How PCOS can affect Fertility

What is PCOS?

PCOS is a common hormonal disorder affecting 8-13% of women of reproductive age. It is characterized by a broad spectrum of signs and symptoms. Diagnosis of PCOS is normally made based on meeting at least 2 out of 3 criteria:

• Irregular or infrequent periods associated with oligo- or anovulation.
• Signs of high androgen levels such as excessive hair growth (hirsutism) and acne.
• Polycystic ovaries (PCO) on ultrasound: the presence of 12 or more follicles in each ovary that measure 2-9mm in diameter and/or increased ovarian volume (>10ml).

PCOS is also associated with metabolic syndrome. Many women with PCOS are overweight and have an increased risk of developing diabetes. Obesity often affects their hormonal balance as well.

Effect of PCOS on Reproduction

1. Sub-fertility: PCOS often presents with menstrual irregularities as a result of infrequent or no ovulation. This means that the ovaries are releasing eggs less often than normal and this reduces the chances of natural conception.

2. Ovarian Reserve: On the other hand, the reproductive lifespan of women with PCOS can extend on average 2 years beyond that of women with normal ovulatory cycles.

3. Miscarriage: Obesity in women with PCOS is closely associated with a greater risk of miscarriage and pregnancy loss.

4. Pregnancy Complications: Pregnant women who have PCOS are more prone to develop gestational diabetes, preeclampsia and cardiovascular disease. The rate of preterm delivery is also higher in these women.

How to manage PCOS

Lifestyle and dietary modification: As fore-mentioned, many PCOS women are overweight and the abdominal obesity is known to link with insulin resistance which can exacerbate the condition. Therefore, weight reduction through diet and exercise is usually the first line approach in women who are trying to conceive. As a side note, some women with PCOS may in fact be underweight and can have very low BMI.

Drug Treatment: Clomiphene Citrate (CC) or Clomid is generally the first line medication for ovulationinduction in women with PCOS. Another commonly used drug to induce ovulation is Letrozole. In addition, Metformin is often prescribed for women with PCOS who are diagnosed of insulin resistance.

How may Acupuncture and Chinese Medicine assist those with PCOS?

PCOS is a chronic disease that needs long term treatment. Women with PCOS seeking menstrual and fertility support now have a greater tendency to turn to alternative therapies as conventional medical treatment has inconsistent results, is expensive and may be associated side effects such as multiple gestation pregnancy.

Amongst all available options, acupuncture has  become increasing popular as an adjunctive treatment to IVF, particularly when ART alone has failed to achieve desirable results. Acupuncture can also support those that are trying to conceive naturally.

Studies find that acupuncture may help to increase blood flow to ovaries, reduce ovarian volume and the number of ovarian cysts, and may control hyperglycaemia by enhancing insulin sensitivity and lowering blood glucose levels. The mode of action appears to be through modulation of endogenous regulatory systems, including the autonomic nervous system and (neuro-)endocrine systems.

Based on Chinese Medicine theories, common disease patterns associated with PCOS are: Kidney Yang/Yin Deficiency, Damp-Phlegm, Blood Stasis, and Blood Deficiency.

Treating these underlying syndromes may help to improve PCOS symptoms and thus, potentially increase the woman’s chances of spontaneous conception. Clinical experience worldwide shows that up to 70 percent of cases of PCOS respond well
particularly to a combination of acupuncture, Chinese herbal medicine, and lifestyle and dietary changes.

Some of the common food advice include having warm/cooked foods and drinks; avoiding oily, pungent, fast and/or deep-fried foods and reducing foods that are known to increase insulin levels, specifically sugar and simple carbohydrates.

You don’t have to navigate your PCOS alone!

If you like to find out more on how to manage your PCOS or are seeking support with your fertility, please contact us or book in for an initial consultation. You can do so by calling us on 0414 067 874 or you can access our online booking system here. We would love to hear from you soon!

This blog post was written by Dr. I-Li Ho (TCM)