1 in 10 women struggling with infertility have been diagnosed with PCOS (polycystic ovarian syndrome), making it the leading cause of female infertility. Though this challenge is common, not all forms of PCOS are the same, and not all fertility solutions are the same.
There are two main categories of PCOS -- Insulin-Resistant PCOS and Non-Insulin Resistant PCOS -- that can also be broken down further into 5 types (as shown in the table below).
Type 1: Insulin-Resistant PCOS
This is sometimes considered the “classical” form of PCOS. It often includes the common symptoms of weight gain, ovulatory challenges (irregular ovulation or anovulation), irregular ovulation cycles or menstrual cycles, facial hair, hair loss, acne, irregular sleep, fatigue or depression. This type of PCOS is also often connected to the potential for developing diabetes.
Often doctors suggest dietary changes, exercise, and weight-loss for those with this type of PCOS. Though it can be a challenge to achieve with this condition, weight loss often helps these symptoms subside.
Type 2: Non-Insulin Resistant PCOS
Though some women experience some of the main diagnostic criteria for PCOS – increased testosterone, abnormal ovulatory patterns, or polycystic ovaries – they do not experience insulin resistance.
There are a variety of causes for this type, and reducing weight does not affect this condition. Treatments might include elimination of certain foods, increased supplementation, or adding progesterone.
Ovulatory Challenges and Solutions
Because there are a variety of ovulation challenges, every woman’s fertility options are different. Women who have irregular cycles may experience instance of anovulation (not ovulating) or may have elevated LH levels throughout their cycle that make it harder to identify their peak and to know whether they have actually ovulated or not. A double-check method like BBT tracking or progesterone tests can help confirm that ovulation occurred by detecting a temp rise/increase in progesterone, the hormone that rises after ovulation to support the potential fetus.
Since PCOS is such a common challenge for women, this topic is continuously studied with frequent new discoveries in research. Though a PCOS diagnosis should be taken seriously and treated carefully, pregnancy is still an option for many TTC women.
Women can take back control of their fertility by seeking professional advice, staying informed, joining supportive communities, and using all of the tools available.