One of the most common hormone disorders and causes of female infertility among women is polycystic ovarian syndrome, or PCOS. Although PCOS can make conception seem more difficult, and there is no cure, there are ways to treat it. It is possible that a woman can have healthy ovulation, conception and a full term healthy pregnancy with PCOS.

PCOS affects close to as many as 5 million American women or up to 10% of women in their reproductive ages. When treating women for healthy conception, it comes with the risk of specific pregnancy complications. Have no fear though! It’s absolutely common that women with PCOS deliver healthy babies daily. 

If you’re looking to get pregnant or help increase the chances of getting pregnant with PCOS – here’s what you need to know.

How Does PCOS Work?

To keep it simple, PCOS affects the ovulation process in women in child-bearing age. Ovulation is where an egg is released into the ovaries from the follicles where it matured.

When it comes to women with PCOS, they produce higher levels of testosterone which affects the entire ovulation process and causes irregular menstrual cycles or no cycle at all. 

More so, the hormonal imbalance interferes with the ability of the follicles to release eggs. Without the release of the eggs, they wind up staying in the ovaries and becoming a cyst. This is where the name poly – many – ovary syndrome comes from. 

Causes

It’s entirely unknown what causes PCOS in the first place. However, there are some factors that are believed to be linked to PCOS:

Obesity or Being Overweight: women with PCOS are at a higher risk for becoming overweight, while overweight women are at a higher risk for PCOS. It’s not been totally proven either is caused by the other but it’s a good idea to choose a healthy lifestyle for increased chances of conception.

Excess Insulin: women with PCOS may be dealing with higher insulin levels. This is because the hormone imbalance causes their bodies to have a hard time using the insulin properly. Which contributes to weight gain.

More Androgens: women who produce higher testosterone because of PCOS also tend to have higher levels of androgen hormones altogether. These are considered the “male hormones” that control things like baldness. Naturally, women already produce these, just at much lower levels.

Genetics: PCOS seems to run in a family’s genetic history. If one of your family members/relative has PCOS, your chances are much higher too.

Symptoms

It’s common to see PCOS develop after puberty but it can also appear in the later years. You might have PCOS if you are dealing with some of its common symptoms:

• Excessive hair growth on the face and other parts of the body
• Irregular menstrual cycle (but you can still have PCOS if you have a regular period)
• Acne
• Prolonged vaginal bleeding (occasionally)
• Thinning hair 
• Insulin resistance or pre-diabetes
• Weight gain

These are common symptoms but not 100% proof that you have PCOS. Some women may deal with some of these symptoms but don’t have PCOS. If you’ve been dealing with any of these symptoms or suddenly develop any of the above symptoms, contact your doctor. 

Your healthcare provider will consider your past, family history, and consider if you need additional examination. They will also conduct blood tests, ultrasound, pelvic exam, and check for ovarian cysts.

Treatment Options

We know there is no cure for PCOS and it doesn’t necessarily go away on its own. One of the better ways to treat it is with a healthy lifestyle. This can help you manage a majority of your symptoms. Overall it makes it all easier to deal with. Talk to your doctor about the best treatment for your needs. 

If you’re looking to lose weight, weight loss has been known to help treat PCOS! This helps normalize hormone levels and improve insulin with a diet that’s high in complex carbs and low in refined carbs and sugar. It’s been proven that losing 5 to 10% of your body weight has been able to improve insulin levels. With normal insulin levels, you can help to regulate your period. 

If you’re not looking to get pregnant, birth control containing progestin may help to reduce higher levels of male hormones and also help to regulate your period.

Getting Pregnant With PCOS

It may sound impossible with an irregular period but getting pregnant with PCOS is entirely possible! Either with lifestyle changes or with the help of medications to help induce ovulation; or both.

Because high levels of androgen interfere with ovulation and the development/regular release of your eggs, this also impacts fertilization. Meaning, if an egg isn’t healthy or being released regularly, it cannot be fertilized. This hinders pregnancy. 

If you find you are missing your period or having irregular periods, this could be the first sign of PCOS.

Regulating Your Menstrual Cycle

Although there is no cure for PCOS there are methods of treatment that can help feel more like a cure. So women of all ages with PCOS can have healthy pregnancies. 

One of the first options your healthcare provider may suggest is birth control pills. These contain artificial versions of the hormones progestin and estrogen. These added hormones can help regulate your menstrual cycle and reduce high levels of androgen production.

Some birth control pills are progestin-only pills. For women who cannot tolerate the combination of both estrogen and progestin in their birth control pills. 

The pill is taken for up to 2 months – designed to help regulate an irregular cycle. 

Are There Risks When Getting Pregnant With PCOS?

Getting pregnant with PCOS does come with a few risks of complications including:

Gestational Diabetes: this disorder only appears during pregnancy. When hormones are released from the placenta, it blocks the body’s production of insulin. This results in high blood sugar levels. This is treatable and will normally go away after delivery. 

Miscarriage: women with PCOS are more likely to have a miscarriage in the early months. However, there are studies that suggest some medications may help reduce this risk.

Preterm Birth: moms with PCOS more commonly deliver babies preterm and spend time in neonatal intensive care. 

Preeclampsia: this happens after week 20 of pregnancy, there is a sudden onset of hypertension. This also results in the swelling of the hands and face. If it’s caught early, treatment is usually successful.

Mood Disorders: PCOS has been proven to contribute to anxiety and depression. As well as higher levels of androgen hormones and binge eating.

C-Section: because of regular complications c-sections are more likely in pregnant mothers with PCOS

Increasing Your Chances Of Getting Pregnant With PCOS

There are ways to increase your chances of pregnancy. Whether through natural lifestyle changes, mediation or surgery.

Birth control pills are a common treatment method for PCOS but if you’re looking to get pregnant, that would not be the best option. Might leave you thinking, if birth control is designed to help ovulation, how do you get pregnant without it? Well, we all know birth control pills are just that… birth control! 

If you need help ovulating to be able to become pregnant, there are certain medicines that could help:

Clomiphene – Clomid, Serophene: this is an anti-estrogen drug taken at the beginning of your cycle. It helps to stimulate ovulation and is standard in infertility treatment. Sometimes used with a drug called Metformin

Metformin: A medication that is used for type 2 diabetes. This drug helps regulate the amount of insulin in your blood. Although it’s not FDA approved, studies have shown that it may help with fertility. If both Clomid and metformin don’t work, you may be prescribed a medication containing FSH, or follicle-stimulating hormone, and a luteinizing hormone as a shot. 

Hormone Shot: injectable infertility drugs are the next step

Letrozole – Femara: this helps induce ovulation. This medication has a very high success rate in women with PCOS. Sometimes used with metformin to help get results.

IVF – In Vitro Fertilization:  if none of the above work, IVF can help!

Ovarian Drilling: a minimally invasive surgery. Ovarian drilling is a thin needle a doctor puts through the abdomen and treats small areas of the ovaries. This helps to lower the levels of male hormones they produce. This is supposed to help with ovulation. Although it has been known to be inconsistent. 

Non-medical Options:

Vitamin D: optimal levels of vitamin D could help women with PCOS get pregnant. Studies have found that women with PCOS who were deficient in vitamin D were 40% more likely to have trouble getting pregnant. Good levels of Vitamin D helped them give birth to healthy babies compared to those who were not vitamin deficient.

Cinnamon: taking 1.5 grams of cinnamon daily has been proven to help regulate higher insulin levels. This is a natural and safe way to possibly boost your odds of getting pregnant. Plus, it doesn’t hurt to try!

Lifestyle Changes:

For some women, weight gain is inevitable in conjunction with PCOS. Gaining weight and losing weight both have an effect on your hormones. Finding a healthy balanced weight can help get your hormones back to normal. As simple as losing 10% of your body fat has shown that it can help with regulating your hormones and menstrual cycle. At least make it more predictable. Which increases your chances of getting pregnant. 

A healthy lifestyle in general: regular exercise, lowering stress, avoiding cigarettes, and a better diet can help improve fertility odds. 

Working closely with your doctor can help get everything under control!

With the right treatment options for you, the impact of fertility on pregnancy can be low. These options make conception and healthy pregnancy possible!

A specialist called a fertility specialist will help make sure you get the help you need, get the right dose of medicines, and make sure to schedule regular check-ups and ultrasounds to check on your progress. 

Trying To Get Pregnant With PCOS? Call Rosh Maternal & Fetal Medicine

If you have PCOS or think you may have PCOS, work with one of the best doctors at Rosh Maternal & Fetal Medicine in NYC. 

Many women have no idea they may be dealing with PCOS. 70% of women have no idea how they’re being affected or the details of their condition. If you are having irregular periods, trouble conceiving, or anything else that might be an underlying sign of PCOS. Talk to our team by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today. Come visit your NYC Maternal and Fetal Medicine Specialists for the safest possible care for you.