3 Things to Do If You're Trying to Get Pregnant With PCOS
Women with polycystic ovary syndrome (PCOS) often have difficulty getting pregnant. The condition involves out-of-whack hormones, which leads to irregular or infrequent periods and interferes with the body’s ability to ovulate.
PCOS, which affects 10% of women, can be successfully managed, however, and women with PCOS can definitely still get pregnant, Elizabeth Fino, MD, a reproductive endocrinologist and infertility specialist at the NYU Langone Fertility Center, tells Health.
In addition to irregular or infrequent periods, women with PCOS often also experience weight gain, unwanted facial or body hair growth, hair loss from the head, acne, and mood changes.
These symptoms are thought to be linked to excess androgen—or male—hormones, Dr. Fino says. Women with PCOS often also have increased levels of insulin, which may be linked to weight gain.
It’s important to get PCOS diagnosed, says Erin Dawson-Chalat, MD, of Women’s Coastal Healthcare in Maine, not only to address any fertility issues you might be having, but to avoid other long-term consequences of PCOS as well. “PCOS can have lifelong health implications like metabolic syndrome, type 2 diabetes, and possibly cardiovascular disease and endometrial cancer,” she says.
Why some women with PCOS struggle to conceive
The average woman in her mid-30s has a handful of follicles that contain egg cells in each ovary during her menstrual cycle. The brain secretes follicle stimulating hormone (FSH) to help select one of these follicles to mature and then release an egg.
But for women with PCOS, these follicles do not mature and ovulation doesn't happen. Instead, they accumulate, and women with PCOS can have at least a dozen in their ovaries. Without ovulation, there can't be conception.
So can you still get pregnant with PCOS?
Yes, although it may take some extra effort. Here are a few things to try.
Eat a balanced diet and exercise regularly. Women with PCOS need to regulate ovulation, and in many cases, that can be done with diet and exercise, explains Dr. Fino.
Because symptoms of PCOS include weight gain and difficulty losing those extra pounds, eating a balanced diet that focuses on protein, healthy fats—olive oil, avocados, and nuts—vegetables, and whole grains can be an effective way to manage the condition.
“While not all women with PCOS are overweight, in overweight women, weight loss alone can restore ovulation—as little as a 5% or 10% reduction in weight,” says Dr. Dawson-Chalat.
Aim for about 30 minutes of moderate-intensity exercise three to five times a week, Dr. Fino says—but be careful not to overdo it. “Some women with PCOS are so stressed about fertility that they don’t eat and exercise 10 times a week, and you still don’t get your period,” she warns. “That’s a common pattern, this extreme overcorrection. You need a balance.”
Consider medication. If adjusting your diet and exercise habits has been unsuccessful, your doctor may suggest medication to help with PCOS.
Common meds to induce ovulation are clomiphene and letrozole. Women with PCOS who are trying to get pregnant will take the clomiphene for five days and then confirm with a doctor if they're ovulating, explains Dr. Fino, while letrozole is generally taken over the long term.
In some cases, women who experience weight gain due to PCOS might find fertility success with medication that targets insulin, like metformin, says Dr. Fino. “But this doesn’t work in the absence of following a healthy diet. You still have to eat well and exercise,” she says.
Don't put off having kids. That is, if you’re ready to have children, don’t wait, says Dr. Fino. The older a woman gets, the harder it is to conceive, regardless of whether she has PCOS.
“If you have a factor that puts you at risk for infertility [like PCOS], you need to think about that early,” she says. You don’t want to end up spending years on hormonal birth control to manage PCOS only to realize later that you need more complex infertility treatment, she adds.
Women with PCOS who are not ready to have children by the time they’re 35 may want to consider freezing their eggs, Dr. Fino says. “If you decide later that you want kids, you might need in-vitro fertilization, and it’s better to go back to a younger egg than one that’s 40 or 42 years old.”