If you have Polycystic ovary syndrome (PCOS), you might be worried about having a baby. While it’s true that PCOS is one of the most common causes of infertility in women, that doesn’t mean you cannot get pregnant. With the right approach, knowledge of your condition and support, many women with PCOS go on to have healthy pregnancies. Let’s dive into what PCOS is, how it impacts fertility, and what steps you can take to boost your chances of getting pregnant.
What is Polycystic Ovary Syndrome (PCOS)?
PCOS is an endocrine disorder that affects 8-13% of reproductive-aged women across the world, though close to 70% remain undiagnosed. PCOS can cause your body to produce too much androgen, a male sex hormone and insulin, a hormone that regulates blood sugar. The hormonal imbalance can cause irregular periods, acne, irregular body hair, ovarian cysts and infertility.
Symptoms of PCOS
The symptoms of PCOS can vary widely from person to person. Some women experience only mild symptoms, while others may have a broader range of more severe issues. Common symptoms include:
- Irregular or absent periods: Approximately 75-85% of women with PCOS have irregular periods.
- Increased facial or body hair (known as hirsutism): As many as 80% of women with PCOS have some form of hirsutism vs 4-11% of women in the general population.
- Hair thinning or loss on the scalp
- Difficulty getting pregnant
Other signs can include small skin tags in the armpits or neck area and areas of darker, thickened skin called acanthosis nigricans. Just because you have one of the above symptoms doesn’t mean you have PCOS; you should seek out a medical professional for a diagnosis.
Do I have PCOS?
Because PCOS remains undiagnosed and many people have mild symptoms, you may not learn you have PCOS until you start trying to conceive. This is especially common if you’ve been on hormonal contraception. The hormones in the pill can actually help PCOS symptoms, creating a regular period and even stopping other symptoms like acne and hirsutism. That’s why hormonal contraception is often prescribed as a treatment for PCOS.
How is PCOS Diagnosed?
When diagnosing PCOS, doctors use a combination of tests and criteria. According to the Rotterdam criteria, a set of criteria created 20 years ago to diagnose PCOS, you need to meet at least two out of three of the below:
- Irregular menstrual cycles: Less frequent periods due to anovulation.
- Elevated androgen levels: Seen through symptoms or blood tests.
- Polycystic ovaries: Confirmed via ultrasound.
Your doctor may also examine other factors, such as body hair, dark patches of skin, hormonal acne, and insulin resistance.
How Does PCOS Affect Fertility?
PCOS affects infertility in two ways: anovulation and hormonal imbalance. With PCOS, your body produces higher levels of androgens, such as testosterone and androstenedione. Normally, testosterone converts to estrogen in the ovarian follicle, but that process is disrupted when androgen levels are too high. As a result, you may not ovulate because an egg either doesn’t fully develop or isn’t released (anovulation). The hormonal imbalance can also cause other issues that impact fertility, like obesity.
How Can PCOS Affect Pregnancy?
Unfortunately, PCOS can also affect your pregnancy and your growing baby once you are pregnant in the following ways:
- Women with PCOS are at an increased risk for gestational diabetes and premature delivery.
- In one large-scale study, babies born to mothers with PCOS are at increased risk of developing “infections, allergies, and other childhood illnesses” by the age of 13.
- Some studies suggest that babies may be more likely to be born larger or be admitted to a neonatal intensive care unit (NICU).
What is the Infertility Rate with PCOS?
Women with polycystic ovaries often face a high rate of infertility, as PCOS can significantly impact their ability to ovulate. It is estimated that between 70%-80% of women with anovulatory PCOS will deal with infertility. Some women with PCOS may ovulate occasionally, while others may not ovulate at all. The inconsistent ovulation makes it difficult to conceive naturally. As a result, many women with PCOS require assistance or treatments to improve their chances of conceiving by encouraging regular ovulation.
Can I still Conceive with PCOS?
Yes, you can still get pregnant if you have PCOS, but you may need some extra help. You should see your doctor as soon as possible, and your chances are better if you're under 35, but even if you're older, don't lose hope; it’s still possible. Some of the most significant factors are finding a treatment that works for you, working with a great healthcare provider who understands PCOS and looking at what lifestyle changes you can make to help your journey. Early conversations with your doctor about fertility options can give you the best chance of success.
PCOS and Fertility Treatments
While a PCOS diagnosis can be upsetting if you're trying to conceive, there are treatment options out there that can help. Currently, there is no cure for PCOS, but some fertility treatments can double as symptom management, which will also significantly improve your quality of life.
Lifestyle Changes
A balanced diet and regular physical activity can make a tremendous difference. Research shows that even a 5% weight reduction can positively impact PCOS symptoms. In a meta-analysis, women with PCOS followed a ketogenic diet for 45 days and saw marked improvement in reproductive hormones.
Fertility Medication
If lifestyle changes alone don’t work, some doctors will try ovulation Induction. Medications like clomiphene citrate, gonadotropins or letrozole can assist in inducing ovulation, thereby increasing your chances of pregnancy. These can either come as an oral medication or an injection and can be done as a stand-alone treatment or concurrently with assisted reproductive technology (ART).
Assisted Reproductive Technology (ART)
ART treatments like in vitro fertilization (IVF) have a high rate of success for women with PCOS–in young, otherwise healthy women, pregnancy rates are as high as 50% with just one treatment. A lesser-known treatment is in vitro maturation (IVM). In IVM, immature eggs are collected from the ovaries and matured in a lab setting before being fertilized and transferred into the woman’s uterus. Sometimes, IVM and IVF are used together.
Learn More: Fertility's Hidden Roadmap: Knowing Your High and Peak Days for Conception Success
How to Reduce Your Risks of Problems During Pregnancy with PCOS
If you have PCOS and are trying to conceive, it may be more challenging, but there are steps you can take to improve your chances of a healthy pregnancy. Reaching a healthy weight and maintaining balanced blood sugar levels through proper diet, exercise, and medication like metformin (which helps regulate insulin) make a big difference. Additionally, upping your intake of folic acid can help improve your overall reproductive health. Start preparing your body for pregnancy today by incorporating essential vitamins, like our Prenatal Multi Capsules or Fertility Supplements, into your routine.
