Having trouble getting or staying pregnant? Visited a few different fertility centers here in Chicago and still looking for answers? We understand. While age remains the biggest challenge in conceiving, Polycystic Ovarian Syndrome (PCOS) is not too far behind as a leading cause of infertility.

During the month of September, we take the time to raise awareness about PCOS which affects 1 in 10 women. We sat down with Nurse Practitioner, Kaitlyn Burke from Reproductive Medicine Institute one of Chicagoland’s leading fertility centers, to help separate fact from fiction when it comes to PCOS and infertility.

In short, what is PCOS?

KB: PCOS is the most common hormonal disorder affecting fertility in women of reproductive age.  It is characterized by difficulty recruiting a mature egg to ovulate, so those with PCOS may ovulate infrequently or not at all, resulting in irregular or absent periods. It also involves increased androgen (male hormone) production.

Those diagnosed with PCOS may experience irregular menstrual cycles or no periods at all, hirsutism (growth of thick hair on areas such as on the face, abdomen, and chest), darkening of the skin on the neck and/or armpits, acne, and difficulty getting pregnant. Obesity and insulin resistance are also associated with PCOS.

How is PCOS diagnosed?

KB: PCOS is diagnosed using a combination of physical exam, medical history evaluation, ultrasound, and bloodwork. The criteria especially important for diagnosis are irregular or absent ovulation, excess androgen (testosterone) production, and ultrasound showing many follicles with potentially enlarged ovaries.

Is there a cure for PCOS?

KB: There isn’t a specific “cure” for PCOS, but there are things that you can do to stay healthy and possibly to achieve ovulation and more regular menstrual cycles. There is fertility treatment to help with ovulation to become pregnant.

If you are not attempting pregnancy, certain forms of contraception can prevent pregnancy while also helping to regulate your menstrual cycles if you are a good candidate. It is important to speak with your healthcare provider if you are having irregular menstrual cycles, whether you want to be pregnant or not. There are also medications that can help decrease the androgen (testosterone) excess that causes some of the symptoms of PCOS.

Can I do anything to decrease my PCOS symptoms?

KB: Achieving and maintaining a healthy weight is important for everyone, but it is especially helpful to those with PCOS to help regulate your menstrual cycles. A normal weight gives you the best chances to help regulate your hormones as well as prevent long term health conditions such as diabetes.

How will PCOS affect my fertility?

KB: Having PCOS can make it difficult to ovulate regularly, which can be very frustrating when trying to become pregnant. A more conservative option for those who are trying to conceive with PCOS is called ovulation induction. Ovulation induction consists of taking a short course of oral medication such as Clomid or Letrozole to help grow a mature egg to ovulate, and then timing intercourse when you are ovulating. You may also have an IUI, or intrauterine insemination, within this type of cycle.

IVF may be indicated for those who grow too many mature eggs with oral medication. In this way, IVF helps to better prevent against a multiple pregnancy, such as twins or triplets. IVF may also be indicated if you do not ovulate with the help of oral medication.

Is more than my fertility affected by PCOS?

KB: Yes, we know that those with PCOS have a higher risk of type 2 diabetes, high cholesterol, high blood pressure and heart disease, so it is especially important to stay healthy and to go to see your primary care provider annually for a physical exam and maintenance labs.

You should let them know if you have PCOS so they can keep a closer eye on any evidence of these conditions and treat you sooner if you do develop them. Having irregular or absent cycles can also increase your risk for problems with the lining of your uterus, so if you are experiencing this, you are recommended to see a women’s health care provider, such as a gynecologist.

Are there any lifestyle changes I can make to improve chance of pregnancy?

KB: We recommend you eat healthy, participate in moderate exercise (150 minutes per week, such as 30-minute exercise sessions 5 days out of the week), and maintain a healthy weight. Dietary recommendations include eating plenty of lean protein, fruits, vegetables, whole grains, and antioxidants, while minimizing saturated fats and simple carbs like white bread and white rice. We can discuss individualized plans to help you achieve your goals as well as refer you to more specialized resources.

I’ve been diagnosed with PCOS, should I see a fertility provider if I am ready to conceive?

KB: If you have been diagnosed with PCOS, you may need additional help to conceive. It would be a good idea to see a fertility provider to further evaluate your specific circumstances. Diagnostic testing will help us to see if fertility treatment is recommended for you to improve your chances of conceiving. We can also discuss more long-term goals and health considerations related to PCOS.

If you have been diagnosed with PCOS, or believe that you may have PCOS, the fertility specialists at Reproductive Medicine Institute can help! We have offices in Chicago, Oak Brook, Oak Law, Elmhurst, Evanston, and coming soon to Naperville.