How PCOS Affects Fertility

Polycystic ovary syndrome can make conception more difficult, but pregnancy remains possible with the right support. Dr Jackson Ndhlovu explains how PCOS affects fertility and what practical steps women can take.

Understanding PCOS And Ovulation

PCOS is a complex hormonal condition that disrupts ovulation, the process by which the ovary releases an egg around two weeks before the next menstrual period.

“This can cause irregular or absent periods, which do not follow a regular cycle of between 25 and 35 days. Tests usually show higher levels of male hormones such as testosterone,” Dr Ndhlovu explains.

The ovaries often contain multiple small cysts. These contribute to hormonal imbalance and make it difficult to track the fertile window. Without regular ovulation, conception becomes unpredictable.

Infertility And Hope

Dr Ndhlovu notes that 15 to 20 percent of South African women may experience infertility. PCOS is a common contributor.

“The good news is this cause of infertility can often be managed to some extent, making pregnancy possible,” he says.

Signs And Symptoms To Watch

Symptoms often begin in adolescence.

Common signs include:

• Irregular or absent periods
• Weight gain
• Acne
• Increased body hair

Dr Ndhlovu emphasises that PCOS does not always present in the same way. Some women maintain a healthy weight and regular cycles yet still struggle to conceive.

Managing PCOS For Better Fertility

Lifestyle plays a central role in management.

“Up to three-quarters of women with PCOS carry excess weight. Losing five to 10 percent of body mass can increase ovulation rates to up to 80 percent of the time,” Dr Ndhlovu says.

Action steps include:

• Exercise consistently
• Follow a balanced, healthy diet
• Stop smoking
• Limit alcohol intake

PCOS also affects mental health. Some women develop sleep or eating disorders. Referral for counselling forms part of comprehensive care.

Certain patients face higher risk of metabolic syndrome, which increases the likelihood of high cholesterol, diabetes and hypertension. Others develop acanthosis nigricans, dark velvety skin patches linked to insulin resistance.

Dr Ndhlovu advises open communication with a medical practitioner about all physical and emotional symptoms.

When To Seek Medical Help

Women under 35 who have tried to conceive for a year should consult a doctor. Women over 35 should seek help sooner if concerned.

If lifestyle changes prove insufficient, doctors may prescribe medication or injections to stimulate ovulation. These require close supervision due to possible side effects.

If conception does not occur after six months of treatment, further options such as in vitro fertilisation may be considered. Routine tests and semen analysis often form part of the process.

Women aged 44 and older face pregnancy rates of less than five percent per cycle. Egg donation may be discussed in these cases. Counselling is strongly recommended to manage expectations.

Addressing IVF Misconceptions

Dr Ndhlovu clarifies that IVF does not guarantee pregnancy. Outcomes depend on factors such as age and sperm quality.

He also challenges the assumption that IVF leads to multiple births. “We prefer transferring a single embryo to reduce risks associated with multiple pregnancies.”

His final advice remains direct.

“Find a medical practitioner with the right experience and speak openly. Do not struggle in silence.”

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