Fertility

Getting Pregnant with PCOS: What You Need to Know

Team Peanut9 months ago7 min read

It’s true that PCOS and pregnancy aren’t exactly the best of friends. As a condition that affects how often you ovulate, it can make it more of a challenge for sperm and egg to have that magical meeting. But getting pregnant with PCOS is by no means impossible – quite the opposite, in fact.

Getting pregnant with PCOS

So, if you’re wondering just how to get pregnant with PCOS, why not read on and find out?

What is PCOS?

PCOS (polycystic ovary syndrome) is a very common condition that affects about 7% of women across the world and around 5 million women in the US alone. When you have PCOS, your hormones (aka the chemical messengers in your body) are out of balance and, sadly, that can impact your fertility.

Common symptoms of PCOS include:

  • Irregular periods
  • Facial hair or extra hair on other parts of your body
  • Lots of (harmless) fluid-filled sacs in your ovaries (hence, polycystic ovary syndrome)

Many women aren’t aware of any symptoms and only get diagnosed with PCOS once they start trying for a baby.

Why is it hard to get pregnant with PCOS?

Ovulation, where your ovaries release an egg, is absolutely key to getting pregnant. Without that, any friendly sperm that turn up are going to be disappointed.

Usually, ovulation takes place about once a month, but when you have PCOS it might be a lot more unpredictable than that. This could be because your hormones aren’t directing your ovaries to release an egg, or because the extra sacs (or cysts) in your ovaries are getting in the way of an egg being sent out.

With ovulation being a bit on the random side, it’s quite hard to schedule sex for that promising meeting between egg and sperm. Thus, getting pregnant with PCOS can take a little extra work.

Can you get pregnant with PCOS naturally?

Getting pregnant with PCOS naturally (that is, without medical treatment) is entirely possible. In fact, the majority of women with PCOS who try for a baby will conceive and give birth at least once in their lifetime, without any fertility treatment.

Depending on which symptoms of PCOS you’re experiencing, you may also be able to make certain lifestyle changes that can boost your chances of conceiving. For example, PCOS is often (though not always) associated with weight gain, which can make it more difficult for you to get pregnant too.

The good news is that weight loss of just 5% has been shown to significantly improve the symptoms of PCOS.

So, if you think losing weight might help you tackle PCOS and smooth the way to pregnancy, you can chat to your doctor about the best ways to achieve this. A couple of good tips are to:

  • Eat a healthy, balanced diet with plenty of fruit and veggies, whole grains, and lean protein. If possible, avoid processed foods that are high in fat or sugar.
  • Make time to exercise by walking, jogging, swimming, or taking part in any other fun fitness activities.

Don’t worry – we’re not talking about running marathons here! One scientific study showed that brisk walking combined with a healthy diet helped women with PCOS improve their menstrual cycle regularity by 50%. Small steps can still be really effective.

How can I increase my fertility with PCOS?

If these changes aren’t cutting it, or if they’re not relevant for you, there are various different fertility treatments that your doctor may suggest. Let’s take a look at a few PCOS treatment options that can speed you along the road to mamahood.

Oral medication

Clomiphene (Clomid) tablets are usually the first treatment to be tried by aspiring mamas with PCOS. You take them at the start of your menstrual cycle, usually for several cycles, and they encourage your ovaries to release an egg.

There are also a couple of other oral medications that aren’t technically licensed for treating PCOS, but they can be used “off-label” for this purpose. Like clomiphene, they work to stimulate ovulation. These are: metformin and letrozole.

Metformin is a treatment for type 2 diabetes, as it helps to balance insulin levels in the body. (Insulin is a hormone that keeps your blood sugar levels in check.) As a person with PCOS, you may struggle with your insulin levels anyway, so taking metformin as a fertility treatment could benefit you in multiple ways.

Letrozole is a treatment for breast cancer, normally, but it can also be very effective at getting that all-important egg to the right place at the right time.

Injection

If oral medications aren’t working for you, you may be offered an injection of one of a group of drugs called gonadotrophins. This is a hormonal treatment that is very good at encouraging your ovaries into action.

One downside is that it can be too effective at stimulating your ovaries, leading to a risk of OHSS (ovarian hyperstimulation syndrome). Symptoms of OHSS include: rapid weight gain, bloating, abdominal pain, and nausea. Let your healthcare provider know straight away if you experience any of these.

IVF or IVM

When medications alone aren’t effective, the next step is to try a fertility procedure such as IVF or IVM.

IVF (in vitro fertilization) is a procedure where fertility drugs are used to encourage your ovaries to produce some mature eggs, and they are then removed via a technique called “egg retrieval”. The eggs are placed in Petri dishes with some sperm (your partner’s or a donor’s) so that the sperm can fertilize them.

After the eggs have been fertilized and had a few days to grow, one or two of them are inserted into your uterus. The hope is that they will then snuggle into the uterine lining and you’ll be on your way to becoming a mama!

IVM (in vitro maturation) is a similar procedure to IVF. The main difference is that your eggs will be removed when they’re still immature (so no fertility drugs are needed, or only a low dose) and then matured in the lab, before being fertilized and placed in your uterus.

Does getting pregnant with PCOS have any risks?

The plain truth is that, unfortunately, PCOS does come with an increased risk of complications during pregnancy. These include:

  • Gestational diabetes
  • High blood pressure
  • Pre-eclampsia
  • Miscarriage

You may also be more likely to need a cesarean delivery (C-section) when you give birth.

What are the chances of getting pregnant with PCOS?

While PCOS pregnancy success rates are difficult to judge because women’s circumstances and treatments vary so widely, it’s clear that most women with PCOS will be able to have a baby if they wish to – particularly with some form of treatment.

For example, medical research has shown that women treated with clomiphene or gonadotrophins have a 70% chance of a successful pregnancy.

So, if you’re trying to get pregnant with PCOS and nothing’s happened yet – don’t worry. With fertility treatment, or just a little extra time, you’ve got every hope of holding your own baby in your arms one day.

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