If you have or are experiencing symptoms of polycystic ovary syndrome (PCOS), you may have concerns about getting or becoming pregnant.
Besides its various health challenges, PCOS can also significantly impact your fertility. The condition can make it more challenging to conceive (get pregnant).
According to the Centers for Disease Control and Prevention (CDC), up to 12% of people in their childbearing years have PCOS. But, less than half of people with PCOS are actually diagnosed correctly. This means that millions may be unaware.
Although it can make it more difficult to get pregnant, there are ways you can boost your fertility.
Here we explore the effects of PCOS on your period and fertility, emphasize the importance of a proper diagnosis and discuss helpful approaches to enhance your ability to get pregnant.
How does PCOS affect fertility?
PCOS is characterized by hormonal imbalances, irregular menstrual cycles (periods) and the presence of cysts on the ovaries.
“This can result in inconsistent or absent ovulation, known as anovulation, which is also the cause of the abnormal menstrual pattern,” said Victoria Fewell, MD, an OBGYN with Banner – University Medicine.
During a typical menstrual cycle, an egg is released from the ovaries and can be fertilized by sperm, resulting in pregnancy.
However, in PCOS, the hormonal imbalance, specifically elevated levels of androgens (male hormones) and insulin, disrupts this process. The ovaries may not release an egg regularly, or the eggs may not mature fully, leading to difficulties in conceiving.
Why is a proper diagnosis important?
Whether or not you desire to get pregnant, if you suspect you have PCOS, it is essential to consult with your health care provider.
Your provider will evaluate your medical history, conduct a physical examination and order tests such as hormone level assessments and ultrasound scans to confirm the presence of PCOS.
A proper diagnosis is crucial to determine the most appropriate course of action, whether that is regulating your period or increasing the likelihood of achieving a successful pregnancy.
“If you don’t want to get pregnant, the goal of therapy is make your periods more regular,” Dr. Fewell said. “If you want to get pregnant, lifestyle modifications and/or medication treatment should be implemented.”
Ways to improve your fertility
While PCOS can present challenges in getting pregnant, there are various treatment options available to improve your chances of getting pregnant. Here are some strategies to consider.
Adopting a healthy lifestyle can have a positive impact on fertility and your overall health.
“It will significantly decrease pregnancy risks associated with PCOS, including miscarriage and diabetes, and will decrease the long-term risk of type 2 diabetes, high blood pressure and heart disease,” Dr. Fewell said.
- Focus on maintaining a balanced diet rich in whole grains, fruits, vegetables, lean proteins and healthy fats.
- Regular exercise, such as brisk walking and swimming, can help manage weight, reduce insulin resistance and regulate hormone levels. Aim for 30 minutes of moderate exercise three to five times a week.
- Manage stress levels through relaxation techniques like yoga or meditation which can aid in fertility.
Maintaining a healthy weight is vital for managing PCOS-related fertility issues.
“Even losing 5% to 10% of your body weight has been shown to help in restoring a normal ovulation cycle and improve the chances of pregnancy,” Dr. Fewell said. “Weight loss can also help with treating hirsutism, or excess hair growth.”
Talk to a registered dietitian or your health care provider for personalized guidance on a balanced and sustainable weight loss plan.
Depending on your specific situation, your provider may recommend medications to regulate your menstrual cycle and stimulate ovulation. Commonly prescribed medications include:
- Metformin. Primarily used to manage insulin resistance in women with PCOS, Metformin can help restore regular menstrual cycles and improve ovulation.
“Metformin may increase the success of lifestyle modifications and weight management,” Dr. Fewell said. “There are new medications available that may be used in the future for PCOS, but they haven’t been studied yet, and safety data in pregnancy isn’t available yet.”
- Letrozole or clomiphene citrate (Clomid). If pregnancy isn’t achieved after these changes, your provider may recommend an oral medication to help stimulate ovulation. Clomid is often the first-line treatment for PCOS-related infertility.
“Before using medications to stimulate ovulation, it is important to consider the associated risks, such as multifetal gestation (twins and triplets) and hyperstimulation syndrome, which can cause large, painful ovarian cysts,” Dr. Fewell said. “People with PCOS are particularly susceptible to each of these risks.”
Assisted reproductive techniques
In cases where lifestyle changes and medications aren’t effective, your provider may refer you to a specialist for a consultation regarding assisted reproductive techniques like intrauterine insemination (IUI) or in vitro fertilization (IVF).
IUI and IVF can assist in fertilization and increase the chances of a successful pregnancy.
The journey of trying to get pregnant with PCOS can be emotionally challenging. Seek support from your partner, friends and family to help you cope with the stress and emotional challenges.
Consider support groups, counseling or therapy to address any anxiety or depression that may arise during the process. This can help you gain valuable insights from others who have gone through similar experiences.
While PCOS can present fertility challenges, it’s essential to remember that there are many ways to improve your chances of getting pregnant.
If you suspect you have PCOS, contact your health care provider right away. A proper diagnosis, coupled with lifestyle modifications, weight management and appropriate medical interventions, can significantly enhance your chances of conceiving.
With the right support and strategies, many people with PCOS conceive and fulfill their dreams of starting a family.
To find a Banner Health specialist near you, visit bannerhealth.com.