In this video, I chat about how PCOS impacts your fertility. If you have or suspect you have PCOS this is a don’t miss.
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Disclaimer: Please keep in mind that I am not a medical doctor. I have been a practitioner of Traditional Chinese Medicine for over 17 years and I will be speaking from my clinical experience helping thousands of women conceive. The office of Aimee E. Raupp, M.S., L.Ac and Aimee Raupp Wellness & Fertility Centers and all personnel associated with the practice do not use social media to convey medical advice. This video will be posted to Aimee’s channels to educate and inspire others on the fertility journey.
See the full transcript below.
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Okay. Facebook says I’m live again. Let’s see how that goes. What I’m going to do is I want to grab my book “Yes, You Can Get Pregnant”. I’m going to read to you from “Yes, You Can Get Pregnant” about PCOS and Facebook. You’re joining live again because the first video ended. I don’t know why, but so we’re back again, so cha, cha, cha. Here we go.
What I want to talk about, so this is from my book “Yes, You Can Get Pregnant”. And on page 157, I talk about PCOS and I want to just give you a brief overview of what is PCOS? I’m sure a lot of you guys know what it is because you guys are all experts in fertility, unfortunately, because you’re dealing with fertility challenges, many of you. But I still like to give the proper medical diagnosis, the background on that, so you can clearly understand what is PCOS, and then I can break down for you how it impacts a woman’s fertility.
I will also say though, research shows that women with PCOS have a similar number of children as women without PCOS. So for all of you, with PCOS, don’t freak out. It’s treatable, it’s doable. You are going to go on to have your children. A lot of times, we just have to figure out how to regulate your hormones and get you to ovulate. If you don’t ovulate, you can’t get pregnant. That’s it, right?
So PCOS, according to the American Society for Reproductive Medicine, the ASRM, PCOS is the most common fertility challenge in the United States, affecting approximately 20 to 30% of all women with fertility issues. It’s interesting though too, I found this really cool diag…, What’s it called? Graph, and causes of female infertility. So the one circle to pie chart, unexplained infertility is about 15% ovulation disorder is about 40%, which ovulation disorders are basically usually a PCOS issue, to bull factor is about 40%, uterine factor, about 5%, and then a smaller graphical of that PCOS makes up 85% of unexplained infertility, or sorry of ovulation disorder of ovulatory, which is 40% of causes of female infertility. So right here, it says 20 to 30% of women with fertility issues have PCOS and a more recent data analysis shows that about 40% of women, that’s about the same actually, within fertility are due to having fertility due to an ovulatory disorder, meaning they’re not ovulating at the right time. There anovulatory. It could be for a different reason, the PCOS like hypothalamic amenorrhea is as an example.
Cysts on your ovaries, that are not PCOS related, like dermoid cyst, things like that could be another example. Endometriosis could be another example of an ovulatory disorder, that’s not PCOS, but of the 40% of women that have infertility issues due to ovulatory disorders, 85% of them are PCOS patients. Okay?
So, PCOS is a hormonal, too much testosterone and estrogen. And also though luteinizing hormone is also elevated. So PCOS women have elevated LH, reduced FSH, and then coupled with elevated androgens, testosterone mainly and insulin. So it’s a metabolic and a hormonal disorder.
So, a hormonal disorder and a metabolic disorder, like I said, so typically too much LH, too much testosterone, too little FSH, and then too much insulin and estrogen. There is some controversy and then this all leads to ovulation dysfunction. So, basically if you’re not ovulating, you can’t get pregnant.
But what it also leads to though is you’re not shedding your lining regularly, if you’re not ovulating, which that can then lead to uterine issues as well, that could lead to implantation issues. It’s also clinically the limited egg development may result in irregular ovulation or a complete lack of ovulation, which is called anovulation, which can persist for months or years. This ovulatory dysfunction is what actually causes infertility in these women. Also, when a woman is not ovulating regularly, the endometrial tissue in the uterus can get very thick, resulting in heavy and or irregular periods.
The increase in androgens is also responsible for some of the PCOS symptoms, typically hair growth, acne, things like that. So there was some controversy. So back to my book, there was some controversy as to whether or not PCOS is actually an auto-immune condition. However, recent research published in 2007, mind you, I wrote this book in 2013, 2014. So, that’s why the research was recent for 2007. Now, its not so current, but the journal of auto-immune review stated a high concentration of anti-ovarian antibodies suggest that immune reaction is associated with PCOS. A high concentration of anti-sperm antibodies suggest an association of the two conditions with PCOS. This means there is some evidence that PCOS is an auto-immune disease and that it causes autoimmunity against ovaries and sperm.
There’s also a significantly higher incidents of PCOS in patients that also have either auto-immune thyroid disease and, or type one diabetes.
I’m going to close my office door. My cleaning lady is here and she’s vacuuming in the room next door. So, that was a little loud. Sorry about that.
So, symptoms of PCOS women. So now this is where my clinician hat goes on. You can have a totally symptomatic PCFS patient and you can have a totally asymptomatic PCOS patient. You could be ovulating regularly with regular menstrual cycles, no acne, no hair growth. And you could still have PCOS. The Rotterdam diagnostic criteria for PCOS is facial hair.
There’s three things. I just want to pull it up because I always, cause in my head there’s like 10 things, but there’s really only three things anovulation, clinical or biochemical signs of hyperandrogenism, which is basically facial hair and polycystic ovaries by ultrasound. That is the Rotterdam criteria, the NIH menstrual irregularity due to delayed or no ovulation, clinical and biochemical signs of hyperandrogenism and then exclusion of other disorders.
Just so we’re aware, that’s how the diagnosis happens. You have to either be delayed ovulation or not ovulating, facial hair, or other signs of too much testosterone and polycystic ovaries by ultrasound. You need to have two out of the three of those is what I remember. Let’s just see this.
Yeah. Okay. So anyway, going back to, I have notes here and I’m reading from here.
So, some women with PCOS present with no symptoms, other than lack of ovulation or infrequent ovulations. However, some common symptoms are acne, weight gain, difficulty losing weight, excessive hair growth on face and neck, breasts, patches of hair loss, scalp, thinning hair, visible cysts seen on the ovaries upon sonogram.
Okay. If there’s questions unrelated to PCOS right now, I’m not going to answer them just so you guys all know. You can save that for my fertility hot seat live and request to join me live. Tests you need to ask your doctor for, if you suspect PCOS, trans-vaginal ultrasound, so they can look at your ovaries and they can see if there are cysts on your ovaries. You should also look inside your uterus, make sure your lining is not too thick, cause that can be very unhealthy.
A thick uterine lining that has not shed is a very toxic environment for the body and that’s unhealthy. And we need it to shed on a regular basis. Hormone panel, we want to get free testosterone checked. We want to get sex hormone binding globulin checked. So this is all in my book, all the ranges are in my book. So you can get a copy of, “Yes, you can get pregnant” and see all of this in there. DHEAS should be checked, FSH to LH the ratio. So, often the ratio should be a one-to-one, but in women with PCOS it’s typically, LH is greater like a three to one or two to one ratio to FSH.
Thyroid panel, we should always, always, always have a complete thyroid panel. If we’re having fertility challenges, a complete thyroid panel includes TSH, free T3, free T4, thyroid antibodies. They should all be checked. They should all be checked. They should all be checked. Your vitamin D should also always be checked.
Glucose tolerance test and prolactin as well.
So, how to naturally manage PCOS, follow the fertility rejuvenation protocol I have outlined in this book, follow the diet I have outlined in this book. So, more recent research shows, like I was saying, PCOS has auto-immune tendencies, auto-immune characteristics. So what does that mean? You have to follow an anti-inflammatory lifestyle, as mapped out in the egg quality diet, as mapped out in “Yes, you can get pregnant”. The difference between these two books is that this is a much more recent book with just dietary information. It gives you a 100 day plan of what to eat, when to eat, how much to eat, how to see if foods are irritants in your body, if they’re triggering inflammation in your body, there are shopping lists, there’s recipes. It is just a food related book with an incredible resources page that has a ton of other information. Like it’s not just a book you’re getting literally, an additional five to six hours of actual free content on the resources page that goes with the book, that goes way beyond diet.
This book is a general, how to, that addresses every layer of impacting fertility, mental, emotional, physical, nutritional, they’re great companion guides, FYI.
So, follow the fertility rejuvenation protocol. So, the biggest things for PCOS and how to get pregnant naturally with PCOS is you’ve got to ovulate right? So PCOS impacts fertility, just like I said, it impacts fertility because typically women aren’t ovulating. So what that means, even if you are ovulating, but you’re ovulating less frequently, is you have less frequent attempts at trying. Right. What I typically see is women get an app on their phone. “Oh, I’m falling. I’m using the flow app. I’m using the period tracker app, right?”
And you plug in your last cycle dates and it gives you an estimation. That’s all it is. Cause it’s not tracking hormones, unless you’re using an app that actually has a device where you’re tracking your hormones as well. Like the OOVA is a great app, that has a device where you track your hormones and then it puts it in the app. And it tells you precisely when you ovulated, precisely that you have ovulated cause your progesterone went up. So, what I see clinically is women come to me and they have a legal ovulation or basically a complete or irregular anovulation or illegal ovulation, which means irregular. So, oligomenorrhea is a regular menstruation. Oligo ovulation is irregular ovulation. And so, some months they ovulate on like 15 cycle day, 15, 17, other months they don’t ovulate till the cycle day 35, but their app hasn’t figured that out cause they’re irregular Oligo ovulation.
So they’re trying at the wrong time. And that is so frustrating. So what I always do is I look at your last menstrual cycle. Day one of your last menstrual cycle. And I count back 14 days because 99% of the time after you ovulate, your luteal phase is 14 days long. Sometimes it’s 15, sometimes it’s 12, but on average, most women, once they ovulate, have a 14 day luteal phase. So, if you go to the day one of your period and you subtract 14, that’s the day you ovulated it on. Did you try on that day? That’s what I start to do with my clients. And then they realize, oh my God, I’ve been trying for six months. And I haven’t actually ever tried. How devastating is that? How heartbreaking is that? And that is the downfall of a lot of these apps.
They are not tracking your hormones. Why I love the OOVA and this is not a, I’m not trying to promote a product right now, but why I love the OOVA is that it’s the best app out there for not just tracking ovulation, it tracks your LH surge, but it also, you keep testing after you ovulate and it tells you when your progesterone goes up. So then, you know, for certain you ovulated. So, the issue with PCOS girls is typically they’re not obviating regularly or at all. And their progesterone actually doesn’t rise the way it should, typically because the follicles don’t mature the way they should. So a lot of times the PCOS, we might have a ton of eggs, but they’re poor quality, because they don’t have all the right hormones in check. Then you throw an insulin resistance, which throws off our hormones even more and it’s a challenging situation. It’s totally fixable. Especially if you follow my dietary recommendations and you manage your stress.
Those are the two big things. And I think every woman with PCOS should be on Myo-inositol, D Chiro myo-inositol, 2000 milligrams a day. Make sure your vitamin D status is in check. You want it between a 50 and a 70. Don’t take no for an answer. When you ask that to get tested, make sure your thyroid is in check. Get that tested. Don’t take no for an answer. It should not be above a two or 2.5 max. So, it impacts fertility because, like I said, you’re not ovulating. And then typically women are trying at the wrong time. So, what I see a lot in my cases is women will come in and they’ll say, oh, “do you menstruate?” And I’ll be like regularly?
“Oh yeah, but I have about like a 40 to 45 day cycle. Sometimes I have like a 28 day cycle.” That my first clue right there. I don’t over-diagnose anybody with PCOS. I don’t really give a shit, what your diagnosis is. My job is to figure out when you ovulate, regulate your ovulation balance, your hormones, reduce inflammation in your body, improve uterine receptivity and work on your mental, emotional health. So, you can have the life of your dreams.
One thing that I know for sure, as an acupuncturist, acupuncture is one of the best tools for regulating ovulation, especially in these PCOS types. Another thing that is super duper important is again, following the diet and not going too long between meals no more than two to three hours without protein keeps your insulin levels even, keeps your blood sugar even, taking the Myo-inositol helps keep your blood sugar even.
Your hormones start to regulate, your cells get what they need, your body starts ovulating. A lot of times, PCOS women have a hard time losing weight. When we follow the protocol as laid out, weight will begin to shift. I am not about you needing to lose 20, 30, 40, 50 pounds. I don’t really give a shit about that. I want to see, okay, the weight you need to be at with regular menstrual cycles, some women that can be 30, 40 pounds overweight and they’re fine. Regular menstrual cycles, perfectly fine. Some women can’t go, their BMI can’t be that high. Everybody is different. If you were having regular menstrual cycles, you’re probably at a fine weight for yourself. I would just keep that in mind. But another thing that I wanted to talk about and now it’s escaped me. I was just rambling about insulin resistance, PCOS, oh, stress levels, stress levels.
So, the other thing that is often, I think overlooked. And if you go to a fertility doctor with PCOS, a lot of times it’s like, oh, we’re just going to give you Clomid, we’ll make you ovulate. Boom, boom, boom, things work out. A lot of women do get pregnant, but I also see a lot of chemical pregnancies that route. I also see a lot of miscarriages that route because we didn’t focus on the whole root of the problem. Like, why are we not ovulating?
And we didn’t fix inflammation in the body. Now, remember I talk a lot about inflammation, but mental, emotional, I call it emotional inflammation versus physical inflammation. So, physical inflammation comes from our diet, not being as clean as it should be, our lifestyle or we’re exposed to too many toxic chemicals, emotional inflammation, repressed, or unresolved traumas, things that you have not looked at from your past, your childhood, your present, trauma causes significant stress on the body and it’s really hard to fix that stress cycle, that hypothalamus, pituitary, ovarian access is thrown off and you will not ovulate regularly. Remember ovulation happens when the body feels safe, and that doesn’t mean that you’re living in a war zone or not. Is the war zone in your head is the war zone in your past and you haven’t looked at those things.
That is a really key thing to think about when it comes to PCOS, when it comes to auto-immunity. So from a Chinese medicine perspective, we see auto-immunity and remember PCOS has these auto-immune like characteristics. When we see that, we know the body’s attacking itself on some level, why? Where’s the inflammation coming from? The inflammation could be coming from? I see girls have the perfect diet, perfect lifestyle, still not working. Things aren’t shifting, their bodies aren’t shifting, because they’re living in a chronic state of fight or flight and it might just be ingrained in them.
It might just be how they were born, what they were raised in. It’s not your fault. It’s never your fault, but become conscious of it, become aware of it. What are things I can do to regulate my nervous system? Again, acupuncture is huge, I love the heart math monitor. There’s a link for it on my website, under Amy’s recommendations. I love meditation. I love acupuncture. Did I say that? I did. Movement exercise. So when we think about PCOS and its impact on fertility, we really do have to think hormonal and metabolic, and auto-immune. It’s an inflammatory disorder with auto-immune characteristics and we have to think whole picture.
PCOS patients can just go and take Clomid and get pregnant. And a lot of times it does work out, which is great. I still like to get ahead of the ball, if you will, ahead of the game and make sure inflammation is reduced because I don’t want that positive pregnancy test, just for the sake of it. I want us to be the healthiest versions of ourselves so we can bring through healthy, beautiful, thriving children into a healthy, beautiful thriving world and community.
So with all that, PCOS patients, there definitely is concern about egg quality, because the way I look at it is there’s so many eggs growing at once, which, you know, a lot of women would, would kill for a ton of eggs and a high AMH. When it’s too high, we don’t like that either, by the way, just so you know, we don’t love a too high AMH and we don’t love a too low AMH, kind of right in the middle. But AMH also changes month to month. I don’t want you to get too fixated on your numbers.
But there’s so many follicles developing at once that they basically have to, this is how it works in my brain, they basically have to fight for the nutrition. There’s only a set amount of nutrition. And like in my body, you know, maybe six follicles are developing at once, right? In a PCOS girl, there might be 30. So, that same amount nutrition now, instead of going to six. So everybody gets like one, you know, one sixth, they’re getting one 30th. So, they’re compromised in their quality. So, if you to know how to regulate your hormones and improve the quality of your eggs, whether you have PCOS or not, I have a free course for you. And it’s Aimeeraupp.com/eggcourse. Is that correct? Beth, let me just see. Yes, Aimeeraupp.com/eggcourse. We’re launching this free mini e-course today for you. It’s called the “Seven ways to better quality eggs”. I put a lot of time and energy into this. It is completely free.
It’s probably over an hour of content. You’re going to get a video a day, over five days. Is that correct to say I’m forgetting now because my team helps me with this. And there’s just so many things in my brain, but I’m pretty sure you get a video a day, over five days. And it’s a lot of great content. And whether you have PCOS or not, but you’re just looking to improve the quality of your eggs. Even if you have my book, “The egg quality diet”, I go into so much more detail about all the things you can do, not just diet, but remember with PCOS. It’s about improving ed quality. It’s about balancing hormones. It’s about regulating blood sugar and improving ovulation, reducing inflammation in your body to improve ovulation function.
So, some girls just have delayed ovulation, but they don’t have PCOS. Some girls have irregular ovulation, but they don’t have PCOS. This would still apply to you though. These things are the keys, in my opinion, we’ve got to reduce inflammation, we have to regulate the immune system, we have to improve uterine hospitality and we have to improve your absorption of nutrition and then reduce the stress load on the body.
The body is designed to get pregnant. I love all of you. I’m not saying that to be mean, cause I know you feel left out of that equation right now, but I’m reminding you, your body is designed to know how to get and to stay pregnant. And when it is not doing that, it is telling us something is awry and we need to look under all of those pillars. Is it my mental, emotional health? Is it my physical health? Is it my nutritional health? Is it my supplements? Is it my lifestyle?
And this mini course is going to help guide you through all of that. So aimeeraupp.com/eggcourse. Again, it’s free. It’s a lot of video content that I created for you and I hope you enjoy it. And yeah, they’ll get the details in the email, but yeah, starts 9/17 and they get one video per day. Oh, okay. So the course doesn’t come out until 9/17, but you guys are getting early sign-up access for it, because today is 9/9. Correct? So yeah. In about 10 days, no, I don’t even know. I can’t even add right now 10 days of me on 19. So in about nine days, eight days, you’re going to start, you’re going to get the first video of the mini e-course and then for four days after, so you get one video a day for five days.
Yeah. I think you’re going to enjoy it and that’s that. Okay. I love you guys. So I hope this was helpful in regards to PCOS and how it impacts fertility and what you can do to manage that. And I love you guys and I’ll see you next week. Same time, same place. Have a great one. For any more information on me or how to work with me or my team head over to aimeeraupp.com. Ciao for now.
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