33-year-old Dubai-based psychologist Anita*, originally from India, struggled with her fertility for more than three years. She was diagnosed with polycystic ovary syndrome (PCOS) – an endocrine disorder that is the leading cause of infertility in women in the UAE – but started to lose all hope when the medical treatment she was recommended made no difference.
Read more: 'Why living in the UAE could be making you infertile'
One day, while researching IVF options, she stumbled across a lecture by the UK-based nutritionist Dr Marilyn Glenville, which recommended a strict three-month diet to treat the hormonal imbalances caused by PCOS. Two months in, and Anita had conceived her little boy, who is now 18 months old. She shares her story here:
Please note – you should always follow the advice of your doctor before embarking on any diet. This story is Anita’s own personal account and may not be the experience of everyone.
“In 2013, we moved to Dubai from India and decided to leave our bachelor lifestyles behind and start a family. Luckily, I conceived soon after we decided. But in the third month I lost the baby. I had no idea what went wrong…
"We started trying to conceive again but for three long years we had no luck. Every month that it didn’t happen dragged my spirits down. I looked everywhere and anywhere for tips on getting pregnant – from observing my body, to more unconventional methods like astrology and even tarot at one point. Nothing seemed to work.
"The never-ending cycle of hope and disappointment made me miserable. I was not happy with myself any more, constantly looking for what I might have done wrong to deserve this bad luck and wanting to put it right so that I could have the baby that was increasingly turning into an obsession. I watched my friends and relatives get pregnant, or would see other women walking down the street with their round baby bumps, and it felt as if it was only me who could not have a baby.
"Initially I kept my pain pent up as I didn’t want to show the fragile and needy side of me to anyone. But later I just could not contain it any more. It was too late by then, my desperation to get pregnant overwhelmed people around me and nobody seemed able to help.
"I saw a family doctor back in India and she declared I had PCOS. She instantly put me on the diabetes medication Metformin, which is used to control blood sugar levels and can sometimes help with the insulin resistance that is associated with PCOS.
"I did not want to trust only her judgment, so we saw another doctor in Dubai, who recommended I stop the Metformin, and we tried a cycle of the fertility drug Clomid instead, which is used to try to induce ovulation. It didn’t work, and this was when I really started to lose hope.
"I had almost completely given up on the idea of falling pregnant naturally and was researching IVF procedures when I stumbled up on a video on YouTube.
"It was a nutritionist, Dr Marilyn Glenville, lecturing other professionals on how to administer a PCOS turn-around diet for their clients.
"I listened to the entire two-hour lecture and all she said made a lot of sense. I was not extremely overweight but in recent years I had gained a couple of extra Kilograms and it was becoming very hard to get rid of it. Dr Marilyn mentioned how eating certain things can aggravate the symptoms of PCOS. She also advised her peers to consider the mental state their clients might be in, and how important it is to address it. I decided to follow the diet as strictly as possible in a last-ditch attempt to get pregnant naturally.
"Initially it was very difficult and frustrating, as the diet requires that you cut out dairy and I love milk and cheese, so it was very hard for me to cut that out of my diet.
"But after some time I started to feel more positive in general. I was even coming round to the idea of adopting a child or going for IVF.
"Although I didn’t begin any specific type of exercise, I started walking more deliberately, and making small changes like taking the stairs instead of the elevator, or leaving the taxi a few blocks away to walk.
"Before the diet I was finding it very difficult to lose the few kilos I had gained over past few years, but within one month I was able to shed the weight and get back to my ideal weight.
"And best of all, within two months of starting the diet, I conceived.
"While I can’t be sure if was due to the diet, I don't have anything else to credit, as my Clomid cycle had failed already and all I did differently was this diet.
"Initially I joked with my husband that it seemed like I was having dairy-withdrawal symptoms. But after a week or two, I started feeling better physically and emotionally. And later on, we conceived! But more than excitement, I finally felt at peace and contended with myself.
"Having tried so hard to get pregnant for so many years, do I feel that my son is a miracle baby? Well, a baby is a miracle in itself. Every single one of them. As you watch your child grow, you see many instances when they show unbelievable resilience and vitality, and I think that is magical."
THE PCOS DIET
- Eliminate sugar and refined carbohydrates a) No artificial sweeteners b) No chewing gum or diet drinks, they have sugar in them
- Increase Omega 3 intake (preferably fish oil supplements)
- Eliminate dairy products
- Increase vegetables, pulses and fruits
- Cut out alcohol
- Cut out caffeine
- Eliminate Trans-fat
Along with this, it's recommended you start taking a multivitamin that includes these supplements:
- Chromium
- Magnesium
- Vitamin E
- Vitamin C Alkaline
- Co-emzyme Q10
- Zinc
- Alpha Lipoic Acid
- B Vitamins
- Green tea extract
- Vitamin D
- Siberian ginseng
- Amino acids
Herbs to include in diet:
- Black cohosh
- Agnus cactus
- Milk thistle
- Saw palmetto
Ideally including all this, exercise and probiotics in the diet is suggested.
The medical opinion: Can a diet really cure infertility?
Studies show that infertility is becoming increasingly common in the UAE: according to a recent study by Aster DM Healthcare, one in five couples in the UAE face fertility issues – a figure that is higher than the world average. Meanwhile the Dubai Health Authority's (DHA) latest findings show that around 50 per cent of women in the UAE face issues pertaining to infertility, and they expect that to double by 2030.
The UAE also has one of the highest incidences of PCOS in the world, with a higher prevalence here than in Europe.
Although it's not certain why there is so much PCOS in the UAE, some experts link it to lifestyle factors - such as a fast-paced and stressful working environment that leaves little time for exercise, and an emphasis on eating out - that mean many residents are carrying excess weight. This can affect their insulin resistance, which in turn is implicated in PCOS.
We asked Dr Kiren Sahota, consultant family medicine at HealthBay Polyclinic in Marina, for more information about PCOS in the UAE and whether a diet could really cure it.
How common is PCOS in the UAE?
There are reports that PCOS is more common in the UAE than in other parts of the world. The increase number of cases here appears to be attributed to the higher levels of obesity in the UAE.
What are the signs of PCOS?
Some people have no symptoms of PCOS, others may suffer with the following:
- Irregular periods or no periods at all
- Difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
- Excessive growth of body hair usually on the face, chest, back or buttocks
- Weight gain
- Thinning hair and hair loss from the head
- Oily skin or acne
PCOS is also associated with an increased risk of developing health problems in later life, such as type 2 diabetes and high cholesterol levels.
Diagnosis is based on:
- Irregular periods–ovaries don't regularly release eggs (ovulation)
- Excess androgen – high levels of "male hormones" in the body, which may cause physical signs such as excess facial or body hair. Found by conducting blood tests.
- Polycystic ovaries – ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs. This is found on an ultrasound scan.
What causes PCOS and how is it usually treated?
The exact cause of PCOS is unknown, but it often runs in families. It's related to abnormal hormone levels in the body, including high levels of insulin.
Insulin is a hormone that controls sugar levels in the body. Many women with PCOS are resistant to the action of insulin in their body and produce higher levels of insulin to overcome this.
Read more: 'The untold pain of secondary infertility'
This contributes to the increased production and activity of hormones such as testosterone. Being overweight or obese also increases the amount of insulin your body produces. However not all individual with PCOS are obese or overweight.
Polycystic ovary syndrome (PCOS) can't be cured, but the symptoms can be managed
If a patient has PCOS and is overweight, losing weight and eating a healthy diet can make some symptoms better.
In overweight women, the symptoms and overall risk of developing long-term health problems from PCOS can be greatly improved by losing excess weight. Weight loss of just 5% can lead to a significant improvement in PCOS.
Weight can be lost using exercise and having a balanced diet that should include plenty of fruit and vegetables, whole foods (such as wholemeal bread, wholegrain cereals and brown rice), lean meats, fish and chicken.
Medications are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems.
If fertility medications are ineffective, a simple surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended. This involves using heat or a laser to destroy the tissue in the ovaries that's producing androgens, such as testosterone.
With treatment, most women with PCOS are able to get pregnant.
Treatment options can vary because someone with PCOS may experience a range of symptoms, or just one.
To what extent can lifestyle factors help with PCOS?
Following a healthy diet and lifestyle can only make things better. However there is evidence that for individual who are overweight, even a small decrease in weight by 5% can improve symptoms of PCOS including fertility
How does this PCOS diet look in your medical opinion – does it seem like the sort of diet that might be able to help with PCOS and fertility?
The diet appears to simply encourage the eating of a very healthy diet. Overall it looks good as it cuts out refined carbohydrates and appears to favour whole and lean foods along with good fats.
The issue is that it is only for three months, which almost implies a crash detox, which could potentially follow on with a massive binge, which isn’t good for anyone.
Overall the recommendations are good, however there are arguments that if dairy is excluded, then one must make sure that they are covering their nutritional requirements for calcium, vitamin D, phosphorus, as well as other essential minerals and vitamins.
As for the use of supplements, these should be discussed with a health provider to make sure that they do not interfere with the breakdown or buildup of any other medication the patient may be taking.
Furthermore supplements, despite being natural, can still cause significant side effects and damage. For example it is reported that Black Cohosh has caused irreversible liver damage in patients.
I don’t think one can say try this diet and you will conceive. This diet will only improve one’s health and make sure they are giving themselves the best chances. It isn’t a given however.
I think taking up a healthy diet, cutting caffeine, alcohol, refined sugars and bad fats would be good for anyone who is trying to conceive, PCOS or not. Being less sedentary too. When discussing PCOS, it may help to reduce a patient’s BMI, which as we have already discussed improves outcomes in PCOS patients.
WATCH Dr Marilyn Glenville's full lecture on PCOS and diet:
*Name changed by request
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