Polycystic Ovarian Syndrome: Infertility Treatments in Ottawa

Polycystic ovarian syndrome treatments in Ottawa, ON Canada are available to help target the multi-faceted condition. PCOS is a unique reproductive imbalance in that there are multiple presentations of the condition itself in affected Women. 

Common symptoms that appear with polycystic ovarian syndrome may include some of the ones listed below, and it is not required to have all of the symptoms to diagnose PCOS. An important fact to know is that the diagnosis of PCOS in Canada can take up to 7 years from when you first present to your healthcare provider as many of the symptoms can be assumed to just be "irregular periods" and treated with a birth control pill.

Symptoms of Polycystic Ovarian Syndrome

1. Hirsutism: increased hair growth, more than what would be considered normal based on genetics and ethnic background (genetically Women have varying concentrations of 5-Alpha Reductase, the enzyme responsible for converting testosterone to DHT and increases hair growth). Hair can appear on the upper lip, jaw-line, neck, breasts, on the back, abdomen, and thighs.

2. Irregular cycles or lack of ovulation: cycles are consistently irregular. They may vary in length from 28 days (or shorter) up to more than a few months. Some Women will have regular periods, but will be unable to ovulate. The menstrual flow is a result of something called estrogen breakthrough or estrogen withdrawal bleeding, but is not related to ovulation and the inability of the egg to fertilize or implant. 

3. Decreased insulin sensitivity: this translates to the body's ability to easily gain weight, but make it very difficult to lose weight. The decreased insulin sensitivity also contributes to the hormonal imbalance seen with PCOS.

4. Short luteal phases: the luteal phase becomes shorter (12 days of less) and/or there is a lot of spotting in this second phase of the cycle.

5. Increased risk for miscarriage: a combination of factors, particularly, decreased progesterone production, increased circulating testosterone, and poor egg quality seem to potentially increase the risk of miscarriages in patients.

6. Many more: this can also include increased acne, anxiety, depression, mood disorders, increased prolactin in the blood, and reduced blood flow to the uterus and ovaries along with increased levels of inflammation in the body.

Treatments for Polycystic Ovarian Syndrome (PCOS)

1. Fertility Acupuncture: specialized protocols can be applied, as done in clinical trials, to help improve likelihood of spontaneous ovulation per cycle, improve progesterone production, improve blood flow to the uterus and ovaries, help support healthy implantation and pregnancy.

2. Botanical Remedies: the use of botanical treatments can be specific to PCOS by using herbs that specifically reduce the production of testosterone from the ovaries, improve progesterone production, improve ovulation rates, reduce stress, reduce anxiety, reduce feelings of depression, and support a healthy pregnancy. It is important to speak to a trained professional in fertility alternative health to help select what is safe or not safe for you.

3. IV Nutrient Therapy: this can help provide treatments which increase antioxidant function in the body and support optimal egg health.

4. Nutritional Supplements: specifically to improve insulin sensitivity that helps to normalize ovulation rates, reduce testosterone production, and supplements to help improve energy (ATP) production in the follicles (eggs) and increase their health and quality.

5. Progesterone Bioidentical Hormone Replacement Therapy: progesterone in the form of a cream or suppository is of significant advantage to help reduce the risk of miscarriages, especially during the first trimester.

6. Diet & Lifestyle Counselling: specific and tested recommendations which help to support a healthy weight, especially weight loss, to help improve the hormone profile, increase egg quality, and reduce hormonal imbalances associated with PCOS.

Diagnosis of Polycystic Ovarian Syndrome (PCOS) is done with the Rotterdam criteria:

 

A patient must meet two of the following three criteria:

  1. Cystic ovaries on an ultrasound

  2. Irregular or absent menstrual cycles

  3. Signs of elevated androgen hormone (i.e. cystic acne, increased hair growth) or elevated androgen hormones on a blood test

 

Latest guidelines recommend against the use of ultrasounds under the age of 18 as they are not as accurate before that age. And it is strongly recommended to test for PCOS in any Women who has periods longer than 35 days on a regular basis. 

 

The updated guidelines recommend that before trying any fertility treatments or medications for polycystic ovarian syndrome, the first intervention tried should be dietary and lifestyle changes. This is due to the fact that dietary patterns and exercise routines can significantly improve the hormonal imbalances, improve insulin sensitivity, help regulate menstruation, and support healthy and regular ovulation. 

 

Which supplements are helpful for PCOS?

 

Supplements can vary depending on the subtype of PCOS you may have. PCOS is not the same for two individuals. It can consistent of multiple or just one of the pathogenic factors: elevated androgen hormones, decreased insulin sensitivity, weight gain, increased hair growth on body, loss of hair on the scalp, anxiety, depression, difficulty losing weight, and/or significant acne. Specific supplements have been shown to help improve the metabolic profile in Women with PCOS by improving sensitivity to insulin and supporting healthier blood sugar regulation. Supplements can also help induce ovulation, reduce inflammation (as PCOS is associated with increased inflammation), reduce circulating androgen/testosterone hormone levels, reduce estrogen dominance, support healthy progesterone production, and increase fertility.

 

How does treating PCOS improve fertility?

 

Treating PCOS corrects fundamental issues that cause infertility. Firstly, it can increase spontaneous natural ovulation rates so that fertilization may occur. It also supports healthy progesterone production to support implantation and help maintain pregnancy. Egg health and quality with PCOS is usually lower, so the treatment with antioxidants and micronutrients can help to improve the quality and integrity of the eggs. Healthier quality eggs translate to an increased probability of fertilization and implantation. Treatments can also help lower androgen/circulating testosterone levels (elevated androgen hormones have been implicated in increasing miscarriage risk in PCOS). Improved blood sugar control and insulin sensitivity can support healthy weight loss and reducing the risk of gestational diabetes once pregnant. 

 

How can acupuncture improve fertility with PCOS?

 

Research evaluating for the role of fertility acupuncture for patients with PCOS have shown that the chances of spontaneous natural ovulation increase. Fertility acupuncture may also help to improve insulin sensitivity in Women with PCOS as well as reduce the risk of ovarian hyper-stimulation syndrome (OHSS) with In-Vitro Fertilization (IVF). Fertility acupuncture may also help to reduce the risk of miscarriage when used prior to, during, and after IVF. 

 

It is important to consult with a licensed Naturopathic Doctor versed in fertility treatments and interventions prior to starting any supplements or treatments. 

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