PCOS and Fertility

1 in every 5 women in India is affected by PCOS. Having PCOS does not lead to permanent sterility, but it is no surprise that PCOS can be one of the many reasons for female infertility. Pregnancy in PCOS is possible once the right hormonal balance is achieved and maintained, but often the chances of miscarriage is higher in women with PCOS.

PCOS women are at risk of Early Pregnancy Loss, defined clinically as first trimester miscarriage. Early Pregnancy Loss occurs in 30% to 50% of PCOS women compared with 10% to 15% of normal women[i].

If you desire healthy full-term pregnancy it is important to ensure that ovulation (release of mature egg) has occurred. Ovulation is estimated to occur on the 14th day of the menstrual cycle only if the hormonal levels are favourable. If ovulation does not occur pregnancy will not take place.

Factors that may prevent ovulation and increase the risk of miscarriage for women with PCOS:
  • Luteinizing hormone (LH) levels – in PCOS the LH levels remains high throughout. This hormone is responsible for the release of the egg with a rise in its level at the time of ovulation. But because it is constantly high, it is unable to create a surge and release an egg. Thus, ovulation does not occur and the ovaries collect fluid filled sacs.
  • Estrogen levels – this hormone is secreted by the follicles and is at peak with the release of the mature follicle. In PCOS, Because of a decreased level of follicle-stimulating hormone (FSH) relative to LH, follicle sensitivity is reduced and they aren’t maturing completely and the ovarian cells cannot convert the androgens to estrogens, this leads leads to decreased estrogen levels and consequent anovulation.
  • Testosterone levels – this male hormone is not converted to estrogen and is over produced within the ovaries due to MI: DCI imbalance and excessive LH secretion. It is responsible for PCOS symptoms like alopecia, acne and hirsutism.
  • Progesterone levels – this hormone is responsible for maintaining pregnancy after ovulation and conception. But it was recorded that women with PCOS, experiencing early pregnancy loss have low progesterone levels than required to support pregnancy. This hormone is also responsible for inhibiting LH production in the luteal phase of the cycle. For women conceiving with hormonal therapy it is important to frequently get their progesterone levels checked and supplemented to avoid mishaps during pregnancy[ii].
  • Obesity - it is well established that obesity is associated with anovulation, miscarriage, or late pregnancy complications (such as pre-eclampsia and gestational diabetes). Obesity is observed in 35%–60% of women with PCOS. Obesity also increases insulin resistances and may worsen PCOS.
Treatment options for PCOS: Hormonal Therapy/Oral Contraceptives Pills (OCP)

How the pills work – these pills are usually combination of high hormones or hormone like substances that mainly replicate estrogen and progesterone. These pills in normal condition are used to inhibit ovulation by maintaining high levels of estrogen and progesterone, tricking the ovaries into experiencing the luteal phase[iii]. They successfully reduces symptoms like acne, hair fall and hirsutism. The OCP’s are usually given for 21 days followed by placebo for 7 days and repeat.

Bleeding on pills is not a true period – OCP maintains false luteal phase for 21 days and causes bleeding for 7 days on placebo or withdrawal. Women may think that they are bleeding every month with these medications, but this is not true. The bleeding is due to the withdrawal of these medications.

Some women with PCOS have benefited from using OCP’s and are able to regularize their menstrual cycle and balance hormone levels after discontinuation, but this is not true in many cases. The pills often cause the patient to develop dependency and they cannot have a period without the pill and once they are off the pill, their cycle is irregular.

Discontinuing the pill for conception – you will have to discontinue using contraceptive pills in order to conceive, but is also important to note that, ovulation is a must for conception. Prolonged oral administration of hormones shuts off the communication between the ovaries and the brain which prevents natural ovulation and prevents the body from making its own hormones.

When this happens you are forced to visit your doctor and start treatment again.

An alternative to this is to use supplements formulated to help reverse PCOS from within the body causing it to produce adequate hormones which will further regularize the cycle and eventually reduce PCOS symptoms.

Unived’s PCOS Fertility - is one such supplement that is formulated with the scientific ratio of 3.6:1 of Myo-Inositol (1100mg) to D-Chiro-Inositol (300mg) along with 400mcg of Folate as L-5 Methyltetrahydrofolate.

We use Caronositol® which is 100% natural plant-based D-chiro-inositol, derived from the fruits of the Carob tree, a standardized and studied ingredient that has shown tremendous benefits in cases of PCOS.

3.6:1 ratio of MI: DCI is scientifically studied to support pregnancy and live birth and is based on the principle of epimerase (the enzyme that converts MI to DCI) deficiency and inadequate DCI for pregnancy. This ratio has a 65.52% fertility success rate in clinical trials and helps reduce chances of miscarriage in PCOS.

Benefits:
  • Supports female fertility and reproductive health.
  • Supports healthy ovarian function.
  • Helps increase chances of fertility by restoring inositol balance.
  • Higher DCI concentration to compensate for epimerase inactivity.
  • Helps reduce hyperinsulinemia, hyperandrogenism, LH levels to help restore ovulation.
  • Helps regularize healthy menstrual cycle.
  • Helps reduce symptoms of PCOS.

If you are a women with PCOS and at a stage in life where becoming a parent is your goal along with managing PCOS, then PCOS Fertility is the right supplement for you. If you are somebody who is not keen on conceiving at the moment and only reducing symptoms is your goal then we recommend our PCOS Management supplement for you.

Please note both of these products are capable of reducing symptoms, regularizing menstrual cycle, but our fertility product is optimized for pregnancy since it contains a scientific ratio of MI:DCI which is clinically studied for supporting pregnancy and reducing the chances of miscarriage.

References

[i] Kamalanathan S, et. Al., “Pregnancy in polycystic ovary syndrome”. Indian J Endocrinol Metab. 2013;17(1):37-43. doi:10.4103/2230-8210.107830

[ii] Badawy A, et.al., “Treatment options for polycystic ovary syndrome”. Int J Womens Health. 2011;3:25-35. Published 2011 Feb 8. doi:10.2147/IJWH.S11304

[iii] S. Nader, E. Diamanti-Kandarakis, “Polycystic ovary syndrome, oral contraceptives and metabolic issues: new perspectives and a unifying hypothesis”Human Reproduction, Volume 22, Issue 2, Feb 2007, Pages 317–322, https://doi.org/10.1093/humrep/del407