help you get pregnant. Eat a healthy diet with more fiber, protein and healthy fats. Getting plenty of daily exercise and strength training can also help your body use insulin better. In some cases, your doctor may recommend medications to help balance your blood sugar levels. A common type 2 diabetes drug called metformin (or Glucophage) makes your body make better use of insulin to lower high blood sugar. This can also help you get pregnant with PCOS. Depending on your blood sugar levels, you may need to take metformin in low doses and only temporarily. For best results, eat a healthy diet and exercise regularly along with taking all prescribed medications to help you conceive. If you have high blood sugar or type 2 diabetes, it’s important to check your blood sugar daily with a home monitor. Your doctor will check your blood sugar levels with tests including: random blood sugar test

overnight fasting blood sugar test

oral glucose tolerance tests (after fasting and drinking a sugary drink)

Hemoglobin A1C test (checks your blood sugar levels for the past two to three months)

Medications If you have PCOS, your body may produce more of both the male hormone testosterone and the female hormone estrogen. Too much (or too little) of these hormones can make it difficult to get pregnant. Your doctor may recommend prescription medications to help balance your hormones. Medications that will help you get pregnant with PCOS include: Metformin, to help balance insulin levels

Clomiphene citrate (or Clomid) to balance estrogen levels

Birth control pills to balance estrogen and testosterone levels (before starting fertility treatment)

Fertility drugs to boost the ovaries to send out more eggs

Fertility Assistance You may need in vitro fertilization (IVF) treatment to help you get pregnant with PCOS. Your fertility doctor will give you an exam, which may include more blood tests, ultrasound scans, and a physical exam. IVF is a process that can take months or even years, whether you have PCOS or not. However, medical research shows that women with PCOS have a high success rate of conceiving with IVF treatment. Some clinical studies found that women with PCOS who took birth control pills before IVF treatment had better outcomes. You may also need other medications to help balance hormones and prepare your body for IVF treatment. For all women, the first step in IVF treatment is a balanced diet and plenty of exercise to achieve a healthy weight. Women with PCOS who are a healthy weight are twice as likely to conceive using IVF as women with PCOS who are overweight. Before considering IVF, your doctor may suggest a less expensive alternative called intrauterine insemination (IUI). This process increases the chances of pregnancy because a high concentration of sperm is directly injected closer to the egg.

Chances of getting pregnant with PCOS If you’re trying to get pregnant with PCOS, you may only need treatment with medication. A medical study found that nearly 80 percent of women with PCOS who were treated with the drug clomiphene citrate ovulated successfully. Of these, half of the women became pregnant naturally within six monthly cycles. If medications don’t help you conceive, your doctor may recommend IVF treatments. Most women with PCOS have a 20 to 40 percent chance of getting pregnant with IVF treatment. Women who are 35 years and older or who are overweight have a reduced chance of becoming pregnant.

The main treatment options are discussed in more detail below.

Treatment options can vary, as someone with PCOS may experience a range of symptoms, or just 1.

There is no cure for polycystic ovary syndrome (PCOS), but the symptoms can be treated.

Your GP may be able to refer you to a dietitian if you need specific dietary advice.

Your diet should include plenty of fruits and vegetables (at least 5 servings per day), whole foods (like whole wheat bread, whole grain cereals, and brown rice), lean meats, fish, and chicken.

You can lose weight with regular exercise and a healthy, balanced diet.

A normal BMI is between 18.5 and 24.9. Calculate whether your BMI is in the healthy range with the BMI healthy weight calculator.

You can find out if you are at a healthy weight by calculating your body mass index (BMI), which is a measure of your weight in relation to your height.

A weight loss of just 5% can lead to a significant improvement in PCOS.

In obese women, losing the excess weight can significantly improve symptoms and overall risk of developing long-term health problems from PCOS.

medication

A number of medicines are available to treat various symptoms associated with PCOS.

These are described below.

Irregular or absent periods

The birth control pill may be recommended to induce regular periods, or periods may be induced by an intermittent series of progestin tablets (usually given every 3 to 4 months but also given monthly).

This also reduces the long-term risk of developing cancer of the lining of the womb (endometrial cancer), which is associated with missed periods.

Other hormonal birth control methods, such as an intrauterine system (IUS), also reduce this risk by keeping the lining of the uterus thin, but they may not cause periods.

fertility problems

With treatment, most women with PCOS can become pregnant.

The majority of women can be successfully treated with a short course of pills taken at the beginning of each cycle over several cycles.

If these are unsuccessful, you may be offered injections or IVF treatment. There is an increased risk of multiple pregnancy (rarely more than twins) with these treatments.

A drug called clomiphene is usually the first treatment recommended for women with PCOS trying to conceive.

Clomiphene promotes the monthly release of an egg cell from the ovaries (ovulation).

If clomiphene does not stimulate ovulation, another drug called metformin may be recommended.

Metformin is commonly used to treat type 2 diabetes, but it can also lower insulin and blood sugar levels in women with PCOS.

In addition to stimulating ovulation, promoting regular monthly periods, and reducing the risk of miscarriage, metformin may also have other long-term health benefits such as: B. lowering high cholesterol and reducing the risk of heart disease.

Metformin is not approved in the UK for the treatment of PCOS, but as many women with PCOS have insulin resistance, it can be used ‘off-label’ in certain circumstances to boost fertility and control symptoms of PCOS.

Possible side effects of metformin include nausea, vomiting, abdominal pain, diarrhea, and loss of appetite.

Since metformin can stimulate fertility, make sure you use an appropriate method of birth control if you are sexually active, if you are considering using it for PCOS and are not trying to conceive.

The National Institute for Health and Care and Excellence (NICE) provides more information about using metformin to treat PCOS in women not trying to conceive, including a summary of the potential benefits and harms.

Letrozole is sometimes used to stimulate ovulation instead of clomiphene. This medicine can also be used to treat breast cancer.

The use of letrozole for fertility treatment is off-label. This means that the manufacturer of the drug has not applied for approval to treat PCOS.

In other words, although letrozole is approved to treat breast cancer, it is not approved to treat PCOS.

Doctors sometimes use an unapproved drug when they think it is likely to be effective and the benefits of the treatment outweigh the risks involved.

Learn more about unlicensed and off-label drug use

If you are unable to conceive despite taking oral medicines, another type of medicine called gonadotropins may be recommended.

These are given by injection. There is a higher risk that they will overstimulate your ovaries and lead to multiple pregnancies.

Unwanted hair growth and hair loss

Medicines used to control excessive hair growth (hirsutism) and hair loss (alopecia) include:

certain types of combined oral contraceptives (such as co-cyprindiol, Dianette, Marvelon, and Yasmin)

cyproterone acetate

spironolactone

flutamide

finasteride

These medicines work by blocking the effects of ‘male hormones’ such as testosterone, and some also stop the production of these hormones by the ovaries.

A cream called eflornithine can also be used to slow the growth of unwanted facial hair.

This cream does not remove hair or heal unwanted facial hair, so you may want to use it in conjunction with a hair removal product.

Improvement can be seen 4 to 8 weeks after treatment with this medicine.

However, eflornithine cream is not always available in the NHS as some local NHS authorities have decided it is not potent enough to justify an NHS prescription.

If you have unwanted hair growth, you may also want to remove the excess hair using methods such as plucking, shaving, threading, creaming, or laser removal.

Laser facial hair removal may be available from the NHS in some parts of the UK.

other symptoms

Medications can also be used to treat some of the other issues associated with PCOS, including:

Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov Test – the first and only FDA-approved test to confirm successful ovulation at home.

Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov Test – the first and only FDA-approved test to confirm successful ovulation at home.

Written on 08/16/21

The short answer is no: without an LH surge, there is no ovulation.

A surge in luteinizing hormone (LH) can help you predict your ovulation so you can plan intercourse around your fertile window and get pregnant faster. But some women may never see LH on their home ovulation tests. Is ovulation possible without an LH surge?

The short answer is no: without an LH surge, there is no ovulation. Read on to learn more about LH and why a surge is so important.

What is LH and why is it important?

Luteinizing hormone is one of the most important reproductive hormones that plays a crucial role during your cycle. At the beginning of your cycle, estrogen levels rise as your ovaries begin to mature the follicles in preparation for ovulation.

Once a follicle is ready and contains a mature egg, the increased estrogen levels send a signal to your brain that it’s time to ovulate! Your brain then releases an LH surge that triggers ovulation. Without LH, there is nothing that causes the follicle to release the egg.

Most women ovulate about 12-24 hours after an LH surge. Tracking LH levels with LH tests (also called ovulation tests) can help you spot a surge to determine your fertile window — i. H. the short period of time that an egg is present and conception is even possible.

How do I know if I don’t have an LH surge?

Tracking LH levels with ovulation tests can help you determine if you are having an LH surge or not. Many threshold-based ovulation tests, such as Proov Predict, are designed to become positive when 25 mIU/mL LH is present in the urine. A positive Proov Predict test indicates an LH surge and identifies your two most fertile days.

However, it is possible to miss an LH surge as it can be very brief – sometimes lasting as little as 12 hours. To ensure you’re catching your LH surge, we recommend starting testing early in your cycle and testing multiple times a day (but more on that later!). Don’t worry: the Proov Insight app will prompt you when to test based on your unique cycle!

It is common for women to have an anovulatory cycle (i.e. a cycle in which ovulation does not occur) every now and then. However, if you test several cycles using the Proov Predict protocol and never get a positive result, it could be a sign that you are not having an LH surge and are therefore not ovulating.

It is common for women to have an anovulatory cycle (i.e. a cycle in which ovulation does not occur) every now and then.

How high does my LH surge need to be to ovulate?

As mentioned earlier, LH is the hormone that causes the follicle to release the egg (i.e., trigger ovulation). In order for this to happen, LH must rise, which means the hormone essentially has to rise drastically and quickly for the ovary to release the egg.

You may be wondering: is there a certain level that LH must reach for ovulation to occur? The answer is yes! And several studies have been conducted to answer this very question.

Studies show that a natural LH surge can range from 20 to 100 mIU/mL. This means that anything above 20 mIU/ml would predict ovulation and anything below may indicate ovulation.

This is further supported by other studies showing us that an LH level of 25-30 mIU/ml is the best predictor of ovulation. In this study, researchers tested LH tests that became positive at 15, 20, 25, 30, 35, and 40 mIU/mL, and then tracked how long it took for a woman to actually ovulate (24, 48, or 73 hours ).

The study found that an LH test with a threshold of at least 25 mIU/mL more accurately predicted ovulation than LH tests with other thresholds. The good news is that the FDA also follows this guideline; the FDA standard threshold for urine-based LH testing is 25 mIU/mL.

So is it possible to ovulate without an LH surge?

The bottom line is that you cannot ovulate without an LH surge. One of the studies mentioned above not only showed us the threshold that best predicts ovulation, but also showed us that most women who only reached an LH level of 15 mIU/ml did not ovulate. This means that lower LH levels are not a good, accurate indicator of ovulation—even if this woman is seeing an increase in LH above her baseline level.

While some people believe you don’t have to have a surge that reaches a certain level, the data tells us that there is a certain level (25 mIU/mL) that is best predictive of ovulation. And we believe it’s important to get the most accurate and reliable information from your LH tests!

If you never get a positive LH test, or suspect that you have persistently no LH surges, we recommend that you consult your doctor.

How do I use Proov Predict?

Proov Predict was developed with science, research and FDA guidelines in mind, which is why we test positive when there is at least 25 mIU/mL LH in the urine.

Now that you understand the importance of a threshold-based test with a positivity level of at least 25 mIU/mL, it’s time to use one! Proov Predict was developed with science, research and FDA guidelines in mind, which is why we test positive when there is at least 25 mIU/mL LH in the urine.

If you’re using Proov Predict, we recommend downloading the Proov Insight app to get tracking throughout the month, get numeric results, information on what they mean and a personalized plan of action. It will make your life easier!

As the app builds the test log for you day by day, here’s a quick preview. You start testing with Proov Predict 18 days before your next expected period. So if your cycle is 28 days, start using Proov Predict on the 10th day of your cycle.

From there, the Proov Insight app will prompt you to test twice a day – once in the morning and once in the evening. This is because LH surges can be brief (as we saw above) and we want to make sure you don’t miss it.

The Proov Insight app takes your LH results one step further by providing numeric LH readings. As soon as your LH level is above 25 mIU/ml, the test is positive and that is considered your “peak day”! It signals that you have entered your two most fertile days and no longer need to continue testing

Although you cannot ovulate without an LH surge, understanding the importance of LH thresholds can help you get more out of your ovulation test results.

Women with polycystic ovary syndrome (PCOS) have abnormalities in the metabolism of androgens and estrogen and in the control of androgen production. In these patients, high serum concentrations of androgenic hormones such as testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEA-S) can occur. However, individual variability is considerable and a given patient may have normal androgen levels.

PCOS is also associated with peripheral insulin resistance and hyperinsulinemia, and obesity increases the magnitude of both abnormalities. Insulin resistance in PCOS may be secondary to a post-binding defect in insulin receptor signaling, and elevated insulin levels may have gonadotropin-elevating effects on ovarian function. Hyperinsulinemia can also lead to suppression of hepatic production of sex hormone-binding globulin (SHBG), which in turn can increase androgenicity. [fifteen]

In addition, insulin resistance in PCOS has been linked to adiponectin, a hormone secreted by adipocytes that regulates lipid metabolism and glucose levels. Lean and obese women with PCOS have lower levels of adiponectin than women without PCOS. [16]

A proposed mechanism for anovulation and increased androgen levels suggests that under the increased stimulatory effect of luteinizing hormone (LH) secreted by the anterior pituitary gland, ovarian theca cell stimulation is increased. These cells, in turn, increase the production of androgens (e.g. testosterone, androstenedione). Due to decreased levels of follicle stimulating hormone (FSH) relative to LH, ovarian granulosa cells are unable to aromatize androgens into estrogens, leading to decreased estrogen levels and resultant anovulation. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) may also increase the effect on ovarian function. [17]

Hyperinsulinemia is also responsible for dyslipidemia and elevated levels of plasminogen activator inhibitor-1 (PAI-1) in patients with PCOS. Elevated PAI-1 levels are a risk factor for intravascular thrombosis.

Polycystic ovaries are enlarged bilaterally and have a smooth, thickened capsule that is avascular. Sectioned sections show subcapsular follicles at various stages of atresia in the peripheral part of the ovary. The most prominent ovarian feature of PCOS is hyperplasia of theca-stromal cells surrounding arrested follicles. Luteinized theca cells can be seen on microscopic examination.

Some evidence suggests that patients may have a functional abnormality of cytochrome P450c17, the 17-hydroxylase that is the rate-limiting enzyme in androgen biosynthesis. [16]

PCOS is a genetically heterogeneous syndrome in which the genetic contributions remain incompletely characterized. PCOS is a genetically difficult disease to study due to its heterogeneity, difficulties in retrospective diagnosis in postmenopausal women, associated subfertility, incompletely understood etiology, and the magnitude of the gene effect. [7] Many published genetic studies in PCOS have been underpowered and the results of published candidate gene studies have been disappointing.

Studies of family members with PCOS indicate that many families with the disease are inherited in an autosomal dominant manner. The fathers of women with PCOS may be unusually hairy; female siblings may have hirsutism and oligomenorrhea; and mothers can have oligomenorrhea. [18] Research has shown that in a large cohort of women with PCOS, a family history of type 2 diabetes in a first-degree family member is associated with an increased risk of metabolic abnormalities, impaired glucose tolerance, and type 2 diabetes. [18] In addition, a Dutch twin family study showed a PCOS heritability of 0.71 in identical twin sisters versus 0.38 in dizygotic twins and other sisters. [19]

An important link between PCOS and obesity has been genetically confirmed for the first time by data from a case-control study in the UK involving 463 patients with PCOS and more than 1300 female controls. [20] Researchers showed that a variant within the FTO gene (rs9939609, which has been shown to predispose to more obesity) was significantly associated with susceptibility to developing PCOS.

Wickenheisser et al. reported that the activity of the CYP17 promoter was four times higher in cells from patients with PCOS. This research suggests that the pathogenesis of PCOS may be partially related to CYP17 gene regulation. [21] However, in a study examining candidate genes for PCOS using microsatellite markers to look for an association in 4 genes – CYP19, CYP17, FST and INSR – it was found that only 1 marker close to the INSR gene was significantly associated with PCOS. [22] The authors concluded that a PCOS susceptibility locus (designated PCOS1) exists in 19p13.3 in the INSR region, but it cannot be concluded that the INSR gene itself is responsible. [22]

Subsequent studies have found additional associations, such as that of 15 regions in 11 genes previously described as affecting insulin resistance, obesity or type 2 diabetes. [23] It has been found that individuals with PCOS are more likely to be homozygous for an upstream variant of the PON1 gene and homozygous for an allele of interest in IGF2. Interestingly, the PON1 gene variant resulted in reduced gene expression, which could increase oxidative stress. The exact outcome of the IGF2 variant is unclear, but IGF2 stimulates androgen secretion in the ovaries and adrenal glands. [23]

In a study by Goodarzi et al. found that the leucine allele, compared to the valine allele at position 89 in SRD5A2, is associated with protection from PCOS. [24] The leucine allele is associated with lower enzyme activity. [24] When the results of this study are compared with those of an observational study by Vassiliadi et al. based on urinary steroid profiles in women with PCOS, further support for an important role of 5-alpha-reductase in the pathogenesis of this syndrome can be found. [25]

In a genome-wide association study for PCOS in a Han Chinese population, 3 strong association regions were identified at 2p16.3, 2p21 and 9q33.3. [26] The polymorphism most strongly associated with PCOS at the 2p16 locus was located near several genes involved in the proper formation of the testicles, as well as a gene encoding a luteinizing hormone (LH) receptor and human chorionic gonadotropin (HCG). This polymorphism was also located 211 kb upstream of the FSHR gene, which encodes the follicle stimulating hormone (FSH) receptor. [26]

The polymorphisms most strongly associated with PCOS at the 2q21 locus encode a number of genes, including the THADA gene, which has previously been associated with type 2 diabetes. In addition, 6 significant polymorphisms associated with PCOS at the 9q33.3 locus near the DENND1A gene, which interacts with the ERAP1 gene, were identified. Elevation in serum ERAP1 has previously been associated with PCOS and obesity. [26]

If you’re trying to conceive, you’re probably familiar with the basics of ovulation: once a month, a mature egg cell is released from one of the ovaries and is available for fertilization. This 12- to 24-hour window is when your fertility is at its peak, making it the best time to have sex if you’re trying to have a baby.

Ovulation occurs in the middle of the menstrual cycle. But every woman’s cycle is different, and your own ovulation may vary from month to month. There are several ways to find out when you’re ovulating, and ovulation test strips are one of the best options out there. Here’s how they work, how to use them, and if they’re right for you.

What are ovulation test strips and how do they work?

Ovulation test strips, or ovulation prediction kits (OPKs), are at-home tests that can help you determine when you’re ovulating. Because you’re most fertile during ovulation, the kits can help increase your chances of success when trying to conceive.

Ovulation test strips measure the level of luteinizing hormone (LH) in your urine. A surge in LH signals the ovary to release an egg – so if your levels reach a certain threshold, you can expect ovulation to occur within the next 12 to 36 hours.

How do you use ovulation strips to predict your most fertile days of the month?

It’s simple, all you have to do is pee on a stick or strip (or pee in a cup and dip the stick or strip in the cup) and wait a few minutes for the indicator to appear. If the test line appears darker than the control line, you are about to ovulate. (There are always low levels of LH in your body, so if the test line appears but appears lighter or fainter than the control line, you are not yet ovulating. Using a digital readout ovulation test strip can completely eliminate this confusion.)

Ovulation usually occurs around the middle of your menstrual cycle. So it is best to start an ovulation prediction test a few days before your half term. (For example, if your cycle is 28 days, take your first test on day 10 or 11. If your cycles are irregular, use the length of your shortest cycle in the past 6 months as a guide and start 3-4 days earlier with testing as the midpoint of your shortest cycle.)

You may need to test for a few days to detect an LH surge, which is perfectly normal. Most kits contain five to ten test strips. If you use an ovulation test strip with a digital reader, it can compare your current hormone levels with those of the past few days. This can make it even easier to tell when your LH is surging.

Are there any other pointers you should be aware of? To get the most accurate reading, you should do the following:

Use an ovulation test strip between 12:00 p.m. and 6:00 p.m. and 8 p.m. Most women have an LH surge in the morning, and these levels can be detected in your urine about four hours later. You could even test twice a day – once between 11am and 3pm. and again between 5 p.m. and 10 p.m. But whether you test once or twice, aim to do it at the same time (or times) every day.

Make sure your urine is sufficiently concentrated. Avoid peeing an hour or two before the test and try not to drink large amounts of fluids.

Follow the package directions carefully. The more closely you follow the manufacturer’s instructions, the more likely you are to get good results.

Once the test indicates your LH levels are rising, start having sex that day. Also, continue to have sex for two to three days afterward, as ovulation can occur within 36 hours of the LH surge.

How accurate are ovulation test strips?

Ovulation test strips are great for letting you know when you are most fertile. In fact, studies suggest they can detect ovulation up to 97 percent of the time, making them the most accurate option on the market.

But there are a few important things to consider. Most importantly? Ovulation strips show if your hormones are at the right level for ovulation. They can predict the ideal time to try to conceive, but they still don’t guarantee that conception will definitely happen.

The kits also tend to be more accurate for some women than others. Ovulation prediction kits are best for women whose cycles are relatively predictable. However, they may be less reliable if you:

I have very irregular periods. Irregular cycles can make it difficult to figure out when ovulation will begin. This can increase the likelihood of using an ovulation prediction kit too early or too late and missing the ovulation window altogether.

Do you have a health condition like PCOS. Women with polycystic ovary syndrome (PCOS) experience multiple LH surges each month, but ovulation doesn’t occur with every surge. This could make the test results unreliable.

Take certain medications. Fertility drugs, hormones (like birth control pills), and antibiotics can all make ovulation test strips inaccurate.

How much do ovulation test strips cost and are they covered by insurance?

Prices vary based on factors like brand, number of strips in the kit, and whether the test has a digital reader. A box of plain test strips typically costs between $12 and $25, depending on how many strips are in the box.

You can expect to pay a little more for ovulation test strips or ovulation prediction kits with digital readers — anywhere from $32 to $52. Tests can be reimbursed with a flexible spending account, health savings account, or health reimbursement arrangement.

Are there any disadvantages or risks of using ovulation strips?

Ovulation test strips are a safe, effective, and inexpensive way to find out when you’re ovulating and maximize your chances of conception. They’re very accurate when used properly, so the only real downside is that they’re not 100 percent foolproof. A test could potentially give a false positive if LH levels surge without ovulation occurring, especially if you have PCOS or are taking certain medications. And you could end up testing too early or too late — and missing your ovulation window entirely — if your periods are very irregular.

Ovulation test strips are a simple, accurate tool that will help you pinpoint when you are ovulating and maximize your chances of conceiving. But they can be more accurate for some women than others. If you have very irregular periods, PCOS, or take medication, talk to your gynecologist to find out if ovulation prediction kits are the best option for you and what you can do to make your test results as accurate as possible.

Getting pregnant with PCOS

Getting pregnant with PCOS can be difficult, which makes sense since it’s the leading cause of infertility. Because PCOS is so widespread, it is well researched and there are many natural solutions and medical treatments available. Of course, other factors such as age significantly affect the chances of women with PCOS conceiving. Getting pregnant in your 30s is easier than getting pregnant with PCOS in your 40s.

In this article, we’ll provide a quick overview of what PCOS is, discuss ways to improve PCOS symptoms, and treatment options that can help you conceive with PCOS.

What is PCOS?

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of childbearing age. The most common sign of PCOS is irregular, infrequent, or non-existent periods. Women with PCOS can have as few as eight periods in a year. Irregular periods can be caused by cysts on the ovaries, another common symptom of PCOS. These cysts are small, fluid-filled sacs that produce excessive amounts of male sex hormones called androgens. When women produce abnormally high levels of androgens, they are dealing with a medical condition called hyperandrogenism. Hyperandrogenism can prevent women from ovulating. It can also cause additional symptoms that PCOS sufferers experience, such as oily skin, acne, and hair loss in men.

PCOS symptoms are not universal and signs and symptoms vary from woman to woman.

Common signs and symptoms of PCOS include:

Irregular periods

Access to androgens

Polycystic Ovaries

anovulation

infertility

obesity

insulin resistance

Access body hair

Oily skin or acne

Thinning hair or baldness

The exact cause of PCOS is difficult to pinpoint because all of the symptoms affect and influence each other. Fertility specialists believe that PCOS can be the result of a combination of factors including genetics, health and lifestyle. Many women are completely unaware they have PCOS until they are having trouble conceiving and consult a fertility specialist.

Chances of conceiving naturally with PCOS

Simply put, PCOS can prevent ovulation, the release of an egg. Without ovulation, pregnancy cannot occur in this cycle. A PCOS diagnosis doesn’t mean you can’t conceive naturally or with assisted reproductive treatments, but it can make the journey longer and more difficult. Because the symptoms of PCOS and their severity vary so much, there is no specific statistic that we can single out to give a chance or percentage of pregnancy.

In a cross-sectional study by the Australian Longitudinal Study on Women’s Health (ALSWH), researchers found that 72% of women with PCOS reported infertility. 16% of the women in the study without PCOS reported infertility. In this study, women with PCOS were 4.5 times more likely to report infertility. Reporting of infertility was significantly higher in women with PCOS.

Why do people with PCOS have trouble conceiving?

Women with PCOS have a higher than normal antral follicle count (20 to 30+) on one or both ovaries. The high levels of androgens and other sex hormones found in women with PCOS disrupt antral follicle growth. Hormonal imbalances can result in follicles not maturing properly and not releasing an egg. When a woman fails to release an egg during a menstrual cycle, it is known as anovulation. Anovulatory infertility is a common consequence of PCOS and 70-80% of women with anovulatory infertility have PCOS.

Age and its impact on pregnancy with PCOS

Women without PCOS who ovulate regularly see a decrease in oocyte count and live birth rate as they age. When these women reach the age of 35-37, their egg count (ovarian reserve) decreases significantly. Because women with PCOS often have ovulation problems and don’t release eggs as regularly, they don’t see the same drastic decline in fertility as they age. Research has shown that women with PCOS have sustained fertility as they age. In this study, women with PCOS between the ages of 22 and 41 demonstrated stable oocyte counts and live birth rates. In another study, researchers found that PCOS patients who underwent IVF treatment showed better oocyte and embryo quality than women with normal ovulation without PCOS who were the same age”/].

How to naturally increase the chances of getting pregnant with PCOS

PCOS symptoms tend to be more severe for those who are overweight or obese. Obesity can contribute to ovulatory dysfunction. Some overweight women have an ovulatory deficiency that may not be as severe or may not occur at all if they were a “normal” weight. Therefore, some women are mistakenly classified in the PCOS category. For these women, losing weight improves their chances of conceiving naturally. Please note that this is not always the case as PCOS can lead to weight gain in some women.

Women with PCOS are often insulin resistant, which means their bodies can make insulin but they can’t use it effectively. This increases the chances of women with PCOS developing type 2 diabetes. In fact, more than 50% of women with PCOS will develop type 2 diabetes by the age of 40. Women with PCOS who are overweight are also at risk of developing serious health problems, such as gestational diabetes, heart disease, and high blood pressure.

It is extremely important for women with PCOS to be aware of their weight and health before, during and after pregnancy. Making changes to your diet, exercise, and taking supplements can help naturally reduce health risks and increase your chances of conceiving with PCOS.

Click here for more information on how to improve your natural fertility!

diet

PCOS has been described as a low-level chronic inflammatory disease. Inflammation is a major cause of infertility in both women with and without PCOS. Chronic inflammation is caused by micropollutants that enter our bodies through what we eat and drink. Inflammation can cause difficulty achieving pregnancy, maintaining pregnancy, or repeated miscarriages. At CNY Fertility, we recommend a high-fat, moderate-protein, low-carb diet nicknamed the B.E.B.B.I. for PCOS sufferers. Diet bacon, eggs, butter, beef, and full-fat (low-sugar) creamer ice cream.

As previously mentioned, PCOS sufferers are at a higher risk of developing obesity and type 2 diabetes. New research suggests carbohydrates are responsible for increases in obesity and other chronic conditions associated with PCOS. The standard American diet is a high-carbohydrate diet that causes chronically elevated blood sugar levels. The sugar and carbohydrates we eat directly affect our blood sugar and insulin levels. PCOS sufferers are already more prone to insulin resistance, so minimizing these levels is important. When insulin or blood sugar levels get too high, reproductive hormone levels can fall further, which can worsen the chances of anovulation in PCOS sufferers and directly affect their fertility.

Recently, more research has focused on the ketogenic diet’s ability to reduce and improve PCOS symptoms, as low-carb diets have been shown to reduce insulin resistance. In one small study, research focused on the effects of a low-carb ketogenic diet on overweight and obese women with PCOS. In the 5 women who completed the study, after 24 weeks they saw a 12% reduction in body weight, a 22% reduction in free testosterone, and a 54% reduction in fasting insulin compared to their baseline levels. The study concluded that a low-carb ketogenic diet may help reduce weight, percentage of free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS. A 2013 study of 30 women with PCOS found similar results. Researchers found that even a small reduction in daily carbohydrate intake can lead to significant improvements in hormone production, weight, and additional PCOS risk factors.

The ketogenic diet requires a high level of fat, making it ideal for PCOS sufferers who are struggling to conceive, as fat is the key element of fertility. Fat provides important building blocks for our cells and helps synthesize vital reproductive hormones. Dietary fat provides our body with energy and essential fatty acids that we cannot produce ourselves. The combination of the ketogenic diet, anti-inflammatory foods, exercise, and additional healthy lifestyle changes can help reduce inflammation and relieve PCOS signs and symptoms.

Click here for more information on PCOS, insulin resistance, keto and more!

exercise

The benefits of exercise for fertility and overall health are well documented. Not only does it help PCOS sufferers lose weight, but it can also help strengthen your heart and improve blood circulation. Improved blood flow caused by exercise pushes more nutrient-rich blood to the reproductive organs. When people think of exercise, they think of weightlifting or running on a treadmill. That probably doesn’t sound very appealing to most people. When we say exercise, we recommend incorporating low-intensity exercise into your daily routine. Stretching, walking, and yoga are great ways to get your body moving without the need for a gym membership or any equipment.

Research has shown that exercise can significantly improve menstrual cycle regularity and ovulation in about 50% of women diagnosed with PCOS. Exercise can help women with PCOS lose weight and lower their BMI. Research has shown that weight loss can also help reduce luteinizing hormone (LH) amplitude, thereby reducing androgen production.

yoga

Yoga is great for PCOS sufferers because it helps strengthen and balance your immune system. Inflammation is the immune system’s response to foreign invaders or injury. Practicing yoga can help reduce inflammation, which as mentioned above affects fertility, especially in PCOS sufferers. Yoga can also help you relax and find your inner peace, which in turn can help increase the number of white blood cells in the body. A PCOS diagnosis can be quite distressing. It is important to manage the stress throughout treatment and to seek support when needed.

Click here to visit our fertility support page!

Fertility Supplements and Vitamins

Many of the vitamins and nutrients found in fertility supplements can also be obtained from eating various foods. It’s almost impossible to ensure your body is getting all the vitamins and minerals it needs to reduce PCOS symptoms and support reproduction through food alone.

The popularity of fertility supplements continues to grow as new research emerges to support various vitamins and minerals for general and reproductive health. Studies have shown that certain dietary supplements can have positive effects on PCOS-related symptoms such as immature ova, hyperandrogenism, and increased BMI.

inositol

Inositol is a type of sugar that plays an essential role in many different bodily functions. Inositol is an essential component of cell membranes, influences insulin production and acts on neurotransmitters in the brain. A poor ovarian response, a symptom of PCOS, is reported in 9-24% of all IVF cases.

Gonadotropin fertility drugs are commonly prescribed to PCOS patients undergoing fertility treatment to improve their ovarian response. Women are considered “poor responders” when their ovaries fail to increase production after taking gonadotropin fertility drugs. Studies have shown that inositol can significantly improve ovarian response in women treated with gonadotropins. Inositol is especially recommended for low responders and PCOS patients undergoing IVF treatment.

Insulin resistance is a key feature of most women with PCOS. Inositol has been shown to be effective in correcting insulin resistance in patients with PCOS. A 2016 study showed that inositol supplementation in PCOS patients can help treat insulin resistance, lower body mass index, and improve ovarian activity.

carnitine

Acetyl L-Carnitine (ALC) is an antioxidant that is naturally produced by the body. ALC helps the body convert fat into energy. A clinical study found that non-obese women with PCOS have significantly lower levels of L-carnitine compared to women without PCOS. The researchers who conducted the study believe that low levels of ALC could be linked to hyperandrogenism and insulin resistance. A clinical study in women with PCOS found that supplementing ALC with clomiphene resulted in thicker endometrium and higher pregnancy rates. Read below for more information on using clomiphene to treat PCOS.

Vitamin D

67 to 85% of women with PCOS are vitamin D deficient. Low vitamin D levels can increase symptoms of PCOS, including insulin resistance, ovulation, menstrual irregularities, infertility, hyperandrogenism, and obesity. Vitamin D supplementation has been shown to have beneficial effects on menstrual regularity and ovulation.

Research has shown that vitamin D supplementation can also positively impact pregnancy rates and fertility treatment outcomes. In one study, women with adequate vitamin D levels had a 52.5 percent chance of achieving pregnancy per IVF cycle, compared to a 34.7 percent chance for women with insufficient vitamin D levels.

Other

In addition to the three above that are specific to being pregnant with PCOS, there are several other vitamins and nutrients that are known to support overall fertility health.

Click Here To Read All About The 10 Best Supplements For PCOS Sufferers!

Drugs used to treat infertility in PCOS patients

Fertility drugs are commonly used in fertility treatment, especially in PCOS sufferers. Medications, along with lifestyle changes, can help PCOS sufferers reduce symptoms, ovulate more regularly, and achieve pregnancy!

metformin

Metformin was originally only used to treat the symptoms of type 2 diabetes. As previously mentioned, a large percentage of PCOS sufferers have insulin resistance and are at risk of developing diabetes. Over the past 20 years, metformin has emerged as one of the most extensively researched and well-established drugs used to regulate and lower insulin levels and balance the metabolic system of PCOS sufferers. Research has shown that metformin can also help trigger ovulation in PCOS sufferers. In one particular study, researchers reported that PCOS patients’ menstrual regularity improved significantly and their androgen levels were reduced when treated with metformin.

Other studies have focused on combining metformin along with lifestyle changes to induce ovulation in PCOS sufferers. This included seven studies on the effects of metformin treatment compared to placebo and its impact on PCOS patients. Of the 156 PCOS patients in the studies who received metformin, 72 (46%) ovulated. 154 PCOS patients did not receive metformin treatment and only 37 (24%) ovulated.

Metformin can also be used by PCOS patients undergoing IVF treatment to reduce the likelihood of ovarian hyperstimulation syndrome. Some fertility specialists believe metformin may be a suitable alternative to oral contraceptives to treat symptoms caused by hyperandrogenism in PCOS patients. Metformin can help treat acne and excessive hair growth caused by excessive androgen levels.

Clomiphene (Clomid) & Letrozole

Letrozole is an aromatase inhibitor (lowers estrogen production) that can be used to induce ovulation in patients with irregular ovulation patterns or those suffering from anovulation. Letrozole improves ovulation by blocking estrogen production, which causes extra follicle stimulating hormone (FSH) to be released. The effects of letrozole on fertility have been extensively studied. Recently, researchers have focused on letrozole’s ability to treat infertility in PCOS patients.

Clomiphene is classified as an ovulatory stimulant and is better known by its brand name, Clomid. Clomid is a common oral medication used to treat infertility. It can also be used to induce ovulation in women who don’t produce eggs but want to get pregnant (like women with PCOS). Clomid is an estrogen receptor modulator that stimulates the production of FSH and luteinizing hormone (LH).

Research on letrozole and clomiphene to treat infertility in PCOS patients is extensive. Studies have shown that both drugs can increase the regularity of ovulation and the chances of conceiving in women with PCOS. However, recent research has found that letrozole is more effective than clomiphene in helping women with PCOS achieve pregnancy. A study conducted by the National Institutes of Health (NIH) found that PCOS patients treated with letrozole were more likely to ovulate and have a live birth compared to women treated with clomiphene. In the study, 374 women were treated with letrozole and 103 (27.5%) of these women had live births. 376 women were treated with clomiphene, but only 72 (19.1%) of these women had live births. The ovulation rate was also significantly higher in the letrozole group than in the clomiphene group.

gonadotropins

Gonadotropins are hormones that act on the ovaries and increase the production of sex hormones. Gonadotropin treatment is usually the second line of infertility treatment for PCOS patients when Clomid or letrozole does not result in pregnancy. Gonadotropin treatments are administered through injections, so they are often referred to as injections. Injectable gonadotropins enable over 90% of women with infertility and PCOS to develop mature follicles and ovulate. Gonadotropin treatment, along with timed intercourse, is associated with a 70% ovulation rate and a 20% clinical pregnancy rate per cycle.

Although gonadotropins can increase natural conception success rates, they are more commonly used with more advanced treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF). Gonadotropins increase the chances of success in IUI and IVF. The American Society for Reproductive Medicine (ASRM) has published research supporting these conclusions and showing that gonadotropin treatment is highly efficient at increasing ovulation and pregnancy rates in PCOS patients

Click here for more information on using gonadotropins to treat infertility!

Laparoscopic Ovarian Drilling (LOD)

Laparoscopic ovarian drilling is a recommended treatment for PCOS patients who are resistant to ovulation-inducing drugs such as clomiphene or letrozole. Ovarian drilling can help these women ovulate and increase their chances of conceiving. Ovarian drilling is a surgical technique that uses a laser or needle to puncture the membranes surrounding the ovary. The reduction in this testosterone-producing tissue results in reduced levels of testosterone in the body. This can help the ovaries release an egg each month, resulting in regular monthly menstrual cycles. About 50% of women become pregnant in the first year after ovarian drilling surgery.

Ovarian drilling is a one-time treatment, unlike most other PCOS remedies that involve taking medication every month. Ovarian drilling reduces the chances of multiple pregnancies compared to using fertility drugs. Ovarian drilling doesn’t cause ovulation or regular periods in all PCOS sufferers, but it can help almost all women respond better to fertility drugs.

Click here for more information on ovarian drilling published by the American Society for Reproductive Medicine.

Getting pregnant with PCOS involves medication and intercourse

Ovulation induction is typically the first medical treatment encountered by a patient with PCOS seeking infertility treatment. Ovulation induction involves the use of medication (such as Clomid/Letrozole or a trigger shot) to stimulate ovulation. Ovulation induction with clomiphene or gonadotropins is effective and causes cumulative live birth rates of about 70%. If medications are successful in inducing ovulation, fertility specialists may recommend beginning a timed intercourse cycle. Use of gonadotropins with timed intercourse is associated with an ovulation rate of almost 70%, a clinical pregnancy rate of 20% per cycle, and a live birth rate of 5.7%. Gonadotropin treatment is expensive, so it’s not common with timed intercourse. Gonadotropins are most commonly used with IUI or IVF as they are associated with higher pregnancy rates in PCOS patients.

For older patients or couples who have been struggling with infertility for a long time, your doctor may skip timed intercourse and recommend either IUI or IVF. Same-sex female couples or women looking to conceive alone with the help of a sperm donor skip straight to IUI or IVF.

Click here to learn more about ovulation induction!

Getting pregnant with PCOS by intrauterine insemination (IUI)

An IUI, commonly referred to as artificial insemination, is a simple procedure in which sperm is collected, concentrated, and deposited in a woman’s uterus. PCOS patients undergoing intrauterine insemination (IUI) treatment use either oral medications or injections to stimulate ovulation. Studies have shown that injectable gonadotropins and IUI increase the chances of a successful pregnancy compared to timed intercourse in patients with PCOS. Other studies have found that clomiphene, letrozole, and gonadotropins are equally safe and effective in treating infertility in women with PCOS undergoing IUI treatment.

Click here to learn more about IUI!

PCOS and In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is the most effective fertility treatment for PCOS patients. IVF treatment offers the highest success rates and fastest time to pregnancy of any assisted reproductive technology (ART). Research has shown that clinical pregnancy and live birth rates are similar in PCOS patients and normally ovulating women without PCOS. Fertility specialists recommend IVF treatment for patients who have tubal blockages or severe male factors at their initial evaluation, are of advanced age, or have failed other minor treatments. IVF can also be used in patients who have undergone tubal ligation.

IVF involves a process lasting several weeks/months in which eggs are removed from a woman’s ovaries, fertilized with sperm in a petri dish, grown in a laboratory for several days (usually 3-5), and then transferred to the woman’s uterus for development and the remainder of pregnancy. IVF is used in conjunction with a variety of drug protocols for PCOS patients to induce ovulation and produce more and better quality eggs, embryos and a receptive endometrium.

Click here to learn more about IVF!

The final result

A PCOS diagnosis is not the end of the world! It is the most common cause of infertility, affecting 1 in 10 women of childbearing age. At CNY Fertility, we work to offer our patients as many resources as possible. Check out the video tab on our Facebook page to learn from our doctors. You’ll find videos on improving fertility, managing stress and more, as well as dedicated videos on PCOS.

Click here to see how our CNY Colorado physician, Dr. Magarelli, discusses everything about PCOS!

Share on Pinterest Let’s get down to business. When you’re trying to have a baby, you want to know when to have sex. An ovulation test can help predict when you are most likely to be fertile, and you should do an ovulation test a few days before you expect to ovulate. Ovulation occurs in the middle of your menstrual cycle, which begins on the first day of your period. Once your ovaries release an egg, it lives for about 12 to 24 hours. This gives the impression that there is a small window of opportunity to conceive a baby each month. However, sperm can survive in your body for up to 5 days. So even if you don’t have sex during that 24-hour ovulation window, you can still get pregnant if you had sex a few days earlier.

What day should I start the ovulation test? The best time to start the ovulation test is a few days before you plan to ovulate. Ovulation occurs in the middle of your menstrual cycle, more or less a couple of days. Your most fertile days of the month are 1 to 2 days before and after an egg is released from your ovaries. Sperm can survive in the body for up to 5 days. So conception can occur if you have intercourse 5 days before ovulation and up to 1 day after ovulation. Predicting ovulation is easier when you have a regular menstrual cycle. With a 28-day cycle, you’ll likely ovulate on or around day 14, so you should start testing around day 10 or 11. If you have a short cycle, you can assume that ovulation will most likely occur within 4 days of mid-cycle. Therefore, you should start using an ovulation test kit 4 to 6 days before the middle of your cycle.

When is the best time of day to use an ovulation test kit? There is no wrong or right time of day to test for ovulation. Some women prefer to test their urine in the morning, while others test it in the afternoon or evening. Whatever time you decide, make sure you test at the same time each day. Keep in mind that liquid can dilute the amount of luteinizing hormone (LH) in your urine. When this happens, it can appear like you’re not ovulating when you are. Therefore, limit your fluid intake about 2 hours before the test. It also helps not to urinate 1 to 2 hours before the test. For the above reasons, many women use ovulation test kits right after waking up. The morning test also gives you plenty of time to put it on if the test gives the green light!

Ovulation Testing for Irregular Menstrual Cycles Ovulation test kits are more accurate if you have a regular cycle as it is easier to predict the middle of your cycle. But don’t worry – the ovulation test can also work with an irregular cycle. You just have to test more often. While women with a regular cycle only need to test for ovulation once a month, someone with an irregular cycle needs to test more frequently. You start testing a few days after your period and once a week thereafter. Even with an irregular cycle, you can look for telltale signs of ovulation that indicate it’s time to start using a testing kit. You need to be aware of physical changes like vaginal discharge and basal body temperature. Start using an ovulation test kit if you notice any of the following symptoms: Increased cervical mucus, especially discharge that feels slippery when wiped or has a protein-like consistency

an increase in your basal body temperature

increased sex drive

spots of light

mild pelvic pain

Testing for ovulation Ovulation test strips are used to detect the presence of luteinizing hormone (LH) in your urine. This hormone signals ovulation, i. H. the release of an egg from your ovaries into the fallopian tube. Although ovulation test strips can determine your most fertile days, they are not 100 percent accurate. But don’t worry — they can have an accuracy rate of up to 99 percent, depending on your menstrual cycle. To test for ovulation, you can urinate on the test stick or urinate into a cup and place the stick in the urine. Results are usually available in about 5 minutes. Ovulation test kits have two lines: one is the control line, which signals the test is working properly, while the other is the test line. This line will be lighter or darker than the control line depending on whether you are ovulating. The test line will appear lighter when you have low levels of LH in your body. It will appear darker when there are higher levels of LH in your body. This indicates that you are more likely to become pregnant. Find ovulation test kits here.

Call the OWH HELPLINE: 1-800-994-9662 9:00am – 6:00pm ET, Monday – Friday

OWH and the OWH Hotline do not see patients and are unable to: diagnose your medical condition; offer treatment; prescribe medication; or refer to specialists. The OWH Helpline is a resource hotline. The OWH hotline does not offer medical advice.

Please call 911 or go to the nearest emergency room if you have a medical emergency.

Many expectant mothers often ask: “How can I track ovulation with irregular periods?”. This question is very common and there are several solutions.

Irregular periods present a challenge when it comes to tracking ovulation and knowing when is the best time to have sex to get pregnant. The good news is that it’s pretty easy to track ovulation with irregular periods. Thanks to advances in modern medicine, you can even track your ovulation with some precision.

Knowing when ovulation occurs is crucial for those trying to conceive

Track your cycle – Even if your cycle is irregular, it’s good to track it on a calendar for a number of reasons. First you might notice some clues that give you a pattern. Second, if you have fertility issues, the data from your tracking efforts is valuable information to share with your gynecologist or fertility specialist.

Cervical mucus – Your cervical mucus changes when you ovulate. The cervical mucus is dry in the first few days after the menstrual cycle. Your cervical mucus begins to increase. As you approach ovulation, cervical mucus will be copious, slippery, clear, and stretchy. Many women compare the consistency to that of egg whites.

Basal Body Temperature – Your body temperature fluctuates as ovulation begins. If you track your basal body temperature, you will notice a rise in temperature when ovulation occurs. This will let you know that ovulation is taking place.

Track Ovulation With Irregular Periods: Ovulation Prediction Kits

Some people find it cumbersome to manually track ovulation when their periods are irregular. Ovulation prediction kits and fertility monitors are tools that do the tracking for you. Unfortunately, if your periods are irregular, especially longer ones, you’ll likely need to do more testing month-to-month.

Luteinizing hormone (LH) is regularly detected in your urine. There is an increase in presence 24 to 48 hours before ovulation. An ovulation prediction kit detects this surge and lets you know you’re ovulating. Because ovulation prediction kits help you identify and confirm when you are ovulating, be sure to put these dates on your calendar. Whether or not you check the calendar for patterns, the information will be helpful to a fertility specialist if you’re having trouble trying to conceive.

Would you like to know more?

Our Ultimate Fertility Resource Guide provides the information you need about fertility, tips on how to get pregnant faster, and how to boost fertility with sometimes simple changes to your lifestyle and approach. The guide is easy to read and intended for anyone looking to increase their ability to conceive. It’s a free download and includes coupon codes for major products. Even complimentary nightfood Nighttime Ice Cream.