If you have PCOS and you’re thinking about having a baby, the first thing to know is that lots of women with PCOS do get pregnant naturally or with treatments available. The main reason PCOS can sometimes make it more difficult to get pregnant is because it affects how your ovaries work and can cause irregular ovulation.
You’re not alone on your PCOS and pregnancy journey. PCOS is a common condition thought to affect up to 15 out of every 100 women. And we’ve got the best science-backed information to help you work out what’s the next best step for you.
So let’s take a look at some of the questions you may have about(PCOS) and pregnancy, how polycystic ovaries affect your chances of pregnancy, and your options for treatment to help you get pregnant, if you need it.
How does PCOS affect your fertility?
While it can be difficult for some women to become pregnant with PCOS, plenty of people do – it may just take longer to conceive naturally. x
Even so, PCOS is one of thewho do struggle to get pregnant. This is because women with PCOS have higher levels of hormones called androgens, which are produced by the ovaries. This can disrupt the balance of hormones in your body, affecting and causing the other symptoms associated with PCOS - such as , , insulin resistance and . Your menstrual cycle is disrupted if eggs aren’t released regularly, and that can mean fewer (or even no periods at all).
That said, studies show that 1 in 4 women with PCOS still have regular periods and ovulate as usual. But even if this isn’t the case for you, it’s still possible to get pregnant either naturally or with medical assistance.
How to get pregnant with PCOS
There’s no one-size-fits-all way of boosting your chances of getting pregnant with PCOS because everyone’s experiences and symptoms are unique. Even so, there’s a lot you can do to help yourself.
Lifestyle changes to help PCOS fertility
Making some changes to your lifestyle may improve your fertility and reduce the chances of long-term health problems, like.
Manage being overweight to help ovulation
Carrying extra weight or beingcan worsen the hormone imbalance in your body and make it more difficult to ovulate.
stick to. In particular, some women with PCOS are (or are at risk of becoming) ‘insulin-resistant’. This means their bodies don’t respond so well to insulin, a hormone that helps the body control how it uses sugar. This ‘insulin resistance’ triggers your body to produce higher levels of insulin to control your blood sugar levels. Maintaining a healthy weight can help to manage your insulin levels. Choose low GI ( ) scoring foods that can help to slowly increase your blood sugar levels and stabilise your insulin levels
try to. This, combined with regular activity, can not only help you to lose weight, but it can also improve ovulation, lead to more regular periods and help your chances of getting pregnant
get support if you need it. Losing weight can be hard – read more about. If you’re struggling, speak to your doctor for extra advice and support to help you get into some healthier lifestyle habits
Quit smoking for hormonal balance
Smoking and passive smoking affect the hormone levels in your body – for example, smoking may increase testosterone and reduce oestrogen. This can lead to weight gain and affect your fertility levels. Smoking can also affect insulin resistance. Quitting can therefore help manage your weight, your insulin levels and improve some of your PCOS symptoms. All this can help your chances of conceiving. Quitting can also reduce the risks of complications like stillbirths and premature delivery after you get pregnant. Find out more about.
What are the chances of getting pregnant with PCOS?
It’s difficult to give a clear figure for the success rate of getting pregnant with PCOS given that treatment options and individual circumstances vary so much.
However, what we do know is that a majority of people with PCOS are able to conceive with the help of fertility treatment. This is especially true for people under 35.
Treatment outcomes are generally pretty positive:
- 3 out of 4 women with PCOS who take clomifene citrate find they are able to ovulate. Of those, around half are able to get pregnant within 6 months of treatment
- If clomifene citrate does not work, your doctor may recommend daily hormone injections or keyhole ( ) surgery. These are thought to prompt ovulation in around 4 out of every 5 women
Read on to find out more about these and other treatment options.
Medical treatments to improve PCOS fertility
If you’ve made changes to your lifestyle, but you’re still struggling to get pregnant, don’t give up – there are treatment options available. Usually, these are recommended by fertility specialists and need regular monitoring both during treatment and pregnancy. It’s important to be aware that some of these options increase the possibility of twins or triplets.
You may be offered:
- clomifene citrate – a medication that’s been used for many years to help stimulate the ovaries to release eggs
- letrozole – a newer treatment that has shown encouraging results in stimulating ovulation and healthy pregnancies.
- metformin – a medication normally used by people with . It can also help balance insulin and blood sugar levels if you have PCOS. There is evidence it can help with ovulation. Metformin would usually be prescribed alongside another medicine such as clomifene
- gonadotrophins – these are hormone-based medicines used to stimulate your ovaries. They are usually given by injection
- keyhole ( ) surgery – this can be used to help restore ovulation. This is usually done by destroying the tissues around your ovaries that are producing too many androgens and causing the hormone imbalance
- – when eggs are removed and fertilised outside the body before being placed into the womb
When to speak to your doctor when trying to get pregnant with PCOS
If you’re experiencing irregular periods or any other possibleit’s a good idea to talk to your doctor – particularly after 12 months of trying (or 6 months if you’re 35 or over).
Your doctor will look at all possible causes of your symptoms and discuss how you can increase your chances of getting pregnant, including self-care and treatment options.
If trying for a baby is affecting your mood or making you feel anxious, it’s also worth speaking to a doctor.
Are there any risks once I’m pregnant?
Most pregnancies in women with PCOS will be straightforward with no complications. However, having PCOS and being obese may increase your risk of certain.
These can include:
- - while miscarriage is common and might happen to any pregnancy, having PCOS can increase your risk by about 3 times. Your doctor may prescribe metformin to help manage this risk
- pregnancy-induced and – having PCOS increases your risk of these by about 3-4 times
- - PCOS can triple your risk of developing this type of diabetes, which only pregnant women get
- – a higher risk of complications such as pre-eclampsia can make it more likely you’ll need to have a C-section
Finding extra support
There is now more support than ever for people with PCOS and fertility problems. Ask your doctor for local contacts or try reaching out to:
- – a UK-based PCOS charity and support group
- – a US advocacy and support group
- – free and impartial advice about fertility
- – advice and support on all sorts of issues relating to pregnancy and childbirth