Low carb eating is the latest diet fad to hit the consumer market. It has been hailed as a cure not only for obesity but for a number of other medical problems such as high cholesterol and high blood pressure. Now a number of experts believe that low carb diets may be just the ticket to solving some women's infertility issues.

Positive Implications for PCOS
Dr. Ellen Hayes, reproductive endocrinologist at Conceptions Women's Health and Fertility Specialists in Littleton, Col., says a diet low in carbohydrates is especially helpful to those women suffering from polycystic ovarian syndrome (PCOS). According to Dr. Hayes, PCOS is a constellation of symptoms including irregular menstrual cycles, elevated androgen (male-type hormone) levels, infertility and frequent obesity.

Researchers have also found that many women with PCOS have insulin resistance. "This means that they have higher than normal levels of insulin in their blood, and this can have a direct effect on the ovary to produce androgens," says Dr. Hayes. "High androgen levels then can interfere with normal ovulation and menstruation, leading to difficulty getting pregnant, as well as causing acne and excess hair growth."

Dr. Hayes says it is a well-known fact that diets lower in simple carbohydrates will not raise insulin levels as high after a meal as diets that are high in carbs. This can be helpful, not only for diabetic patients who are trying to maintain normal blood sugar levels, but also for PCOS patients who have abnormally high insulin levels. "By keeping their insulin levels in the normal range, we can lessen the effect of high insulin levels on the ovary and help to treat their metabolic syndrome as a whole," says Dr. Hayes. "In this way, we may be able to get these women to experience more regular ovulation and menstrual cycles, leading to improved fertility."

Christina Worrall of Wilmington, Del., was diagnosed with PCOS in 2001. She tried to get pregnant on her own without success. She went to a support group two years later and met Dr. Ronald F. Feinberg of Reproductive Associates of Delaware. "Dr. Feinberg told me about the relationship between diet and fertility," says Worrall. "If I made better choices, my body would start to get back on track. Before making lifestyle changes, I tried Clomid, and it didn't work. While taking a break from fertility treatments, I started taking Glucophage in addition to eating better and exercising. I lost a significant amount of weight, and my cycles returned. Within a few months, I was pregnant. I had an uncomplicated pregnancy and gave birth to my son, William, 5 months ago."

Dr. Feinberg, author of Healing Syndrome O: A Strategic Guide to Fertility, Polycystic Ovaries and Insulin Imbalance (Avery Penguin, 2004), has seen success quite often with women like Worrall. He wrote Healing Syndrome O to help millions of women in the United States and around the world who suffer with the basic triad of Syndrome O: overnourishment, ovarian confusion and ovulation disruption.

"The sad culprit of overnourishment, particularly on a chronic basis, is the overproduction of the insulin family of hormones," says Dr. Feinberg. "Insulin and related hormones wreak havoc with the female reproductive system, contributing to frustrating years of abnormal periods, infertility, the frequent sadness of miscarriage and pregnancy loss, as well as multiple complications throughout pregnancy. Although some equate Syndrome O with PCOS, Syndrome O encompasses so much more general health and wellness issues for women."

Diet vs. Drugs
In his medical practice of reproductive endocrinology and infertility, Dr. Feinberg discovered a large unmet need for carefully explained information, both about insulin resistance and fertility care. He believes that many doctors are quick to prescribe drugs to reduce insulin and promote ovulation, and many of these drugs are not being carefully monitored.

"With regard to diets, I prefer to think of a nutritional approach that could best be called sensible carbs," says Dr. Feinberg. Though he maintains that it is virtually impossible to prescribe one specific diet approach for everyone, many of Dr. Feinberg's patients have benefited from a sensible carbs approach, which deletes simple sugars and sugar waters from their diet. "I do feel that there is a useful place for higher fiber [and] lower glycemic index carbs, including most fruits and vegetables," he says. "Some multigrain, high-fiber breads and starches might even be OK, especially if energy expenditure occurs throughout the day."

The Keys
Dr. Feinberg believes the key to sensible nutrition probably lies in how insulin and related hormones are secreted minute-by-minute, both while awake and asleep. Any nutrition plan that causes major surges in insulin hormones is probably anti-fertility for women. "Avoidance of simple sugars and foods with high glycemic indications probably helps control insulin levels," he says. "Overnourishment needs to be avoided. Believe it or not, individuals can still gain weight on high-protein diets if they take in more calories than their bodies' burn. The body contains special enzymes that can convert protein and fat to simple sugars. It's the body's way of protecting itself from starvation."

Exercise is also a key in Dr. Feinberg's plan to help women suffering from Syndrome O, as stress worsens insulin output through adrenal cortisol production. "Sensible carb nutrition is part of an overall plan toward healing Syndrome O," he says. "I call the overall plan the Syndrome O Survival (SOS) Strategies. We have many, many success stories with patients who understand the life-altering approaches they need to take to improve their health and fertility."

Want to see more?

• Making Sense of PCOS
• Excerpt >From PCOS: A Woman's Guide to Dealing with Polycystic Ovary Syndrome
• Herbs for Infertility: Do You Know Your Options?
• Talk about it!