Having PCOS does not mean you can’t get pregnant. PCOS is one of the most common, but treatable, causes of infertility in women. In women with PCOS, the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation). If you don’t ovulate, you can’t get pregnant.
All treatment are obviously based on getting regular ovulation.
If you want to get pregnant and have PCOS you may have a lot of questions. The good news is that it’s possible to get pregnant even if you are diagnosed with PCOS. However, it can take longer for a woman with PCOS to conceive compared to a woman without PCOS. Why is this the case? And what can be done about it?
Let’s learn more about it:
How PCOS affects Fertility
PCOS is the main cause why there is no ovulation (anovulation) in women. Anovulation means that your ovaries are either not or not regularly releasing mature eggs. It is difficult to define the exact cause of anovulation in PCOS. There are various hormonal abnormalities within and outside the ovaries that are associated with PCOS.
Being aware about the effects of PCOS on fertility is important in finding the right treatment approach for you and increasing your chances of pregnancy.
How to Improve your Chances of Getting Pregnant
If you are diagnosed with PCOS, there are several treatment methods available to improve your chances of getting pregnant. Only a small number of PCOS patients will require assisted- reproductive methods (IVF) to improve their chance of pregnancy. Your doctor will recommend an appropriate treatment plan after assessing your symptoms and overall condition.
Treatment Options for those who are Trying To Conceive:
A high body mass index (BMI) can have an impact on the development of PCOS6, according to a 2019 study, and weight gain contributes to worsening symptoms. Fortunately, even a small amount of weight loss through diet and behaviour changes can improve symptoms.
If you are overweight or obese, you will be advised to lose weight with a healthy diet and increased physical activity. A loss of 5 to 10% in body weight is associated with improvement in PCOS symptoms and ovulation rate.
You can find out whether you’re a healthy weight by calculating your body mass index (BMI), which is a measurement of your weight in relation to your height.
A normal BMI is between 18.5 and 24.9. Use the BMI healthy weight calculator to work out whether your BMI is in the healthy range.
You can lose weight by exercising regularly (combination of resistance and cardio training) and eating a healthy, balanced diet such as the Mediterranean diet or low carbohydrate diet
A medication called clomiphene may be the first treatment recommended for women with PCOS who are trying to get pregnant.
Clomiphene Citrate often called Clomid encourages the monthly release of an egg from the ovaries (ovulation).
If clomiphene is unsuccessful in encouraging ovulation, another medicine called metformin may be recommended.
Metformin is often used to treat type 2 diabetes, but it can also lower insulin and blood sugar levels in women with PCOS.
As well as stimulating ovulation, encouraging regular monthly periods and lowering the risk of miscarriage, metformin can also have other long-term health benefits, such as lowering high cholesterol levels and reducing the risk of heart disease.
Metformin is not licensed for treating PCOS in the UK, but because many women with PCOS have insulin resistance, it can be used “off-label” in certain circumstances to encourage fertility and control the symptoms of PCOS.
Possible side effects of metformin include nausea, vomiting, stomach pain, diarrhoea and loss of appetite. ( Many women with PCOS use the supplements Inositol, Myo-Inositol or D-Chiro-Inositol instead of metformin without its side effects)
Letrozole is sometimes used to stimulate ovulation instead of clomifene. This medicine can also be used for treating breast cancer.
Use of letrozole for fertility treatment is “off-label”. This means that the medicine’s manufacturer has not applied for a licence for it to be used to treat PCOS.
In other words, although letrozole is licensed for treating breast cancer, it does not have a license for treating PCOS.
Doctors sometimes use an unlicensed medicine if they think it’s likely to be effective and the benefits of treatment outweigh any associated risks.
If you’re unable to get pregnant despite taking oral medicines, a different type of medicine called Gonadotrophins (GnRH) may be recommended.
These are given by injection. There’s a higher risk that they may overstimulate your ovaries and lead to multiple pregnancies.
Assisted-Reproductive Technology /IVF
If you have PCOS and medication does not help you to get pregnant, you may be offered in vitro fertilisation (IVF) treatment.
This involves eggs being collected from the ovaries and fertilised outside the womb. The fertilised egg or eggs are then placed back into the womb.
IVF treatment increased the chance of having twins if you have PCOS.
A diagnosis of PCOS does not necessarily mean you will struggle to get pregnant. For women with
very mild symptoms, infertility is rarely an issue. Those with excess weight and insulin resistance
will benefit from a healthy diet and regular exercise to increase the chances of restoring their
ovarian function. If you are trying to conceive and nothing seems to be working, get in touch with
your GP and PCOS care team, as they can help you find the best treatment approach for your
specific situation, or put you in touch with a fertility expert.