Can IVF help PCOS? Exploring IVF as a Treatment Avenue for PCOS

Polycystic ovary syndrome (PCOS) is a complex hormonal imbalance affecting countless women globally, and it’s a leading cause of infertility. Assisted Reproductive Technologies (ART) including in vitro fertilization (IVF) are a helpful avenue for women with this condition to conceive. This article delves into IVF for women with PCOS, and how this technology extends a pathway to parenthood for many grappling with PCOS-related infertility.

What is PCOS?

PCOS is a hormonal condition that causes the ovaries to become enlarged with small cysts on them. It can lead to irregular menstrual cycles, elevated androgen levels, and ovulation challenges, often resulting in symptoms like acne, weight fluctuations, and infertility.
According to the World Health Organization, an estimated 8–13% of women in their reproductive years are affected by this condition, with up to 70% of cases going undiagnosed. Certain ethnicities have a higher prevalence of PCOS, and individuals from these groups often face increased complications, especially concerning metabolic issues.

Challenges of conceiving with PCOS

Because of the impact PCOS has on reproductive hormones, infertility poses a significant concern. When ovulation is irregular or absent altogether, conceiving without assistance becomes challenging. Nonetheless, numerous women with PCOS can conceive with the help of lifestyle changes, medication, and reproductive health technologies, including IVF.

Options to help women with PCOS get pregnant

If you’re having trouble conceiving naturally due to PCOS, know that there are many options available to help you fulfill your dream of becoming a mom. 

Having excess weight is common in women with PCOS, and can lead to further hormonal disruptions. So, women who are overweight can improve their fertility with regular exercise and following a fertility diet. 

If insulin resistance is an issue, metformin can help regulate the body’s metabolization of sugar and balance the cycle. The medications letrozole and clomiphene can be used to stimulate the ovaries and induce ovulation, and have a high success rate (80%) of helping women with PCOS ovulate. A minimally invasive surgery called ovarian drilling is another option to lower testosterone levels and normalize the cycle to cause ovulation. 

If these treatments are unsuccessful, the next step is to try in vitro fertilization (IVF).

What is In Vitro Fertilization (IVF)?

IVF is a method to help couples have a baby when they have trouble conceiving naturally. It starts with hormonal medication to help women produce more eggs in a monthly cycle. These eggs are collected through a simple procedure. Then, the eggs are mixed with sperm in a lab to create embryos. Finally, one or more embryos are placed into the woman’s uterus to hopefully result in conception, implantation, and a successful pregnancy.

How IVF helps women with PCOS become parents

IVF presents a promising avenue for women with PCOS grappling with infertility by directly addressing challenges with irregular ovulation and lower egg quality. Tailored ovarian stimulation protocols optimize the chances of successful egg retrieval and fertilization, which increases the chances that conception will be successful. Furthermore, only the best embryos will be selected during the IVF to be transferred into the uterus, which helps mitigate the risk of miscarriage and chromosomal anomalies. This is especially important for women with PCOS who have a higher chance of pregnancy complications.

Things to consider

While IVF offers a promising avenue for pregnancy for women with PCOS, everyone considering this treatment should be aware of the emotional, physical, and financial strains that can come along with it. 

IVF often requires more than one round to lead to a successful pregnancy, which can be taxing on the body and mind. IVF costs can run up to the tens of thousands and may not be covered by insurance. However, you may be able to reclaim some of the costs for IVF treatment in your tax return. 

It’s also important to note that women with polycystic ovary syndrome (PCOS) undergoing IVF face a heightened risk of ovarian hyperstimulation syndrome (OHSS). Choosing the optimal method of ovarian stimulation and trigger method is essential to decrease the chances of OHSS and increase the amount of eggs per cycle. 

Research shows that antagonist cycles that use GnRH agonist trigger and pre-treatment with metformin and vitamin D can help reduce the risk of OHSS. Women with PCOS typically have a frozen embryo transfer (FET) as this is better for women with irregular cycles, but may increase the risk of hypertensive disorders in pregnancy including high blood pressure and preeclampsia.

Takeaway

For countless women grappling with PCOS, IVF represents a beacon of hope in their journey toward becoming parents. By directly addressing infertility, IVF offers a practical path to achieving pregnancy, enabling women with this condition to build the family of their dreams.

• Polycystic ovary syndrome. World Health Organization. Accessed 3 April 2024.
• Kotlyar, A and Seifer, D: Women with PCOS who undergo IVF: a comprehensive review of therapeutic strategies for successful outcomes. Reproductive Biology and Endocrinology. 2023:21;3.
• Ovarian Drilling for Infertility. ReproductiveFacts.org from the American Society for Reproductive Medicine. Accessed 05 September 2022.
• Teede HJ et al.: Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fert Stert, ASRM Pages. 2018. 10;3:364-379.