While probability of childbirth is similar between groups, women with PCOS need longer time to get pregnant. Earlier diagnosis and intervention can shorten the time to get pregnant with PCOS and improve the chances for live birth. You need to educate yourself and seek care from fertility specialists. It is also important that you start as early as possible. Let’s take a deeper look at PCOS.
What is PCOS?
PCOS, as the name implies, is a syndrome, a collection of symptoms. These symptoms vary between individuals. Your reproductive endocrinologist specialist (REI) will conduct a thorough health history review and order hormone analysis that can help with a diagnosis.
The three features of PCOS are:
- High levels of “male” sex hormones, such as testosterone
- A large number of immature ovarian follicles (fluid-filled sacs that develop and release eggs)
- Irregular menstrual cycles (typically less than 10 per year)
If you have two out of three, yes you do have PCOS. Later we will explain how to find out.
How many people suffer from PCOS?
Millions. 1 in 10 women. Moreover, 70% of people with PCOS are either misdiagnosed or undiagnosed. So you may suspect you have PCOS, but still not know for sure. Get checked.
What causes PCOS?
Although we do not currently know the exact underlying cause of PCOS, we think it is due to abnormal hormone secretion in the brain along with abnormal insulin sensitivity in the muscles, and here is how it works:
1. Your cells are not responding normally to insulin which leads to its high levels of insulin. It’s called insulin resistance. Insulin controls how food is changed into energy. As a result of resistance, your insulin blood levels become higher.
2. Insulin resistance can also lead to high levels of androgens (male hormones) can prevent the ovaries from releasing an egg during each menstrual cycle, also causing extra hair growth and acne.
Why is it harder to get pregnant with PCOS?
Because PCOS makes women ovulate irregularly or not at all. Ovulation is a key requirement for getting pregnant.
- If an egg is not released, there is nothing for the sperm to fertilize and create an embryo.
- If the ovulatory process is irregular, it is difficult to identify a fertile window.
How do I know I have PCOS?
Help us to help you:
- Track your menstrual cycles. How frequently they occur and how long they last ( and how painful or heavy they are). Report if your cycles are greater than 45 days apart or less than 10 per year
- Complete the work up recommended by your REI: get bloodwork done or order home test kits to check certain hormone levels
- Confirm polycystic ovaries using an ultrasound
Remember! PCOS is a spectrum and will have variable presentation and symptoms. The diagnosis is made when two of the three criteria are present.
Can I get pregnant with PCOS naturally?
Is it likely to pregnant with PCOS? Yes, but it takes 2.5 years longer to get pregnant with PCOS. Combined with effects of age on fertility, it can be a risky situation. You can work on eating healthier, losing weight, or quitting smoking. However, lifestyle interventions alone do not work for the majority of women, and they will need additional interventions to establish regular ovulation.
Is it possible to get pregnant with PCOS quickly?
Is it hard to conceive with PCOS? Yes. However, getting pregnant in general is not a quick process. While a completely healthy young couple has a 25% chance of getting pregnant during a single cycle, chances of “absolutely healthy” individuals reduce with aging. PCOS makes it even more complicated. A few of our patients have conceived on their first cycle using standard medicated treatment. Although this is a rare case, Charity W from Oklahoma decided to share her experience with you:
Can I get pregnant with PCOS and no periods?
Is it impossible to conceive with PCOS without having periods? No. As you’ve seen in the testimonial above, Charity didn’t have periods at all and she got pregnant during her first cycle of treatment. Although medical miracles are rare, women with PCOS have one of the best prognosis when undergoing fertility treatment and most of them will eventually become pregnant. Even if they didn’t have periods before the treatment.
How to get pregnant with PCOS?
The good news is that with treatment, most patients would get pregnant. If the initial lifestyle changes like losing weight are not successful in initiating regular menses or you are not able to delay treatment, we recommend you start acting immediately, especially if you are over 35 years old, as the chances of pregnancy begin to decline. Also, there are some medical disorders that can mimic PCOS, so we strongly recommend you visit a Reproductive Endocrinologist with experience in evaluating and managing women with PCOS. Please, do not wait and do not lose your precious time.
There are two types of medicines used in fertility treatments for patients with PCOS:
Clomiphene or Letrozole
are usually the first medication type recommended for women with PCOS who are trying to get pregnant. Both medicines induce ovulation by encouraging recruitment, growth, and the monthly release of an egg from the ovaries (ovulation).
Makes the body more sensitive to ovulation inducing medications if Clomiphene or Letrozole are unsuccessful in encouraging ovulation.
We can also recommend as appropriate supplements from Theralogix™ that have been proven to help with fertility. They include CoQ10, Inositol, and prenatal vitamins. There are also supplements available for men to improve sperm quality.
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.
Are there any real success stories of getting pregnant with PCOS?
There are millions of stories like this, including our own patients. The following one is also real and very complicated at the same time. Keep in mind that you should not take it as treatment advice. Every case can be individualized.
Tiffany came to Fertility Cloud after three cycles of Clomid and two cycles of Letrozole ovulation induction. She was a twenty-eight-year-old woman who had not been pregnant previously, diagnosed with PCOS at age twenty-one and has been on birth control until she started trying to get pregnant.
Testing confirmed the diagnosis of PCOS. Unfortunately, she did not ovulate on clomiphene and her initial trial of letrozole. Our approach was to make her ovaries more sensitive to ovulation induction. We started her on metformin and a small dose of dexamethasone. Then we increased her dose of letrozole. She ovulated in the first month and became pregnant after three cycles.
So, what does it mean for me?
Although while it is hard to get pregnant with PCOS, the good news is that women with PCOS typically have some of the best prognosis when undergoing fertility treatment. Most of them will eventually become pregnant. Treatment has improved significantly and has become more effective as well. The general rule in fertility treatments is the sooner you begin, the more likely you are to succeed. And it’s smart to choose an experienced doctor with an understanding of PCOS. Don’t delay! A consultation with a qualified REI can clear up any confusion or concerns you may have about getting pregnant with PCOS.