Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a common hormonal disease that may affect regular monthly periods, ovulation, and fertility. Women who have been diagnosed with PMOS are often concerned about their ability to get pregnant naturally or through any fertility treatment.
The reality is that PMOS and pregnancy are highly compatible for numerous women. Even though PMOS frequently causes ovulation problems and irregular menstrual cycles, and thus affects fertility, the condition can be controlled by making the right lifestyle changes, as well as receiving proper medical care.
Moreover, understanding the causes of PMOS, as well as being able to identify the symptoms, will help you in determining if and when you should visit a fertility clinic.
In this article, we will discuss PMOS and pregnancy, as well as the available treatments and therapies.
What Is PMOS?
Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a hormonal and metabolic disease associated with the ovarian function disorder.
Irregular menstruation, high levels of androgen hormones, and multiple follicles in the ovary are common symptoms of the condition. However, having cysts is not mandatory for a PMOS diagnosis. Only a healthcare provider can determine whether a woman has PMOS based on the symptoms, examination, and laboratory tests. The disease may cause infertility due to the disruption of the ovulation process, although it depends on the patient’s condition and treatment options available.
Even though most women with PMOS have difficulty getting pregnant, some get pregnant naturally while others require ovulation induction to become pregnant.
Can You Get Pregnant With PMOS?
Yes, it is possible to get pregnant with PMOS. Many women have gotten pregnant naturally or with the help of fertility treatments.
The fertility problem that causes difficulty getting pregnant for many women with PMOS is irregular or absent ovulation. This makes it hard to know when you are ovulating and therefore decreases your chances of getting pregnant.
Other factors that can contribute to difficulty getting pregnant include: age, sperm quality, fallopian tube damage, being overweight, and having other medical problems.
Having PMOS does not necessarily mean that you are unable to have children. See a fertility doctor who can help you determine what options are best for you and your partner.
How Does PMOS Affect Fertility?
Polyendocrine Metabolic Ovarian Syndrome may cause infertility in a number of ways.
Irregular Ovulation
Ovulation occurs when an ovary releases an egg. With PMOS, hormones must be balanced in order to allow ovulation to happen. Meaning, a woman may not be able to regularly produce eggs that are capable of being fertilized. This may result in difficulty getting pregnant.
Hormonal Imbalances
Women with PMOS commonly have higher than normal levels of androgens (male hormones). Hormonal imbalances may prevent normal ovulation from occuring and may cause other symptoms such as acne, unwanted hair growth, absent periods, etc.
Insulin Resistance
Women with PMOS are at a higher risk for insulin resistance. Not all women with PMOS will experience insulin resistance though. When the body cannot properly respond to insulin, the hormone that allows the body to process sugar, the body will begin to produce additional insulin to make up for it. Having too much insulin in your system can affect the way your body produces hormones, which can lead to PMOS. Treating insulin resistance may help in your PMOS treatment plan as well as your treatment plan for becoming pregnant.
Other Causes of Infertility
Sometimes, despite PMOS, a woman may have difficulty getting pregnant. Other factors such as male infertility, tubal adhesions, age, PMOS itself, and other medical conditions may affect the likelihood of becoming pregnant. Getting your fertility tested can help determine what may be affecting your ability to get pregnant.
Common Symptoms of PMOS
PMOS symptoms can be different for each woman. Some women may have many symptoms, while some may only have a few.
- Irregular periods
- Infertility or difficulty getting pregnant
- Excess hair on face and body
- Acne or oily skin
- Hair loss or thinning of the hair on the head
- Weight gain or have a hard time losing weight
- Dark patches of skin may also develop
Having these symptoms does not necessarily mean that you have PMOS. If you are having irregular periods or any of the above symptoms, it is best to speak with a qualified medical professional.
How Is PMOS Diagnosed?
There is no particular test that can confirm PMOS in every woman. The doctor usually evaluates the signs and symptoms, medical history, pelvic examination, and additional tests.
The doctor may recommend the following:
Medical history and menstrual history: The doctor will review your medical records and inquire about irregularities in your menstrual cycle, significant symptoms, previous pregnancies, and contraceptive use.
Hormone tests: Measures hormone levels, including androgen levels, and helps to rule out other possible disorders such as diabetes. A blood test for glucose tolerance can also be prescribed.
Pelvic ultrasound: An ultrasound scan allows the doctor to see the number and shape of follicles in the ovaries. This procedure is indicated if other tests are inconclusive or if the doctor needs to monitor ovulation in a woman with PMOS.
Other hormone problems, such as thyroid hormone imbalances or high prolactin levels, must also be excluded.
In addition, diagnostic methods may vary depending on age and other individual characteristics. A pelvic ultrasound is not enough to confirm PMOS on its own.
How to Increase Your Chances of Pregnancy With PMOS
The most suitable option is determined by whether a woman has regular ovulation, the nature of other medical issues and whether other fertility problems are present.
1. Eat a Healthy Diet
A healthy diet is important for general well-being and to regulate metabolic problems associated with PMOS.
The following are some of the best ways to maintain a healthy and balanced diet:
- Eat plenty of vegetables and fruits.
- Eat whole grains and other high fiber foods.
- Eat lots of protein, including eggs, legumes, beans, fish, and other food.
- Consume healthful fats, such as those found in nuts, seeds, and other nut products.
- Drink lots of water.
It has been found that there is no particular diet that can help PMOS. Therefore, it is essential to focus on healthier eating rather than on restricting oneself on specific PMOS-friendly foods.
2. Exercise Frequently
Exercise is a vital part of women’s lives with PMOS. It helps to control and maintain the metabolism and general wellbeing. Swimming, walking, and other physical activities can be considered. Exercise helps to normalize the metabolic processes in women with PMOS who do not lose weight. It has been found that exercising can help a woman who has PMOS, even if she does not lose weight. A woman with PMOS should avoid extreme forms of exercise and dieting.
3. Manage Weight When Medically Appropriate
For some women with PMOS, excess body weight may worsen their insulin resistance and impact their ovulation.
If losing weight would benefit your health then slowly making some lifestyle changes could help to regulate your cycle.
However, PMOS can happen at any weight and although losing weight may help some people, it isn’t always a requirement for treatment or conception.
4. Tracking Your Menstrual Cycle and Ovulation
Tracking your menstrual cycle can help you to understand whether your periods are regular and whether you are ovulating.
However, ovulation predictor kits aren’t always reliable for those with PMOS as a result of high levels of luteinising hormones.
If you’re having irregular periods your doctor may recommend some tests to check if you’re ovulating
5. Take Recommended Preconception Supplements
Folic acid is recommended for most women planning pregnancy to reduce the risk of neural tube defects in your developing baby.
Your health care professional can advise you on the proper dose and whether you may need additional supplements, based on your medical and nutritional history.
Do not take fertility supplements or high-dose vitamins unless you have talked to a doctor about it first.
Fertility Treatment Options for PMOS
If lifestyle measures alone are not sufficient or ovulation is irregular, medical treatment may help.
The optimal choice depends on your diagnosis, desire for pregnancy, and other fertility factors.
1. Ovulation Induction Medication
For women with PMOS who have difficulty conceiving due to lack of ovulation, letrozole is typically the preferred medication for inducing ovulation, when there are no other infertility factors calling for a different treatment.
Letrozole can help stimulate follicular growth and ovulation, but should only be used under medical supervision.
Clomiphene citrate may be considered in selected cases when an alternative approach is appropriate.
Your doctor will determine which medication is appropriate and whether you will need to be monitored while taking it.
2. Metformin
Metformin is a medication commonly used in the management of type 2 diabetes that may also be prescribed in the context of PMOS in certain cases.
It can help regulate metabolic abnormalities associated with PMOS and may also help regularity or ovulation in some women.
However, metformin is not the optimal choice for a fertility medication in all women with PMOS, and your doctor will take that into account when discussing your treatment options.
3. In Vitro Fertilisation (IVF)
IVF can be considered when other appropriate treatments have failed or where other fertility issues mean that it may be a suitable option.
During an IVF cycle, the ovaries are stimulated with medication, eggs are collected and fertilisation takes place in a laboratory and a suitable embryo can then be transferred into the uterus.
Women with PMOS can sometimes exhibit a very strong response to ovarian stimulation, putting them at greater risk of developing ovarian hyperstimulation syndrome (OHSS). Fertility specialists can individualise ovarian stimulation and utilise strategies to reduce the risk of this occurring.
IVF is not necessarily indicated for all women with PMOS.
4. Other Treatment Approaches
In selected circumstances, alternative approaches may be considered based on the underlying cause of infertility and response to previous treatment. These may include injectable fertility medications, or in specific circumstances, surgical approaches.
Such treatment decisions should be made with a fertility specialist who can discuss the potential benefits, risks and monitoring required.
Does PMOS Increase Pregnancy Risks?
Women with PMOS have an increased risk of developing gestational diabetes, gestational hypertension and pre-eclampsia.
These risks are individual and while the likelihood is higher, many women with PMOS go on to have uncomplicated pregnancies.
Before trying to conceive, it is advised to speak to your doctor about your blood pressure, levels of glucose in the blood, medication and any other concerns.
Once pregnant, antenatal and screening tests will be conducted to identify and manage any complications.
Do not stop taking or change medication without the advice of your healthcare professional.
When Should You Consult a Fertility Specialist?
Consider consulting a healthcare provider if you have PMOS and are attempting to get pregnant. If your periods are irregular or absent, it’s critical to seek medical assistance.
In general, you should get tested for infertility after
- 12 months of trying to conceive if you are younger than 35
- 6 months if you are 35 or older
- Promptly if you are over 40 or have known fertility concerns that warrant earlier assessment
If you have absent periods or extreme period irregularity, you don’t have to wait for a specific amount of time.
A fertility specialist will be able to examine you for signs of ovulation and other issues that could be causing infertility.
Conclusion
PMOS and pregnancy compatibility is possible for most women as this condition may impact the ovulation process and conception in some cases.
Being educated about the condition, taking care of yourself in the best possible way, and receiving the right medical help are the key factors influencing your chances of conceiving successfully. Remember that in some cases, a fertility clinic specialist may prescribe ovulation induction pills or perform an IVF procedure to stimulate egg growth and facilitate the ovulation process.
Each woman’s fertility is unique in every aspect, so it is crucial to pay enough attention to your body and consult with a professional gynaecologist or a fertility specialist. A personal health assessment is necessary to understand whether your PMOS is having a significant influence on your chances of getting pregnant and how to deal with the complications in each particular case if they occur.
If you are struggling with Polyendocrine Metabolic Ovarian Syndrome and want to become pregnant, contact a professional fertility specialist to develop the best possible treatment strategy.
FAQs:
There is a high likelihood that a woman with PMOS will get pregnant on her own, even though there may be instances of ovulation. This can depend on a variety of factors, including the individual’s fertility level.
The PMOS condition can make it harder for a woman to become pregnant due to anovulation but does not necessarily make them infertile.
Letrozole is the best medication, for women with PMOS-related anovulatory infertility and no additional factors, for getting pregnant. However, you should only take it after consulting with your doctor. Firstly, the doctor will need to establish that you have PMOS and the best way for you to treat it.
Making diet and lifestyle changes can assist in making you fit and healthy. It might not necessarily make you fertile, but it can have a positive effect on your PMOS.
The link between PMOS and miscarriage has been established by research, but it can be genetic and can come with other factors. Therefore, it’s essential to speak to your doctor about the risks and how they can be reduced
IVF can be an option for getting pregnant for women with PMOS; however, it’s essential that you speak to your doctor about it. It’s important to note that when it comes to PMOS and IVF that additional steps need to be taken as there is an increased risk of OHSS.
Yes, it’s essential that women, who have PMOS and want to get pregnant, consult with healthcare professionals before getting pregnant. If you have PMOS and your periods are not regular or don’t occur, it’s essential that you get them checked out by a doctor.
