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Polycystic Ovary Syndrome (PCOS) is a prevalent yet often undiagnosed hormonal disorder that affects up to 15% of women in North America, with potential far-reaching health implications. 

In Canada alone, it is estimated that as many as may be afflicted with the condition, which can directly impact fertility. 

, one of Canada’s leading IVF and fertility centres offers expert insights to help clients navigate the details of PCOS, its impact on fertility, and practical strategies for improving their chances of conceiving.

What is PCOS?

PCOS is a multifaceted condition that can disrupt hormonal balance, ovulation, and metabolism, often leading to insulin resistance. There is also a genetic component, with a higher risk if PCOS runs in your family through your mother, sisters, or aunts.​

​How does insulin resistance affect fertility?

Insulin, a critical hormone, regulates sugar and starch conversion into energy or storage. Insulin resistance means your body requires more insulin to process sugar, resulting in excess insulin levels. 

Elevated insulin can trigger the rise of male hormones (androgens), leading to various symptoms such as acne, excessive hair growth, male-pattern hair loss, weight gain (especially in the abdominal area), and ovulation irregularities. The excess androgens can disrupt normal follicle development, potentially preventing egg release.

Diagnosing PCOS

PCOS can be difficult to diagnose due to the absence of a single definitive test, and symptoms can vary among individuals. Typically, a diagnosis is made if you have two out of three of the following symptoms:

1. Irregular, infrequent, or absent menstrual periods.
2. Excessive androgen levels, including symptoms like excessive body hair, acne, hair loss, weight gain (particularly around the belly), and elevated testosterone in the blood.
3. Distinctive appearance of polycystic ovaries on ultrasound.

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​Improving fertility with diet, weight loss, and lifestyle

While there's no one-size-fits-all solution for PCOS, research indicates that lifestyle changes can significantly enhance androgen levels, ovulation, and menstrual regularity. 

Here are some key strategies:

1. Low glycemic diet

The glycemic index (GI) ranks carbohydrates based on their effect on blood sugar levels. High-GI foods cause rapid blood sugar spikes, which leads to increased insulin production, weight gain, and a higher risk of diabetes. 

A low-GI diet can enhance insulin sensitivity and stabilize menstrual cycles. A has shown that a ketogenic (keto) diet may lower testosterone levels in women with polycystic ovary syndrome and improve fertility.

2. Weight loss

Obesity and excess weight are common in PCOS; even modest weight loss (5% of body weight) can improve fertility. If you're pursuing in vitro fertilization (IVF) and have a BMI over 40, losing a small amount of weight can boost success rates. 

According to , GLP-1 agonist medications like Liraglutide or Saxenda may also aid in weight loss and improved hormonal parameters in women with PCOS.  

3. Exercise

Regular physical activity can significantly increase insulin sensitivity. Aim for at least 30 minutes of moderate to high-intensity exercise daily, enough to break a sweat to help reset your insulin sensitivity.

4. Supplements

Consider incorporating the following supplements into your routine:

• Omega-3 Fish Oil: Reduces inflammation, insulin resistance, and testosterone levels while promoting regular menstrual cycles.
• Vitamin D: Common deficiency in PCOS linked to lower fertility, insulin resistance, and irregular cycles.
• Coenzyme Q10 (CoQ10): An antioxidant essential for cellular energy production; combined with clomiphene citrate, it may enhance ovulation and pregnancy rates.
• Inositol: Can reduce insulin resistance, regulate menstrual cycles, and promote ovulation and healthy egg quality in women with PCOS.

PCOS, a condition that impacts fertility, can have far-reaching effects on your overall health. However, the good news is that lifestyle changes, dietary modifications, and supplements, along with medical guidance and medications, can help you manage your PCOS effectively and increase your chances of achieving a successful pregnancy. If you suspect you have PCOS or are experiencing fertility challenges, consult a healthcare provider for personalized guidance and support.