5 easy additions to support your fertility with PCOS
This is PCOS - Part two. For a what-is-PCOS and information on diagnosis, check out part one here.
The two biggest concerns for women with PCOS in terms of fertility are lack of ovulation and disruption to the maturation of the follicle, with ramifications for oocyte quality. Supporting fertility with PCOS doesn’t have to be complicated and doesn’t have to be one approach all the way - there is certainly plenty of research to support the value of a complimentary team.
PCOS fertility concern: I rarely, or never ovulate.
1. Add a supplement: NAC
N-Acetyle-Cysteine is a favourite for our patients with PCOS who just can’t kick ovulation into gear.
Research has showed that women taking NAC have increased likelihood of ovulation, conception and going on to have a baby than women taking a placebo.
Look for practitioner level NAC. Dosing in trials starts at around 600mg per day, but work with a practitioner for a specific and personalised dose.
2. Add a habit: Regular acupuncture
Chinese medicine practitioners have a long history of treating PCOS under traditional disease categories, and have records of acknowledging the link between difficulty losing or body maintaining weight. Biomedical findings absolutely help with the treatment strategy – acupuncture points for a woman with multiple cysts will be different to those selected for her friend with high androgen levels.
The evidence is for acupuncture alone inducing ovulation in women with PCOS is conflicting, some RCT’s have shown no impact, while other studies have found acupuncture to have a positive effect on ovulation, theorising that acupuncture drives beta-endorphin production driving the hormone shift necessary for follicular selection.
Research from 2019 have shown that acupuncture is certainly helpful alongside induction treatments have the potential to improve the chance of ovulation when using a pharmaceutical approach. This study found
Clomid alone resulted in ovulation for 65% of women
Acupuncture + clomid resulted in ovulation for 86% of women
3. Add some herbs: TCM herbs, alone or as an adjunct
Clinical trials of TCM herbs are becoming more prevalent in China where formulas are being designed specifically for women with PCOS to use alongside pharmaceutical ovulation induction options. Studies have shown a greater chance of ovulation when patients use herbal formulas alongside Clomid or Letrozole, than when using the pharmaceuticals alone.
TCM herbs are rarely prescribed individually. Work with a practitioner for a tailored formula.
PCOS fertility concern: I want to support the quality of my eggs
4. Add a supplement: Alpha-lipoic acid
Alpha-lipoic acid an antioxidant which plays a role in breaking down and converting carbohydrate into energy. Emerging research suggests it’s beneficial for egg quality for women with PCOS.
This small pilot study found that women with PCOS who took Alpha-lipoic acid in conjunction with B9 and myo-inisotol leading up to their IVF protocol had a significantly higher number of grade 1 embryos, than women who used myo-inisotol alone.
For a personalised program, work with a practitioner. Dosing for alpha-lipoic acid in clinical trials starts at 100mg per day.
5. Add a habit: Daily moderate exercise
Some evidence suggests that cholesterol levels play a role in diminished egg quality for women with PCOS, so it makes sense that lowering cholesterol levels will benefit the growth and development of follicles.
This trial found that women with PCOS who engaged in moderate-intensity exercise improved several components of their lipoprotein profiles including cholesterol levels. Importantly, it wasn’t about weight loss - exercising women saw an improvement even without signifiant weight loss.
We rarely use the work ‘exercise’ in clinic, we tend to encourage movement. It doesn’t have to hurt and doesn’t have to suck the life out of you. Start with a podcast, your earphones and an easy walk.
Our clinical experience is that most PCOS patients respond best to a multidisciplinary approach. Many of the women we work with who have PCOS are also working with one or more health professionals, exercise physiologist, nutritionist, a great GP, naturopath or fertility specialist. We work with other health care practitioners and understand how to be part of your team.
Curious? Reach out.