How Women With PCOS Can Become Pregnant

The hormonal imbalances disrupt ovulation, making it difficult for women with PCOS to conceive or become pregnant. Polycystic Ovary Syndrome (PCOS) affects millions of women worldwide, especially 6-12% of women of reproductive age. PCOS comes with irregular periods, excess androgen levels (male hormones), and, often, the presence of multiple small cysts on the ovaries. This hormonal disorder can affect a woman’s ability to conceive and start a family.

PCOS and Fertility 

One of the significant symptoms of PCOS that directly affects fertility is irregular menstrual cycles. Many women with PCOS have irregular periods or the complete absence of menstruation (amenorrhea). Without ovulation, the chances of conceiving are lower.

Other symptoms that can affect fertility include:

• Anovulation (lack of ovulation)
• High levels of androgens, which cause excess hair growth and acne
• Weight gain and obesity (in more severe cases)
• Insulin resistance

Learn more: How PCOS affects fertility.

If you have been diagnosed with PCOS and are trying to conceive, you are not alone. Many women like you have successfully gotten pregnant and have healthy babies. You must focus on understanding your options and working with your healthcare providers to find what works best.

Now, we will share how to get pregnant with PCOS. From effective lifestyle changes to medical interventions, we have provided a comprehensive overview to help improve your fertility journey.

Lifestyle Changes as First-Line Treatment

Weight management

For many women with PCOS, weight management can improve their chances of conceiving. Losing 5 to 10% of body weight can help regulate menstrual cycles and improve ovulation. Maintaining a healthy weight also reduces insulin resistance, which plays a significant role in hormonal balance.

Diet and exercise 

Eating healthy and regular exercise are crucial in maintaining a healthy weight. When it comes to diet, focus on:

• Low glycemic index foods to help manage insulin levels
• Lots of fruits, vegetables, and whole grains
• Lean proteins
• Healthy fats found in avocados, nuts, and olive oil

You can work with a registered dietitian to find an eating plan that works for you and boosts your fertility.

Managing stress

Stress disrupts your hormonal balance and significantly affects fertility. You can manage your stress levels by engaging in relaxing activities. These include like:

• Meditation
• Deep breathing exercises 
• Getting 7-8 hours of sleep

Read more tips for managing PCOS naturally (insert link).

Medications to Induce Ovulation

Changing your diet and habits might not make a difference. If this is the case, your doctor may prescribe some medications. These medications help to stimulate ovulation and increase your chances of getting pregnant. Some of these are:

Clomiphene Citrate (Clomid)

Clomid is usually the first-line medication for inducing ovulation in women with PCOS. It blocks estrogen receptors in the brain, which causes the body to produce more follicle-stimulating hormone (FSH). Increased FSH levels stimulate the ovaries to produce and release mature eggs for ovulation. 

Clomid is usually taken for five days at the beginning of the menstrual cycle. Success rates vary. Studies show that about 75% to 80% of women who take Clomid will ovulate. About 22% of these women even conceive after each cycle.

Letrozole (Femara

Letrozole is fast becoming popular as a first-line treatment for ovulation induction. It lowers estrogen levels, which stimulates your brain to produce more FSH. Some studies suggest that Letrozole may be more effective than Clomid, especially for women with PCOS who are overweight or insulin-resistant.

Insulin sensitiser

As the name implies, medications like Metformin improve insulin sensitivity. Metformin is popularly used to manage type 2 diabetes, especially for women who have insulin resistance. By balancing insulin levels, Metformin can regulate your menstrual cycle and ovulation. It is usually prescribed alongside other fertility treatments to enhance its effectiveness.

Gonadotropins

Gonadotropins are considered second-line agents when the first-line medications don’t work. For women who do not respond to oral medications, your doctor may recommend injectable fertility drugs known as gonadotropins. These stimulate the ovaries to produce multiple mature eggs, which increases your chances of conception. While this may be effective, you will need to be closely monitored by a fertility specialist. Taking these medications increases your chances of having multiple pregnancies and the risk of ovarian hyperstimulation syndrome (OHSS). 

Assisted Reproductive Technologies (ART)

For some women, medications alone may not be enough to induce ovulation or help them get pregnant. In these cases, your doctor may recommend assisted reproductive technologies. These advanced fertility treatments include:

In Vitro Fertilization (IVF)

IVF is a highly effective treatment that can be an option if other methods don’t work. During an IVF procedure, the ovaries are stimulated to produce multiple eggs. The eggs are retrieved and fertilised with viable sperm in a lab, and then the embryo(s) are transferred back into the uterus to develop. For women with PCOS, IVF is sometimes performed carefully with ovarian stimulation protocols to reduce the risk of OHSS.

Keep in mind that an IVF procedure can span across months or years. The first step in preparing your body for an IVF treatment is to eat a balanced diet and exercise regularly to maintain a healthy weight. Women with PCOS who have a healthier body mass index (BMI) and weight are twice as likely to get pregnant. You may also need some medications to balance your hormones and prepare your body for the IVF treatment. Taking birth control pills before the IVF treatment can improve your results.

Intrauterine Insemination (IUI)

With intrauterine insemination (IUI), the sperm is inserted directly into the uterus during ovulation. Ovulation is either induced with medication or naturally during the menstrual cycle. IUI is less invasive and less expensive than IVF. However, IUI success rates are generally lower than that of IVF, especially in women with severe PCOS symptoms. 

When compared to medicine, IVF has higher pregnancy rates of about 50% from a single treatment cycle. 

Surgery

If other treatment options are unsuccessful, your doctor may suggest a surgical intervention to boost fertility. An excellent example of this is a surgery called ovarian drilling.

Ovarian Drilling

Laparoscopic ovarian drilling is a surgical procedure where small holes are made in the ovaries using heat or laser. This procedure helps to lower androgen levels and restore regular ovulation in some women with PCOS. With the availability of effective medications, this surgery is not common. 

The effectiveness of ovarian drilling varies. Some studies show that about 50% of women who undergo the procedure ovulate within a few months. They even get pregnant within the first year after the surgery. The downside is that the effect may be temporary.  

Conclusion 

Struggling with PCOS and infertility takes an emotional toll on women. Many women experience frustration, sadness, and isolation during this journey. The anxiety, medical treatments, and societal pressures to conceive make this period even more overwhelming. 

With proper treatment, many women with PCOS can have successful pregnancies. Keep in mind that these fertility treatments come with a risk of having multiple births (twins or triplets). Your healthcare provider will monitor you closely to minimise this risk while maximising your chances of conception.

Frequently Asked Questions (FAQs)

What are my chances of getting pregnant with PCOS?

While PCOS makes it harder to conceive, many women with PCOS can get pregnant and enjoy a healthy pregnancy with proper medical care. You can work closely with your doctor to improve your pregnancy chances.

Remember that every woman is different. Different treatments have different success rates, so there are no exact statistics. 

How long does it typically take to get pregnant with PCOS? 

The time it takes to get pregnant with PCOS varies. Some may conceive quickly with lifestyle changes or first-line treatments. Many women conceive within 6-12 months, but it may take longer for others.

Can women with PCOS have a healthy pregnancy?

Yes, many women with PCOS can enjoy a healthy pregnancy with proper medical care. However, they may need closer monitoring due to an increased risk of complications like gestational diabetes.