Women across the U.S. are reconsidering their family planning decisions due to coronavirus-related financial and health concerns, according to a recent study published by Modern Fertility and SoFi. As a result, egg freezing may look particularly appealing right now for women with polycystic ovary syndrome (PCOS) who are worried about starting a family directly after a pandemic but who also know that it will become especially challenging for them to conceive the longer they wait. But as with any procedure where a preexisting condition is involved, there are several unique considerations that women with PCOS need to keep in mind before deciding if egg freezing is right for them.
PCOS May Be Beneficial During The Egg Freezing Process
While PCOS symptoms may make women miserable enough to sometimes fantasize about pulling out their own ovaries, when it comes to egg freezing, there is a surprising benefit to having the syndrome: it may help women produce more eggs for extraction.
Dr. Sharon Briggs, who leads the Clinical Product and Research team at Modern Fertility, a company that sells at-home fertility tests, explains that PCOS can cause a build-up of unreleased eggs, or follicles, inside the ovary. When the ovaries are stimulated during the egg freezing process, these multiple follicles are able to produce more eggs than a non-cystic ovary. Dr. Briggs says there is also no difference between the egg quality of a woman with PCOS and those of a woman without the syndrome. The hormonal imbalance of PCOS prevents eggs from being ovulated but it does not affect egg quality.
The Health Concerns of Freezing Your Eggs When You Have PCOS
The primary health concern for women with PCOS who want to freeze their eggs is ovarian hyperstimulation syndrome (OHSS) explains Dr. Fahimeh Sasan. She is the founding physician and OB-GYN at the New York-based health and fertility clinic, Kindbody. OHSS is a painful swelling of the ovaries that can sometimes require hospitalization. This condition is caused by elevated levels of human chorionic gonadotropin (HCG) which is used during the egg freezing process to increase the number of released eggs.
Women with PCOS are more susceptible to developing ovarian hyperstimulation syndrome during egg freezing because they are likely to have a higher number of follicles, and the more follicles an ovary has the more likely it is to be overstimulated by the injected HCG. However, Dr. Sasan says that by refining their techniques the fertility community has “reduced the rates of OHSS [to the point] that we can say it is quite uncommon.”
Women with PCOS may also need more time to recover after the entire egg freezing process is over, says Alisa Vitti, an integrative nutritionist, hormone expert, and author of WomanCode: Perfect Your Cycle, Amplify Your Fertility, Supercharge Your Sex Drive, and Become a Power Source. She recommends focusing on eating clean, managing blood sugar levels, supporting the gut microbiome, and restoring micronutrients to support the body’s return to its baseline.
And once the body has returned to its baseline, Vitti stresses the importance of healing the underlying hormonal imbalance of PCOS. “If you have gone through the process of spending money and putting your body through the whole [egg freezing] experience then take your hormonal health seriously,” says Vitti. She emphasizes that healing the hormonal imbalance will help increase the chances of successful conception when women are ready to use their frozen eggs.
The Important Unanswered Question of PCOS and Egg Freezing
Some of the most distressing health problems linked to PCOS are anxiety, depression, and mood swings. So it is important to highlight that both Vitti and Dr. Briggs say they are unaware of any research that looks at how the hormones used in egg freezing affect mental health. “I would imagine that for someone who has depression or anxiety, whether or not you have PCOS, injecting hormones may make that more intense,” says Dr. Briggs.
Vitti says that many women report experiencing temporary mood swings during the egg freezing process. With this in mind, she advises women with PCOS to advocate for themselves by making their loved ones aware that the condition can cause extreme mood fluctuations and that going through the egg freezing process may make this symptom more acute.
Modern innovations in medicine, like the development of egg freezing, have empowered women to take control of their fertility and their future. Though gaps in medical research have left many unanswered questions surrounding PCOS, egg freezing certainly seems to be an option for women with the syndrome. Those who decide to pursue this procedure, however, should consider having a conversation with a medical professional about their risk of OHSS, supporting their body in recovery, establishing a mental health support plan, and addressing their hormonal imbalance to ensure successful conception in the future.