Polycystic Ovary Syndrome (PCOS) is the most common ovulatory disorder among individuals with ovaries, yet it remains widely misunderstood. At Boston IVF, our expert fertility care team and registered dietitians at the Wellness Center specialize in helping PCOS patients achieve their family-building goals while improving their overall health. Whether you’ve recently been diagnosed or have been managing PCOS for some time, this guide will help you better understand the condition and how to optimize your fertility and health.

What is PCOS?

PCOS is a hormonal disorder that disrupts normal ovulation. In a typical menstrual cycle, small follicles develop in the ovaries, eventually forming eggs. During ovulation, one egg is released, and the remaining follicles break down. In individuals with PCOS, ovulation doesn't occur as expected. Instead, follicles remain in the ovaries, forming fluid-filled cysts. While these cysts are not harmful, they lead to hormonal imbalances that affect fertility and overall health.

Common Symptoms of PCOS

PCOS symptoms vary, but many are linked to higher-than-normal androgen (male hormone) levels, including:

• Irregular, infrequent, or absent menstrual periods
• Infertility or recurrent miscarriage
• Thinning hair on the scalp and/or excess facial and body hair
• Acne and oily skin
• Pelvic pain
• Patches of thickened, dark, velvety skin
• Insulin resistance or type 2 diabetes
• Weight gain or difficulty losing weight

How is PCOS Diagnosed?

There is no single test for PCOS. Diagnosis is based on a combination of clinical, ultrasound, and laboratory findings, such as:

• Blood Tests: To assess hormone levels, including FSH, LH, estrogen, and androgens
• Ultrasound or Pelvic Exams: To check for ovarian cysts
• Medical History: Including past fertility challenges or family history of PCOS
• Endometrial Biopsy: In some cases, to evaluate irregular periods

Understanding PCOS and Insulin Resistance

A significant number of individuals with PCOS experience insulin resistance (IR), where cells become less responsive to insulin. This leads to excess insulin production, which contributes to weight gain, difficulty losing weight, and increased androgen production, which can further disrupt ovulation. Common signs of insulin resistance include:

• Fluctuations in energy levels
• Intense cravings for sweets
• Irritability when hungry
• A history of unsuccessful weight loss attempts
• Increased risk of type 2 diabetes and fatty liver disease

PCOS and Fertility

PCOS affects fertility by disrupting hormonal communication between the ovaries, hypothalamus, and pituitary gland. Excess insulin stimulates ovarian cells to produce more androgens, further interfering with ovulation. Additionally, abnormal levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) can hinder egg development.

How Can You Alleviate PCOS Symptoms?

While managing PCOS can be challenging, lifestyle changes can significantly improve symptoms and fertility outcomes. Key strategies include:

1. Nutrition & Diet

A diet focused on whole, nutrient-dense foods can help regulate insulin and hormone levels. Consider incorporating:

• High-fiber foods: Whole grains, fruits, vegetables
• Lean protein: Fish, poultry, legumes
• Healthy fats: Avocados, nuts, olive oil
• Limiting processed carbohydrates and added sugars

2. Exercise

Regular cardiovascular exercise (150 minutes per week) and strength training (twice per week) can improve insulin sensitivity, regulate hormones, and support overall well-being.

3. Supplements

Certain supplements may support PCOS management. Always consult your healthcare provider before starting any new supplements. Common options include:

• Inositol: May improve insulin sensitivity and egg quality
• N-Acetylcysteine (NAC): An antioxidant that supports insulin regulation
• Berberine: Aids in blood sugar control and may lower testosterone
• Vitamin D: Supports reproductive health
• B12: Particularly if taking Metformin

How Boston IVF Supports PCOS Patients

At Boston IVF, we provide comprehensive care for PCOS patients, including:

• Personalized fertility treatment plans
• Nutrition and wellness coaching with PCOS specialist Hillary Wright, MEd, RD, LDN
• Ovulation induction medications (e.g., Clomid, Letrozole)
• Insulin-sensitizing medications (e.g., Metformin)
• IVF and other advanced fertility treatments

While managing PCOS can be challenging, you are not alone. With the right combination of lifestyle changes, medical support, and fertility care, achieving pregnancy and improving your health is possible.