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PCOS And Egg Freezing

Marked by irregular periods, excess androgen levels, imbalanced hormones, and ovarian cysts, Polycystic Ovary Syndrome, PCOS, is often associated with infertility. The good news is that egg freezing is a viable option for those with PCOS — ensuring you can plan accordingly for your future.

Whether you’re busy with your career, focused on your education, or simply would rather wait to have a family, egg freezing empowers you with the choice to do so. So, let’s take a closer look at PCOS and egg freezing. What should you know?

What Are Signs Of PCOS?

PCOS symptoms usually emerge in one’s teens or 20s and can be active throughout the reproductive years. These often include:

Irregular periods
Hirsutism (excessive hair growth due to high androgen levels)
Irregular or no ovulation
Weight gain
Insulin resistance

Depending on the individual and their lifestyle choices, PCOS may also lead to an increased risk of diabetes or metabolic syndrome and high cholesterol.

Can PCOS Lead To Infertility?

About 80% of anovulatory infertility cases, which means ovulation doesn’t occur, are caused by PCOS. Moreover, approximately 70-80% of individuals with PCOS will experience difficulties with conceiving. Simply put, PCOS can contribute to infertility — yet, this doesn’t mean that getting pregnant is impossible.

This type of infertility is usually treatable, with fertility treatment recommended after six months of trying the all-natural way without success.

PCOS Fertility Treatments

A PCOS diagnosis isn’t the end of the road to achieving your future dreams of having a family. There are various options, including egg freezing, lifestyle changes, dietary changes, ovulation medication, and in vitro fertilization (IVF).

PCOS Egg Freezing

It’s important to keep in mind that PCOS can show up on fertility tests, often with results indicating a higher ovarian reserve (AFC usually over 20-30, normal 14; AntiAMH >45pmol/L), which can be misleadingly reassuring. However, despite this apparent abundance, the eggs or follicles in PCOS are still vulnerable to declining fertility as maternal age progresses. So, those with PCOS who are considering delaying fertility plans, just like anyone else, should think about egg freezing. The bright side? You’re likely to have a good number of eggs to work with!

So, what should you expect? Generally, the EVOLVE egg-freezing process follows these steps:

Step 1: Consultation

This initial consultation with an EVOLVE nurse is to help you understand the process and determine if it’s right for you. You can also ask any questions you might have about how it works or the steps involved.

Step 2: Fertility Testing

If you’re ready to take the next step, we will set up a fertility assessment for you. This involves testing for AMH, FSH, estradiol, and AFC, as well as a collection of your medical history.

Step 3: Follow-Up Appointment

This appointment breaks down the results of your fertility tests. From this, your physician will inform you of the number of eggs likely to be retrieved. These tests further determine your exact stimulation cycle.

Step 4: Stimulation

At this stage, medication is taken each day to stimulate the egg follicles to grow and mature. Each plan is different, depending on the unique results from your fertility testing and your medical history.

Step 5: Egg Retrieval

Approximately 36 hours after your trigger shot (a medication involved in the stimulation phase), you undergo the egg retrieval procedure. This involves light sedation, where your fertility team extracts the eggs using aspiration.

Step 6: Egg Freezing

The eggs collected then undergo the egg vitrification process. This means they are frozen and kept safe until they are needed later on. After this, you also have a follow-up appointment with your fertility team, where you’re informed about the success of your procedure.

PCOS Lifestyle Changes

With a PCOS diagnosis, your healthcare team will often recommend dietary and lifestyle changes. In terms of lifestyle changes, this may involve an encouragement of regular physical activity to help maintain a healthy weight.

Additionally, healthy stress management strategies may be advised. This often varies from person to person. For example, meditation or deep breathing exercises might be effective for some individuals, whereas others might find relief through journaling or alternative stress-relief techniques.

Dietary Changes For PCOS

Nutrition is usually one of the first approaches for managing PCOS. With insulin resistance closely linked to this condition, a healthy diet can help re-balance hormones and enhance fertility. Note: not every individual with PCOS experiences insulin resistance, and it is not part of the official diagnostic criteria. However, there is a strong connection between your insulin levels, PCOS, and your body’s capacity to use insulin.

Some things to consider include:

Balancing carbs and protein at each meal for blood sugar regulation
Avoiding high-sugary beverages
Selecting low-GI (Glycemic Index) foods
Limiting trans-fatty foods
Incorporating more vegetables
Adding healthy fats to meals
Limiting alcohol and processed foods

Ovulation Medication

Because of the irregularity of hormones and the menstrual cycle with PCOS, ovulation frequently fails to occur (called anovulatory cycles) or occurs irregularly. If you’re experiencing anovulatory cycles, your doctor may recommend ovulation medication to help your follicles release an egg. Options may include the following, however, we recommend you consult with your physician:

  • Clomiphene: This is usually taken during the first half of the menstrual cycle to encourage ovulation.
    Metformin: If clomiphene alone doesn’t work, metformin may be prescribed. This medication helps improve insulin resistance, which may enhance the ovulation process.
  • Gonadotropins: While more expensive than other options, this medication is taken as shots and also helps trigger ovulation.
  • Letrozole: This medication works by slowing estrogen production and increasing the Follicle-Stimulating Hormone (FSH), which is necessary for ovulation.

IVF For Polycystic Ovaries

Most individuals with PCOS respond well to in vitro fertilization (IVF). The first step of the IVF process is the egg retrieval procedure—the same as the egg freezing process minus the freezing step—described above. The additional steps in IVF involve creating an embryo and implanting that embryo in the hope of a successful pregnancy. However, these additional steps for IVF can also be followed after the thawing of frozen eggs.

A risk that comes with this, however, is Ovarian Hyperstimulation Syndrome (OHSS). While uncommon, this condition is more likely to happen to those with PCOS. Yet, a trusted and experienced fertility team will monitor you closely and manage any risks throughout the process. Note — it is very rare to become significantly ill with OHSS.

If you’re interested in learning more about freezing your eggs, talk with us. Book a call with an EVOLVE nurse today to determine if egg freezing is right for you.