Polycystic ovarian syndrome (PCOS) is a condition millions of women face, and it’s a common cause of infertility. Sometimes called polycystic ovary syndrome, this endocrine disorder affects hormones in a way that disrupts ovulation or can stop it entirely, making it harder to get pregnant.
Women of childbearing age who have PCOS have small cysts on their ovaries. While these cysts are not cancerous, they can impact the ability to get pregnant. Women who have PCOS also have higher levels of androgen hormones, which can cause excessive hair growth and acne.
PCOS is one of the medical conditions that can cause irregular periods or even an absence of periods. It puts women at higher risk of miscarriage. It can also cause insulin resistance and obesity, which can impact a woman’s ability to get pregnant. Furthermore, it can cause higher levels of the hormone LH, which can make it harder to use at-home ovulation kits reliably.
Fortunately, it is possible to get pregnant, even if you have PCOS. There are many pregnant women with this condition, and treatment is possible as well. You’ll want to explore a few options:
- Get a reliable diagnosis: If you’re having trouble getting pregnant, don’t assume it’s PCOS, even if you have cysts on your ovaries. Get a proper diagnosis by a doctor. You may need to get ultrasounds and blood work to determine your levels of androgens, but it can help rule out other conditions that could be affecting your fertility.
- Make lifestyle adjustments: One of the challenges with PCOS is insulin resistance, which can cause obesity and weight gain. A higher BMI, in turn, can further disrupt the menstrual cycle. Women with PCOS who are significantly overweight sometimes miss their periods and ovulation for months at a time. In some cases, exercising, eating a healthy diet and losing weight can help make ovulation regular enough to allow conception to happen. In addition, a healthy lifestyle is a good first step toward and medical procedure if lifestyle adjustments alone do not help you get pregnant. Even losing 10% of your weight if you’re overweight may help start ovulation again.
- Talk to your physician about Metformin: Metformin is a medication used to treat insulin resistance and diabetes. It’s sometimes given to women who have PCOS and are trying to get pregnant, even if they don’t have insulin resistance. This medication may restart menstrual periods and can help some fertility drugs work better. Some researchers have also found that it can help women who have had multiple miscarriages reduce their risk of miscarriage. Usually, Metformin alone is not enough to tackle infertility caused by PCOS, but it may be successful combined with other options.
- Talk to your doctor about Letrozole: Known most often by its brand name Femara, this is a cancer drug rather than a fertility drug. Some studies have found that it can start ovulation for women with PCOS.
- Consider Clomid: Talk to your doctor about Clomid, which is a fertility drug commonly prescribed to women with PCOS who are facing challenges with fertility. Like all medication, Clomid has side effects and risks, so it’s important to consult with a medical professional.
- Consider injectable fertility drugs: Also known as gonadotropins, these medications are made from hormones FSH, LH or both. They are marketed under many brand names. Injectables can cause an increased risk of ovarian hyperstimulation syndrome (OHSS), which is caused by the ovaries overreacting to treatment. It’s important to stay monitored during your treatment. To reduce risk, your doctor may place you on lower doses of injectables along with some other fertility drugs.
- Think about whether intrauterine insemination (IUI) is right for you: IUI is an option for couples struggling with some types of male factor infertility, irregular ovulation, unexplained infertility, absent ovulation or cervical issues. In IUI treatment, sperm that has been concentrated and washed is placed inside the woman’s uterus. The high concentration of sperm right near the fallopian tubes increases the chances of conception. In IUI, women are also given medication to promote ovulation, which can improve the chance of success.
- Discuss IVF (in vitro fertilization): IVF involves stimulating the ovaries with fertility drugs and then retrieving mature eggs. The eggs are combined with sperm in Petri dishes. Once the eggs are fertilized and given up to five days to grow, one or two of the eggs are transferred to the uterus. After two weeks, a doctor can test for pregnancy to see whether the treatment was successful.
- Consider IVM (in vitro maturation): In cases where a woman or doctors are concerned about ovarian hyperstimulation syndrome (OHSS), IVM is another option. It works much like IVF, except the patient is given either no fertility drugs or very low doses of them. The eggs are retrieved while still immature and allowed to mature in the lab before the rest of the process takes place.
- Talk about surrogacy: In many cases, women with PCOS are able to get pregnant without needing a surrogate. They can carry the baby to term and usually do not need an egg donor. However, if there are other fertility issues or if other treatments have not worked or are not right for you for some reason, surrogacy may be an option. In cases of advanced age or in situations where a potential mother has had surgical treatment for PCOS, ovarian reserves may be lower and surrogacy may be the right option.
If you have PCOS, remember that there are many options to help you become a mother. If you’re considering and weighing all your choices, could you use some professional advice and recommendations? Western Fertility Institute has a team of professionals who can help you through every step of the journey.
If PCOS has affected your fertility, schedule an appointment with a New Patient Liaison at Western Fertility Institute. We can address your questions and give you information about your options to help you make the right choice and move forward.
This content was medically reviewed by the Western Fertility Institute medical team on November 18, 2019.