PCOS and fertility
How body weight affects fertility is only just becoming understood. It is thought that too much of the hormone insulin in the blood reduces the function of the ovaries in females and sperm production in males. So, having a healthy body mass index (BMI) and good nutrition is important for the health of both partners and improves the chances of a natural pregnancy.
In females, Oestrogen is needed to ensure the correct functioning of the ovaries and the lining of the womb (the endometrium). If oestrogen levels fall then the follicles – little sacs in the ovaries containing immature eggs – fail to release their eggs.
The immature eggs stuck in their swollen follicles are visible under ultrasound as little bumps on the surface of the ovary; this is a condition known as polycystic ovarian syndrome (PCOS) . This is a major cause of female infertility, as a mature egg is no longer being released each month ready to be fertilised with sperm.
Under normal circumstances, one egg will be released each month, and if it isn’t fertilised ovulation will be followed by a period.
However women with PCOS are not ovulating – releasing an egg – so instead the lining of the uterus thickens until eventually it is lost in a bleed.
A regular menstrual cycle is therefore a good indication that you are ovulating.
PCOS is diagnosed by Bourn Hall with a questionnaire about medical history and lifestyle, scanning the ovaries to look for raised follicles and by using blood tests, which look at the ratio between the fertility hormones. This diagnosis can be achieved quickly and is free for NHS patients referred by their GP or available for a small fee for those without a referral.
Bourn Hall encourages its patients to get fit for fertility and works closely with nutritionists and other complementary therapists. If specialist fertility treatment, such as IVF, is required the woman’s BMI needs to be 30 or less to be eligible for NHS funding
In the video below Dr Arpita Ray talks about PCOS and the fertility treatments available, however she stresses that having a healthy BMI (between 18.5 – 24.9) is the first step and seeking advice while you are younger gives greater options for treatment.
Dr Ray says “Women that do lose weight often manage to restart ovulation and either get pregnant naturally or are successful with ovulation induction”
Ovulation induction (OI) is where the ovaries are stimulated with medication to produce one mature egg and intercourse is timed with ovulation.
“Supporting these patients and their partners with a rapid diagnosis and the right information about nutrition and lifestyle can take them closer to achieving their dream.”