PCOS and Fertility

Polycystic Ovarian Syndrome (PCOS), is a condition that is often associated with infertility. Women who experience PCOS often have longer menstrual cycles that are greater than 35 days or them to have less than 9 cycles a year. They also experience “hyperandrogenism,” where they exhibit symptoms of high androgens, such having acne anywhere on the body (commonly back and/or face), or hirsutism, where they have facial hair along their jawline. Asian women are less likely to display facial hair due to PCOS. During Ultrasound, a String of Pearls is often seen, caused by 10 or more follicles that were not able to mature along the periphery of the ovaries (Merck Manual). People who experience PCOS often have a difficult time regulating their blood sugars, sometimes leading to later diagnosis of Metabolic Syndrome.

Balance Hormones

This goes without saying. Hormones are how the body communicates what to do between different organs. Your brain sends messages to the pituitary gland, which sends messages to different organs to get things done. Every hormone if your body comes with a feedback loop, where the concentration of certain hormones is regulated. Balancing hormones would allow your body to regulate itself better and allow more regular cycles, and better regulation of insulin, and a decrease of hyperandrogenism symptoms.

One of the easiest recommendations to help with hormonal balance is by losing weight. A 5-10% decrease in body weight can be enough to regulate your menses, blood sugar, and allow you to get pregnant (Jiskoot et al, 2017). This might be all you need to balance your hormones and get pregnant; however, you may want to do more to continue enhancing your chances.

Regular Cycles & Ovulation

One thing that can happen from having irregular cycles or missing your cycle, can be not ovulating for that month. This is also known as anovulation and can be due to a hormonal imbalance between progesterone and estrogen. Women that do not ovulate can experience breast tenderness, fluid retention, PMS symptoms, and painful cramps with clots and heavy flow. These symptoms are also associated with estrogen dominance, which can prevent the body from ovulating and having regular cycles. Which brings us back to hormonal balancing.

As mentioned above, losing 5-10% of body weight can be enough to regulate hormones. However, if you are still not where you want to be, there are certain foods you can eat to help balance hormones. The Cruciferous vegetables contain sulforaphane glucosinolates that can up regulate glutathione, which is the master antioxidant in the body. It helps bind metabolites and is able to stop reactive oxygen species from attacking the cells (Fahey J, 1999). As a food, you would have to eat a ridiculous amount of these vegetables to experience the benefits.

If you have thyroid concerns, specifically hypothyroidism, make sure that you are cooking these vegetables because they are goitrogenic. This means that they can interrupt the production of thyroid hormones (Paśko et al, 2018).

Playing with hormones without proper knowledge can be a challenge and be potentially dangerous, depending on how you choose to go about it. So before you start working on your hormones, make sure that you find a practitioner that will be able to guild you properly.

~ Dr. Charmagne

Acupuncture and Fertility

Acupuncture has been used for thousands of years, first seen documented around 100 to 200 BC. Initially, sharpened stones or bones were used during treatments (News Medical Life Science), instead of the needles we now associate them with. Luckily, practitioners now use sterilized needles, of various widths and lengths. These needles are not coated with any medication and are single-use, and are disposed into a sharps container afterwards. All of the needles that I use are thinner than a needle that you get with injections. Some needles have a very thin layer of silicon around the shaft of the needle to help the practitioner insert the needle "faster and painlessly;" however, in my experience, it does not make much of a difference, unless you have fibromyalgia or another condition that makes you extremely sensitive to pain. Acupuncture is an incredibly safe therapy to use, whether it's for pain, improving fertility, relieving stress, regulating the nervous system, etc. when done by someone who has been trained properly. Treatments range from 30-45 minutes, depending on what is being addressed. 

Acupuncture is a useful therapy to use in conjunction with preconception care. Treatments have been known to decrease stress, and modulate the nervous system - which in turn can modulate hormones. There have been studies that have found that acupuncture, especially after in vitro Fertilization (IVF) increased rates of pregnancy, and delivery (Qian). Jungyoung found that acupuncture increased pregnancy, and ongoing pregnancy rates in women with Polycystic Ovarian Syndrome (PCOS). While Balk found that women undergoing IVF and receiving acupuncture, objectively felt less stress than women who did not have acupuncture. As a result, more women receiving acupuncture with their IVF became pregnant (64.7%), whereas 42.5% of the women not receiving acupuncture with their IVF became pregnant. 

Using acupuncture to help increase conception rates with or without IVF, is another tool in the toolbox that naturopathic doctors can use to help couples conceive. It helps increase blood flow (and therefore nutrition) to the uterus, improves egg quality, decreases uterine spasms, decreases stress, promotes relaxation. If you were looking for extra support throughout your journey, having a Naturopathic Doctor on your side would be a great addition to your health team. 

~ Dr. Charmagne

Preconception

Preconception is when couples start planning on having a baby, and preparing with what they think will improve their chance of conceiving. This period can be filled with stress and expectation - on yourself and your partner. This expectation can be counterproductive, and in some cases, cause quite a bit of tension. Know that you may not conceive the first time you try - and that is completely normal! Medically speaking, it's not considered infertility until you have tried for over 1 year - that being said, it wouldn't be considered infertility if you have only tried a handful of times within that 1 year.

Preconception is the perfect time to address diet and lifestyle changes with both partners. Lifestyle can heavily impact rates of fertility (to find out how you can improve your Foundation of Health, check our my series about it here). Being overweight, has a tendency to increase risk of malformation in the developing baby, and poses a greater risk for complications later on in pregnancy for Mama and babe (Zeynep), while decreasing sperm count, quality, and mobility in men (Ramaraju). The good news, is this is modifiable! Which means you have the power to change this factor! And what makes it even better, is the weight loss doesn't have to be dramatic - losing 5-10% can improve ovulation and fertility! Another lifestyle change that can have a huge impact of your fertility is quitting smoking. Smoking causes can increase infertility by 60%,  increase miscarriage, and risk of malformation in developing baby. 

Stress can be another influencing factor on fertility. If your mind and body is stressed, it isn't going to think you are safe to have a baby, and as a result, will suppress those functions until it thinks you are safe. Check out my other blog for tips and tricks to manage your stress. There's a high chance you may know someone, who wanted to have a baby, couldn't, and decided to adopt - just to conceive on their own shortly after. Yes, there can be a number of reasons why this happened; however, they also weren't putting that much pressure on themselves or their partners to conceive. 

It's nice to give your body 100 days to reboot from all of these changes. It takes at least 3 cycles for a woman to improve fertility and decrease risks, this is because the ova (eggs) are susceptible to damage 100 days before ovulation. As for men, it takes 72-116 days for sperm to mature, and during that time, they are also susceptible to damage. Rebooting your body during these 100 days is an amazing way to give your body the time it needs to optimize your fertility. During this time, be gentle with yourself, practise self-care via taking care of your body via healthy diet and activity, and any additional lifestyle changes you want to implement. You have enough pressures in your life, you don't have to add the stress about fertility on it as well. Practice this for 100 days, with no expectations, and be gentle with yourself.

There are also supplements and vitamins that you can take to improve fertility (eg. CoenzymeQ 10, and omega-3s); however, these basics are much more important, and in some cases, this is all couples need to conceive. If you have been working on this already, and are still having a difficult time. Book in with someone to help guid you, and who can make specific recommendations for you and your partner - because after all, it takes two to tango. Fertility isn't isolated to a single gender. 

Warmly, 

~ Dr. Charmagne