Gynaecological conditions like Polycystic Ovarian Syndrome (PCOS) and Endometriosis impact thousands of women, but how do they affect fertility? We asked Professor Eileen McLaughlin, a reproductive biologist and the Executive Dean of the University of Wollongong’s School of Medicine, Science and Health to explain some of the most common FAQs about fertility and reproductive health.
Q. What impact does PCOS have on fertility?
People who have polycystic ovarian disease grow large numbers of immature eggs,which means that they don’t ovulate properly and they don’t produce normal eggs for conception. This is compounded by having metabolic differences where people with PCOS have higher levels of male hormones and they also have higher levels of insulin. And this causes the problems in the production and maintenance of a pregnancy.
Some people with ovarian polycystic ovarian disease also have excess facial hair and evidence of androgen production. The androgen production and the excess insulin production is what leads to poor quality eggs. Many people will have no overt symptoms, and regardless of symptoms, many people with PCOS get pregnant perfectly normally.
Q. What impact does endometriosis have on fertility?
Endometriosis, which affects around 10% of all women, is a condition for which we are not completely sure of the origin. However, it may be due to parts of the endometrium or the lining of the uterus ending up within the pelvic region.
When it’s in the pelvic region, it undergoes inflammation and cycles which lead to damage to the pelvis and other reproductive organs. It can impact getting pregnant due to damage to the ovary, damage to the fallopian tube and damage to the uterus.
Q. Will falling pregnant help my endometriosis
No, the evidence is that if you are pregnant, then your endometriosis will continue as normal.
Q. What impact do irregular periods have on falling pregnant?
If your periods are not regular, then you are not producing the same number of healthy eggs as someone with regular periods. You should then investigate this with your doctor, as there are a number of reasons why that might be happening.
Q. What impact does smoking have on my fertility?
Smoking depresses your fertility. It does this through a number of different ways. First of all, the quality of your eggs is impacted by smoking due to oxidative stress. The number of eggs that you have is depleted prematurely during smoking and then your chances of miscarriage are actually higher because the quality of the embryo is impacted by the smoking. If you continue to smoke during pregnancy, it affects the ability of the placenta to support the baby. And the baby is likely to be born early and/or small for dates.
The latest science and a new guide for Polycystic Ovary Syndrome (PCOS), ABC Health Report
PCOS Guideline, Monash University