Can You Get Pregnant if You Have PCOS? What To Know

Polycystic ovarian syndrome (PCOS) is an imbalance of female reproductive hormones that can affect fertility. In addition to symptoms like weight gain, unwanted hair growth, and acne, PCOS can make it difficult to get pregnant.

Between 5-10% of people between the ages of 15 and 44 have PCOS. It can lead to cysts in the ovaries, anovulatory cycles (cycles where you don’t ovulate), and irregular periods. Lifestyle changes, medication, and other treatment options can help improve your fertility.

PCOS is a common cause of infertility. Between 70-80% of people with PCOS have difficulty getting pregnant. However, PCOS is one of the most treatable causes of infertility, and there are several effective treatment options.

Infertility treatment for people with PCOS focuses on inducing ovulation and regulating menstrual cycles. Treatment effectiveness varies by person based on treatment type, ovulation frequency, age, and other underlying health conditions. Inducing ovulation with medications like Clomid (clomiphene) and gonadotropins is typically about 70% effective. A technique called ovarian drilling works about 50% of the time.

Lifestyle changes are often the first way to address PCOS. They can help induce ovulation and regulate menstruation. These lifestyle changes are often combined with medication and medical interventions.

Maintain a Healthy Weight

A healthy weight looks different for everyone. Losing weight through diet and exercise can help improve PCOS symptoms.

Weight loss may help regulate blood glucose (sugar) levels. This is important for people with PCOS prone to insulin resistance, which occurs when the body doesn’t respond effectively to the hormone insulin, which helps regulate blood glucose. Losing weight may also regulate your menstrual cycles and cause more regular ovulation.

Exercise

Exercise is beneficial for everyone, but it’s especially valuable for people with PCOS. Studies have shown that exercising regularly can notably improve menstrual regularity and ovulation in people with PCOS. International PCOS guidelines recommend 150 minutes of regular exercise weekly, with about 90 minutes of moderate-intensity aerobic exercise.

Diet and Nutrition

A nutritious, well-balanced diet can improve PCOS symptoms, regulate periods, and increase the likelihood of ovulation. People with PCOS often experience insulin resistance, which causes excess glucose in the bloodstream.

Focusing on a diet high in protein and fiber, foods with a lower glycemic index (GI), and whole grains and complex carbohydrates (e.g., bulgur, cornmeal, farro, oatmeal, and whole-wheat flour) can help regulate blood glucose levels.

Medical interventions, including medication, surgery, and other procedures, are often necessary to treat fertility issues related to PCOS.

Ovulation-Inducing Medication

The first-line medical treatment for inducing fertility in people with PCOS is to prescribe medication that can stimulate ovulation. Clomid (clomiphene) is the most common medication, typically tried first. If Clomid doesn’t work, a medication called Femara (letrozole) is another option.

Gonadotropins

Gonadotropins are considered a second-line treatment for lack of ovulation in people with PCOS. Gonadotropins are hormones that regulate ovarian function. Examples include follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which facilitate the release of an egg from your ovary.

Metformin

Metformin is a medication used to manage type 2 diabetes. It’s not FDA-approved to treat PCOS but is often used off-label for this purpose. Metformin can make your body more sensitive to insulin and decrease blood sugar. It often prompts ovulation in people with PCOS.

Surgery

PCOS may cause the outer shell of your ovaries to thicken, making the release of an egg more difficult. Surgery is an option if other treatments don’t work. This typically includes ovarian drilling, when your healthcare provider makes small holes in your ovary using a fine needle or a laser to help restore fertility and allow for the release of eggs.

Assisted Reproduction

If medication doesn’t help you ovulate, treatments like in vitro fertilization (IVF) may be an option. IVF is a type of assistive reproductive technology (ART) that joins an egg and a sperm cell in a laboratory dish to create an embryo. Ovulation is induced, eggs are retrieved and mixed with sperm, and then the embryo is transferred to your uterus for implantation.

Here are five basic stages of an IVF cycle:

Preparation: Includes blood tests (e.g., STIs, hormones), optional genetic screening, semen analysis, uterine imaging (e.g., transvaginal ultrasound), and possibly taking birth control
Ovarian stimulation: Includes medications and monitoring egg development
Egg and sperm retrieval: An in-office procedure to retrieve the eggs, as well as sperm collection (e.g., frozen samples or surgical removal)
Egg fertilization: Combining the retrieved eggs and sperm in a laboratory dish and monitoring the developing embryos
Embryo transfer into the uterus: An in-office procedure, usually 3-5 days after egg retrieval

Some people choose to cryopreserve (freeze) eggs or embryos they don’t plan to use immediately. They can use these eggs or embryos for future pregnancies or possibly for donation.

Various alternative and complementary therapies might help increase fertility with PCOS. It’s important to discuss these with your healthcare provider before trying them.

One review published in GREM Gynecological and Reproductive Endocrinology and Metabolism suggested that the following may be effective treatments for infertility associated with PCOS:

Inositol supplements: Supplements like myo-inositol and delta-chiro inositol can increase your sensitivity to insulin and lower blood sugar, which may help you ovulate more easily.
Melatonin supplements: Melatonin can help you sleep better, balance your hormones, and improve ovulation.
Vitamin D, vitamin B12, and calcium: These supplements can help balance hormones and treat ovulation challenges.

There’s clinical evidence that complementary therapies like acupuncture can also help regulate hormones, induce ovulation, and help manage insulin resistance among people with PCOS.

Experiencing fertility issues—whether from PCOS or other causes—can be a significant source of stress, disappointment, and even shame. It can affect your ability to cope in your day-to-day life and affect your work life, family life, and other relationships. People who experience infertility are also more prone to mental health conditions like anxiety and depression.

Take care of yourself as you navigate infertility and infertility treatments. Here are some coping strategies, as recommended by the American Psychiatric Association:

Let yourself “feel the feels” vs. trying to push away feelings
Don’t be afraid to cry or feel anger about the situation
Understand and accept that your partner may have different emotional reactions than you
Ask for support from your partner, family, and friends
Set boundaries about social gatherings that may be triggering, such as gatherings with pregnant people or young children
Connect with other people who have similar experiences
Consider free support through groups such as RESOLVE

Talk to your healthcare provider about any concerns you have. They can offer more ideas for support resources.

PCOS is one of the most common causes of infertility. People with PCOS have difficulty becoming pregnant because they often don’t ovulate and typically have irregular menstrual cycles.

Treatments to restore ovulation in people with PCOS include lifestyle medications, medications, and medical treatments and procedures. Each person with PCOS is unique, and multiple factors determine the most effective infertility treatment options.

Fertility treatment can take time and may require multiple approaches. Always discuss treatment options with your healthcare provider to develop the most promising plan for you.

Source link

Wendy Wisner