PCOS and Fertility

Polycystic Ovarian Syndrome (PCOS) can be a complex issue to understand. If you have been diagnosed with PCOS, there are some risks and some challenges for you, but there are also some things you can do to help.

Polycystic Ovarian Syndrome usually affects a woman’s hormones; she ends up producing too many male sex hormones (androgens), which can cause her to take on some male physical traits, like male pattern baldness, or growing facial hair. Other characteristics of PCOS are acne or oily skin, sleep apnea, and missed periods. Because of the hormonal imbalance, a woman’s fertility is also affected. When a woman without PCOS ovulates, her ovaries build what’s called a follicle, which develops and then releases the egg into the fallopian tube. When a woman has PCOS, the follicle develops partially, but there are not enough hormones to develop the eggs, so the follicle just sort of hangs around in the ovary. Sometimes the unused follicle attaches to the ovary as a cyst, hence the name: Polycystic Ovarian Syndrome.

This is obviously a major challenge to women with PCOS who want to conceive: if you don’t ovulate, you can’t get pregnant! So what can you do to increase your chances of getting pregnant?

Another hormonal component of PCOS is that it affects insulin production. You will likely want to speak to a nutritionist about a healthy, whole food-based, low-carb diet to help control your blood sugar levels and keep your weight in check. It is especially important to maintain a healthy weight in order to help keep reproductive hormones in check. It is difficult as a woman with PCOS, since the hormonal imbalance often encourages weight gain. Your hormones encourage weight gain and your weight gain encourages hormone imbalance—tough spot to be in. Make sure you exercise daily as a means of encouraging hormonal health as well as maintaining an ideal weight.

If that is not enough to get your cycles back on track and get you on your way toward making a baby, you can try taking fertility meds like Clomid. Clomid (a trade name for a drug called clomifene) works to help your ovaries produce and release eggs. This may be the “missing piece” in your fertility puzzle, although there are some side effects. If the Clomid doesn’t work, there are some more powerful hormonal treatments you can use to increase your chance of ovulation, but the side effects of these are even more intense than with Clomid. Finally, you can try in vitro fertilization (IVF), where several fertilized eggs are implanted into your uterus in the hopes that one or more will implant and grow into a healthy pregnancy. This also carries risks, and is very expensive.

There are many options to try if you have been diagnosed with PCOS, but they all need to be discussed with your doctor. PCOS used to almost be a death sentence to a woman’s desire to have a baby, but now women have many options to help them conceive!

Fertility Drugs and Acupuncture


Treatment by acupuncture

When you’re trying to conceive, and there’s still no sign of a bun in the oven, what is your best approach to take: a modern western approach, or an ancient eastern approach? Both have advantages, although, until recently, it was seen as an “all or nothing” equation. Western doctors tended to be unwilling to discuss alternative therapies as they prescribed drugs.

But as the song goes, ‘the times, they are a-changin’; fertility drugs and alternative therapies can be seen as complementary practices, rather than opposing forces.

Women who are unable to conceive due to lack of ovulation are often prescribed a drug called Clomid (clomifene). Clomid can also be prescribed for women who are unable to conceive for unknown reasons, but it has shown to be far less effective in this scenario. It works by stimulating the body to produce more estrogen, so that a woman’s ovaries will produce and release a mature egg each month. There are other fertility medications, but most are considered a less-desirable option due to a higher chance of side effects and a potentially lower level of effectiveness.

Acupuncture also claims to be able to help with infertility, by aligning the individual’s meridians (energy pathways) in the body in order to allow for a better flow of qi (energy), resulting in greater relaxation and better health. Of course, the relaxation angle only works if you can be comfortable with the idea of needles going into your skin all over your body! Other than that, it seems that there could be some merit to those claims.

There have been some studies in combining western infertility approaches like IVF or the use of Clomid with acupuncture, and they have shown that acupuncture can increase the chances of conceiving. If you have been trying to conceive for long enough that you would be considered for either of those treatments, it likely would be worth it for you to combine those treatments with acupuncture. Clomid might be partially or mostly covered by health insurance, but IVF will cost tens of thousands of dollars. If you’re already spending that much money on fertility treatments, you may as well spend a few hundred more on acupuncture to increase your chance of success.

There are no known side effects of acupuncture on a woman trying to get pregnant, so, while there are no guarantees, many women may decide that it is worth stepping outside their comfort zones in order to increase chances to conceive without experiencing any extra negative side effects. If you get pregnant while you’re doing acupuncture, it can even be helpful to maintain acupuncture treatments into pregnancy, as there have been no negative side effects of acupuncture on pregnancy (obviously, once you see the two blue lines, you will want to follow your doc’s orders about discontinuing fertility treatments).

So modern and ancient techniques can work together in harmony! Just listen to your body and make sure you are discussing all potential treatments with your partner and your doctor.

Understanding Clomid



When you’re trying to conceive and you don’t get the positive pregnancy test you were looking for after several months, it can get discouraging. You may feel frustrated that what seems like such a simple process isn’t working as you’d hoped. Maybe you’d started to plan a birth date during a certain season, and you have to keep changing your expectations as the seasons pass and you keep seeing only the one blue line. You may start to feel that something is wrong with you.

If this happens to you, it’s a good idea to start with your doctor. It may help to get a full blood panel to check out your hormones, levels of trace elements, and to see if anything else is going on. Your partner will want to see a doctor as well, for the top-to-toe check up and maybe a test to check sperm count and motility. If, after all the tests, the doc thinks that the reason that you’re not conceiving is that you are not ovulating, Clomid may be an option for you. Clomid usually only works on women who are not ovulating, and there is much less success if the cause of infertility is unknown.

Clomid (trade name for a drug called Clomifene) works by telling your body to ovulate, whereas you may not naturally ovulate on your own. Obviously, ovulation is necessary for making a baby, so if you’re not ovulating, or ovulating only intermittently, your chances for sperm meeting egg go way down.

How it works is you take 50mg a day for five days, starting a few days after your period starts. Around the time you would normally ovulate, your doc will tell you that you should have sex as much as you can (not too shabby!). You can also use tests to detect luteinizing hormone (LH) to see if the pills are working as you want them to. (If there is no surge in LH, it means that you are not ovulating, and they can artificially induce ovulation by giving you a massive shot of hCG, but this is not a preferred method for a number of reasons.) You can use Clomid for successive cycles if you don’t end up getting pregnant right away, increasing the dosage each time, but the number of cycles you should take it (per manufacturer’s instructions) is six.

As with any drug, there’s the possibility for side effects: the most common side effects are headache, vision problems, hot flashes, and abdominal discomfort. There may be a chance that it may increase your risk for certain cancers, but this has not been proven conclusively. It also makes it more likely that you will release multiple eggs, so your chance for twins and triplets goes up.

It’s an emotionally and physically challenging landscape to navigate, so you need to make sure that you and your partner are keeping the ol’ lines of communication open. Make sure you talk about your fears and concerns and that you stay in touch about what you each are thinking about different treatment options. Clomid is one tool in the fertility tool belt, and it may or may not be the right treatment for you. Good luck!


Freezing Fresh Sperm Is Viable Option for Infertility

Sperm removed from testicles and frozen, then given to men who have no sperm in their semen works as well as fresh sperm in assisting couples conceive using in vitro fertilization (IVF), according to research at Washington University School of Medicine in St. Louis.

Scientists also found that the facility where sperm is removed and how far from the IVF lab doesn’t affect pregnancy outcomes.

The conclusions, presented online in PLOS ONE, may be advantageous to males without sperm in their semen for various reasons. These men don’t have enough sperm to conceive their own kids via IVF without biopsies.

In these males, testicle biopsies often result in enough usable sperm for a procedure named intracytoplasmic sperm injection (ICSI) as part of the IVF procedure for men suffering from severe infertility.

The biopsy, normally an outpatient process, involves taking tissue from testicles and analyzed for sperm. If sperm are detected, they’re withdrawn and immediately used in ICSI or frozen for later use.

When using fresh sperm, the biopsy for taking the sperm needs to be undertaken within a day of retrieving eggs from the woman. This may not be particularly accommodating for the couple. Should frozen sperm be used, the guy can first undergo his biopsy. If sperm is located, it can then be stored. Later, when the couple is ready, his partner’s eggs are removed and ICSI can be finished.

Prior to ICSI, the woman gets daily injections of fertility medicine for up to 10 days to prompt her ovaries to release eggs. Using ultrasounds to find eggs, the doctor then takes them from the ovaries with a tiny needle.

In this research, scientists studied information from 1995 through 2009 from Washington University Infertility and Reproductive Medicine Center.

Testicular biopsies were done on 136 men and used in the ICSI. Of those procedures, 84 percent included frozen sperm while the remaining 16 percent utilized fresh sperm. There was a statistically significant variation in fertilization rate between fresh sperm (47 percent) and frozen sperm (62 percent), respectively. There wasn’t a noticeable variation in the delivery rates.

Two urologists carried out 150 testicular sperm biopsies inside an operating room next to the IVF lab, inside an operating room located in a different building roughly one mile away from the IVF lab, then in a mobile surgical center approximately 15 miles away from the IVF lab. The third site was no more than 30 minutes from the IVF lab.

No statistically significant differences were recorded from the different locations and pregnancy developments.

“Men without sperm in their semen now have multiple options to bear their own children,” said Randall Odem, MD, professor of obstetrics and gynecology and co-author of this research, who advises that infertile men seek medical care from a urologist experienced with male infertility and a reproductive endocrinologist.

“This research shows that utilizing frozen sperm removed by biopsy works just fine for many patients in the most important thing, pregnancy rates,” he stated.


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Fertility after Cancer Treatments

When you get the awful news that you have cancer, fertility isn’t likely to be the first thing on your mind. At that point, you’re more likely to be asking questions about survival rates, available treatments, and whether your hair is going to fall out. However, patients of childbearing age who receive a cancer diagnosis should make it a point to ask their doctors about the effects on fertility of any cancer treatments they recommend.

This is information that many doctors share as a matter of course, but recent surveys have shown that not all cancer patients get the information they need about the effects of cancer treatments on fertility. The real shame of this is that many cancer patients could safely and effectively have their eggs or sperm harvested in order to allow them to have children after their cancer treatments are finished.

Having your sperm or eggs frozen to ensure that you can have children after cancer is not covered by most insurance companies. If you are unable to meet the expense, however, there are agencies, such as Fertile Hope which may be able to help you cover the out of pocket expenses.

The degree to which cancer treatments affect your ability to conceive naturally depends on which type of treatment you are undergoing and the parts of your body affected by the cancer and the treatment. Cancers involving the reproductive organs have a greater impact on fertility than cancers which affect other organs.

These cancer treatments often have a negative effect on your fertility:

  • Chemotherapy. Most doctors advise waiting at least two years after chemotherapy to become pregnant, even when it doesn’t affect your fertility. If you want to become pregnant after cancer treatments, make sure your doctor is aware of this. Some chemotherapy drugs have more effect on fertility than others. Most will make you infertile for at least six months. Some can make you permanently infertile.
  • Radiation therapy. Radiation therapy generally only has a permanent effect on fertility when the treated area is in the pelvic region or near reproductive organs. Radiation treatment can also have an effect on sexual function in general. The effects may or may not be permanent, so make sure to discuss the risks with your doctor before undergoing treatment.
  • Surgery. The effects of surgery depend on the part of the body from which the cancer is being removed. Surgery on reproductive organs obviously has an effect, but if your cancer was caught early, doctors can sometimes operate without eliminating your chances of having a baby altogether.
  • Hormone therapy. Some of the hormonal therapies involved in treating cancer-especially breast cancer-are believed to have a negative impact on fertility, though the extent of this impact isn’t fully known.
  • Bone marrow or stem cell transplant. Because these procedures include large doses of radiation and chemotherapy, they often affect a woman’s ability to produce eggs. Talk with your doctor before beginning treatment.


What medical procedures have you experienced which can affect fertility?

Opening Up Your Options: After Infertility

Some couples have conditions that just can’t be fixed with fertility treatments. For many, the dream of becoming parents ends right there. They feel like having their own natural child is the only and best choice.

Still, that desire to become a parent doesn’t always go away. While it’s not always ideal, there are some options for couples to become parents even after infertility has removed their hope of having a biological child.

Here are some of the options you have after infertility:

  • Adoption. Most couples struggling with infertility consider adoption at some point. The fact is there are many children and babies that need a family. If you’re intent on adopting a baby, you might have a long wait as there are many couples who are in the same boat. If you’re willing to adopt a baby or even a little bit older child who has special needs, however, you may find you’re a parent much quicker. There is a great need for adoptive families both in the United States as well around the world. In many cases, if you adopt a special needs child, there may be state or federal financial assistance that can help with the child’s care.
  • International adoption. Many couples who have become frustrated with the domestic adoption situation turn to international options. There are many countries that allow Americans to adopt, and in many cases these healthy babies simply need a place – other than an orphanage – to live and grow.
  • Foster parenting. You can also consider taking in foster children. A foster child stays with you for a short term, in many cases. However, if you really click with the foster child and if the court allows it, fostering can be the first step in an adoption.
  • Moving on with support. The above options aren’t always easy or attractive to every couple. The stress of infertility is often enough to turn the couple off to the idea of having children altogether. There are support groups for survivors of infertility, and these groups can help you understand how to process your feelings and how to move forward. Couples or individual therapy can be helpful here, as well.

Infertility doesn’t mean you’re less of a person, or that you don’t have options. It just means you need to figure out what’s best for you going forward.