PCOS: A Common Cause of Infertility

PCOS (polycystic overy syndrome) is a common cause of infertility. Treatment appears to be more effective when combined with acupuncture and/or Traditional Chinese Medicine (TCM). A study1 published in Zhongguo Zhen Jiu (Chinese Acupuncture and Moxibustion) looked at the effects of the PCOS medication Clomid alone, and in combination with TCM, and TCM plus acupuncture. It found that the drug plus both complementary therapies improved fertility in polycystic ovary syndrome patients.

Polycystic ovary syndrome is a hormonal imbalance in women that has many undesirable effects. Most patients have small cysts on the ovaries. These ovarian cysts are not directly harmful, but they cause hormone imbalances. Symptoms of PCOS include some or all of the following:

  • Irregular periods. Fewer periods or no periods.
  • Heavy bleeding
  • Acne
  • Weight gain and difficulty losing weight
  • Extra facial and body hair (darker, thicker facial hair. More hair on back, chest and/or stomach)
  • Hair on the scalp is thinning
  • Depression
  • Infertility or difficulty getting pregnant
  • Insulin resistance (Type II diabetes) - the most commonly used drug to treat this is Metformin
  • High blood pressure or hypertension

PCOS should never be self-diagnosed. A doctor will run tests and review medical history to determine whether an individual has PCOS. The earlier it is diagnosed, the easier it is to mitigate its effects.

If a woman is having difficulty getting pregnant, the doctor will usually investigate whether PCOS is one of the reasons.

The causes of polycystic ovary syndrome are not understood. It runs in families to some extent, but genetic links are unclear.

Getting treatment for polycystic ovary syndrome helps reduce the symptoms, as well as avoid long-term damage to health. Treatment is especially important for women with PCOS who want to get pregnant.

The primary treatments2 for polycystic ovary syndrome are:

  1. Getting regular exercise
  2. Eating a healthy diet
  3. Controlling weight
  4. Stopping smoking

A heart-healthy diet has plenty of fruits, vegetables, beans, nuts, beans, whole grains, and fewer saturated fats. Even a small amount of weight loss, such as 10 pounds, can balance the hormones and reset the menstrual cycle. Smokers with PCOS should consider quitting, because their higher androgen levels3 make symptoms worse.

The doctor may prescribe birth control pills to reduce PCOS symptoms (if immediate pregnancy is not desired). Fertility medications can be used to increase the chances of getting pregnant.

A research study looked at a common fertility medication, Clomid (also known as Clomifene and Clomiphene). This drug can be given to women who are infertile due to anovulation (not ovulating) or oligoovulation (infrequent or irregular ovulation).4 120 participants were broken into three groups of equal size and given treatments:

  • Group A: Clomid
  • Group B: Acupuncture and Traditional Chinese Medicine
  • Group C: Clomid, Acupuncture and Traditional Chinese Medicine

These treatments were used for three consecutive menstrual cycles. The researchers examined endometrial thickness, endometrial type and cervical mucus score on human chorionic gonadotropin (HCG) day. They also measured ovulatory cycle rate, clinical pregnancy rate and miscarriage rate after the treatments.

The results showed that combining all three treatments improved fertility the most.

  • For HCG day cervical mucus score, endometrial thickness and endometrial morphology (A type rate), the groups getting acupuncture and TCM (B & C) had better results than the groups getting Clomid alone.
  • Group C had better cervical mucus score and endometrial morphology (A type rate) than Group B. Therefore, adding the fertility drug increased these scores.
  • Group B (acupuncture and TCM alone) had a lower ovulatory cycle rate than the groups that used the fertility drug Clomid.
  • Group C (all 3 treatments) had the highest pregnancy rate and the lowest number of miscarriages.

    • In the Clomid groups, the drug was given orally from the 5th day of menstruation. Groups B and C got warm needling therapy at specific acupuncture points starting on day 5: Zhongji (CV 3), Guanyuan (CV 4), Guilai (ST 29), etc. The groups that got TCM were given Chinese herbal medication for tonifying the kidney and activating blood circulation. The P values in this randomized, controlled trial were P<0.01 or P<0.05.

    Female reproduction is complicated. Using complementary approaches to becoming pregnant, such as drug therapy combined with acupuncture and TCM, appears to increase success. Addressing barriers to fertility such as polycystic ovary syndrome fundamentally starts with a healthy lifestyle, including proper nutrition, daily exercise and weight management. The study showed that if PCOS is present, using the fertility drug Clomid with acupuncture and Traditional Chinese Medicine had the best results.

    Footnotes

    1. Infertility in polycystic ovary syndrome treated with acupuncture and clomiphene: a randomized controlled trial, D. Jiang, Y. Zhang, X. Wu, S. Wu S., Zhongguo Zhen Jiu (Chinese Acupuncture & Moxibustion), February, 2015.
    2. WebMD: Polycystic Ovary Syndrome (PCOS) - Topic Overview
    3. Barbieri RL (2010). Polycystic ovary syndrome. In EG Nabel, ed., ACP Medicine, section 16, chap. 5. Hamilton, ON: BC Decker.
    4. Use of clomiphene citrate in infertile women: a committee opinion. Fertility & Sterility, August, 2013