A large percentage of my patient population is PCOS patients. And a large population of my PCOS patients are also fertility patients.
PCOS is definitely associated with infertility and subfertility, but it isn't necessarily an infertility or subfertility diagnosis. There are a few different layers to consider when thinking about PCOS and fertility, some of which are listed below:
If you have anovulatory cycles i.e. you're not ovulating, then conception won't happen because we need an egg for fertilization.
If you have delayed or irregular cycles, it can be hard to gauge when you're ovulating.
If you have excess androgens like testosterone, that can interfere with the menstrual cycle and hormone release.
If you have unmanaged insulin resistance, then high insulin levels can interfere with placental development and lead to early pregnancy loss (as well as a variety of other maternal and foetal outcomes).
If you have a comorbidity like hypothyroidism, that can get in the way of conception, implantation, and pregnancy maintenance.
You might have a vitamin D deficiency at the same time, and that can impair implantation and pregnancy outcomes as well.
There are many other considerations here but those are some of the top ones. IUI and IVF can be helpful here, but those procedures will not change the environment in the body i.e. the higher risks of miscarriage, gestational diabetes, and gestational hypertension seen in PCOS still apply.
That's why a full assessment, comprehensive testing, and a tailored treatment plan is important. We don't only want to help with conception, but also with implantation, the maintenance of a viable pregnancy, healthy fetal and maternal outcomes, and a thriving babe.
Talk to your doc. And if you're in Ontario, feel free to reach out.
