PCOS Fertility and Pregnancy

Polycystic ovary syndrome (PCOS) is a common hormone problem that affects many people with ovaries and can make it difficult to have a baby.

Here at Banner Health, we are here to help you understand PCOS, how it affects fertility and ways you can boost your chances of getting pregnant.

What is PCOS?

PCOS is an endocrine disorder that affects the ovaries (the organs that create and release eggs). It usually happens during the childbearing years, from your teens to early 40s.

PCOS can lead to irregular menstrual periods and make it difficult to get pregnant (infertility). It can also cause excess hair growth on the face and body, along with acne. Over time, PCOS can even lead to chronic health problems like diabetes and heart disease.

Although PCOS can make it hard to have a baby, many people with PCOS can and do manage to get pregnant.

How does PCOS affect fertility?

In some people with PCOS, the ovaries don’t always let an egg go each month, a process called ovulation. Without ovulation, you can’t get pregnant.

PCOS sometimes runs in families. It can also have different symptoms from person to person, including these problems that can affect ovulation:

• Hormone imbalance: PCOS can make the ovaries produce high levels of androgens (male-type hormones), which can stop eggs from forming and getting released.
• Tiny ovarian cysts: Multiple Small, painless, fluid-filled sacs may develop on your ovaries.
• Thick ovary shell: The outside of the ovaries may appear thicker than normal.
• High insulin: You might have trouble with insulin resistance or high blood sugar levels, which means your body can’t use insulin properly and makes too much of it.

These factors can make it tough to get pregnant and lead to other problems. Learn more about what causes PCOS and its signs and diagnosis.

What are the treatment options for PCOS if I want to get pregnant?

Treatment depends on your unique situation. Talk to your health care provider to figure out the best treatment for you.

If you’re trying to have a baby, your treatment will focus on getting your ovulation back on track, weight loss and improving your overall health. Here are some things you can do to help your chances of getting pregnant:

Lifestyle changes

Maintain a healthy weight with a balanced diet and regular exercise, like brisk walking and swimming. Losing 5% to 10% of extra weight may help your fertility. Manage stress through relaxation methods like yoga and meditation.

Tracking ovulation

Keep an eye on your menstrual cycle and try to have sex when you’re ovulating (your ovaries release an egg). Many calendars and fertility apps are designed to help you figure out when this happens every month.

Medications

Your provider might prescribe medicines to help you ovulate, like metformin, clomiphene citrate (Clomid) and letrozole (Femara). Metformin helps manage insulin issues, which may boost ovulation. Clomid and Femara stimulate the ovaries to make more eggs.

Assisted reproductive technology

If other treatments don’t work, your provider might recommend procedures like intrauterine insemination (IUI) and in vitro fertilization (IVF). IUI puts sperm inside the uterus to help with fertilization, while IVF involves fertilization outside of the body.

Surgery

If medication and lifestyle changes don’t help, your provider might suggest laparoscopic ovarian drilling (LOD). LOD is a minor surgery where a surgeon makes small holes in the surface of your ovary using lasers or a fine needle heated with electricity. It can help improve ovulation for about six to eight months but is not permanent.

Emotional support

Fertility challenges can cause emotional stress, including depression and anxiety. Seek support from your partner, family, friends and support groups. Speak with a licensed behavioral health specialist to help with anxiety or depression.

How does PCOS affect pregnancy and the baby?

In addition to making it hard to get pregnant, PCOS can cause problems during pregnancy for both you and your baby:

• Miscarriage or early loss of pregnancy: People with PCOS are more likely to miscarry in the early months of pregnancy than those without PCOS.
• Gestational diabetes: This is a type of diabetes that only pregnant people get. It tends to go away after childbirth. Some people with PCOS may also develop type 2 diabetes after pregnancy.
• Preeclampsia: PCOS can increase the risk of high blood pressure during pregnancy, which can harm you and the baby.
• Cesarean section (C-section): You may be more likely to need a C-section instead of a vaginal birth due to issues like gestational diabetes or larger babies.
• Higher birth weight: Babies born to someone with PCOS may be larger, which can lead to delivery problems.

You can lower your risk for pregnancy complications by maintaining a healthy weight and stable blood sugar levels before pregnancy. Taking folic acid before, during and after pregnancy is also important.

What if nothing works?

If your treatment is not helping, your health care provider may explore other possible causes, like endometriosis, blocked fallopian tubes or sperm issues.

Your provider can do tests to find out what’s going on and suggest treatments or steps to help you have a baby. Many couples facing this challenge find ways to become parents with proper care and support.

Can pregnancy cure PCOS?

No, pregnancy does not cure PCOS. It is a lifelong condition. It’s important to keep managing your condition even after pregnancy.

Some people with PCOS notice fewer symptoms during pregnancy because of hormonal changes. However, these changes may be temporary and may return after giving birth or postpartum.

Schedule an appointment

If you have PCOS and are having trouble getting pregnant, schedule an appointment with one of our Banner Health specialists. We’re here to provide expert guidance and treatment options tailored to your needs.