- Home
- Advice And Support
- Conception
- Fertility & Infertility
- Getting Pregnant With PCOS
Getting Pregnant with PCOS
Discover practical tips and guidance for getting pregnant with PCOS, including lifestyle changes and treatment options to improve fertility.
Polycystic ovary syndrome (PCOS) is a common condition that can impact fertility, but it doesn’t mean pregnancy is out of reach. Many individuals with PCOS have successfully conceived through lifestyle changes, medical interventions, and, if necessary, fertility treatments. This article aims to empower and inform you about navigating your PCOS and conception journey.
What is PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects individuals of reproductive age. It is characterised by an imbalance of reproductive hormones, leading to a range of symptoms and, in some circumstances, challenges with fertility.
PCOS often results in irregular ovulation or the absence of ovulation, which can make it difficult to conceive. Other hallmark features include multiple small cysts on the ovaries and elevated levels of androgens (male hormones) in the body.
PCOS Symptoms
Common PCOS symptoms include:
- Irregular periods: Lengthy or infrequent menstrual cycles can signal inconsistent ovulation.
- Excess hair growth: Increased hair on the face, chest, and back (hirsutism) is linked to elevated androgen levels such as testosterone.
- Acne: Hormonal imbalances and excess testosterone can contribute to persistent acne.
- Weight gain: Many with PCOS struggle with weight management.
- Thinning hair: Hair thinning or hair loss on the scalp can occur and is related to increased levels of testosterone.
- Insulin resistance: The cells in the body are resistant to the effect of normal insulin levels and to compensate, more insulin is produced to keep the blood sugar normal. This raised level of insulin creates a hormonal imbalance and is thought to be one of the reasons why PCOS develops.
- Mood changes: PCOS may also have an impact on your emotional and mental health including low self-esteem and depression
- Sleep disturbances & fatigue: Symptoms of fatigue include feeling tired in the day, struggling to concentrate, mood swings and headaches. Fatigue can also be due to sleep disturbance such as Obstructive Sleep Apnoea (OSA).
- Acanthosis nigricans: Dry, dark patches of skin that usually appear on the neck, groin or under your arm
PCOS Causes
The exact cause of PCOS is unknown, but several factors are believed to contribute, including:
- Genetic predisposition: It is now thought that having polycystic ovaries may run in families and there is evidence of a genetic cause
- Hormonal imbalances: Elevated androgens can interfere with ovulation.
- Insulin resistance: This condition increases insulin levels, which can exacerbate hormonal imbalances.
Getting a PCOS Diagnosis
Unfortunately, it can take several years, and many trips to see your doctor, to be diagnosed with PCOS. This is in part because PCOS is a complex condition with varying symptoms and degrees of severity, making it challenging to diagnose. However there also exists a lack of medical knowledge about PCOS and sadly, medical gaslighting. The key here is to learn as much as you can, which will help you to effectively advocate for yourself to get the help and support you need.
In 2018 the International Evidence-based Guideline for the Assessment and Management of PCOS was published and later updated in 2023. These guidelines endorse the Rotterdam PCOS Diagnostic Criteria that state that the syndrome is defined by the presence of at least two out of the following three characteristics:
- Signs or symptoms of high androgens (unwanted facial or bodily hair, loss of hair from the head, acne or an elevated blood level of testosterone) after other causes for this have been excluded.
- Irregular or absent menstrual periods after other causes for this have been excluded.
- Polycystic ovaries detected on ultrasound scan or a blood test showing elevated anti-mullerian hormone (AMH) levels
Can You Get Pregnant with PCOS?
While PCOS can affect fertility, many people with PCOS conceive successfully. The key lies in understanding your menstrual cycle and when you are fertile and adopting the right strategies. It can be difficult to know when you’re ovulating, especially if you have irregular or lengthy cycles
Some individuals may need assistance, such as medications to induce ovulation or, in some circumstances, fertility treatments, while others may conceive naturally by addressing underlying factors.
Trying to get pregnant with PCOS often starts with tracking ovulation to optimise your chances of conceiving and getting advice and support from your doctor.
Tips for Conceiving with PCOS
Maintain a healthy weight
Achieving and maintaining a healthy weight can improve ovulatory function and enhance insulin sensitivity, which are both crucial for fertility. Even a modest weight loss of 5-10% can make a significant difference. The emphasis here should be on a healthy lifestyle generally rather than focusing on restricting diets which are often not sustainable. You may like to seek the help and support from a qualified dietician, if weight management is an area you are struggling with.
Exercise
Incorporating regular exercise into your routine can help manage insulin resistance and regulate hormones. A combination of aerobic exercise and strength training is especially beneficial for overall health and fertility.
Monitoring your cycle
You may want to find out more about your menstrual cycle to feel empowered and take back control of your PCOS. You can do this by tracking your cycles to find out what is normal for you and when you are ovulating. There are various ways you can track your cycles, from using simple apps to taking your basal body temperature and monitoring your cervical secretions to using a fertility monitor. It’s important to be aware that ovulation predictor kits (OPK’s) may not work for women with PCOS.
Follow a balanced diet
A balanced diet focused on whole foods, lean proteins, a good variety of vegetables and low glycaemic index fruits, and healthy fats, can help regulate hormones and support reproductive health. The Mediterranean diet is a good example of this and supports PCOS, fertility and your general health.
Try to avoid restricting specific food groups. There is no evidence to support cutting out dairy or gluten unless you have an intolerance to these food groups.
Find emotional support
Finding the right emotional support for you can make a difference to your PCOS journey. This might come from a friend, a healthcare professional or a support group. Verity is the UK PCOS support charity providing online and in-person support groups and a wealth of information and relevant resources. AskPCOS is an app designed to support women in managing their PCOS.
Treatment for PCOS
For those who need additional support, several treatment options are available, including:
- Medications: Letrozole or Clomiphene Citrate to stimulate ovulation. A drug called Metformin may be offered to you if you have insulin resistance.
- Assisted Reproductive Technologies (ART): Procedures like in-vitro fertilization (IVF) can help achieve pregnancy.
- Other treatments and medications: If you suffer with excess bodily hair, acne or sleep apnoea seek advice from your doctor for how these symptoms could be managed to help you.
Consult a healthcare provider to explore options tailored to your specific needs.
