Polycystic ovary syndrome, also known as PCOS, is one of the most common causes of female infertility. Because it affects as many as 5 million American women, or about 6 to 12 percent of those of childbearing age, there’s a good chance that someone you know has it.[1]
While this condition can make conceiving more challenging — and it raises the risk of certain pregnancy complications once you do conceive — women with PCOS deliver healthy babies every day.
Here’s what you need to know to boost your odds of getting pregnant and having a healthy pregnancy with PCOS.
What is polycystic ovary syndrome (PCOS)?
PCOS is a hormonal condition that results in problems ovulating. Ovulation is a process in which a mature egg is released from the tiny, fluid-filled sacs (follicles) in the ovaries each month.
Women with PCOS sometimes produce higher-than-normal levels of the male hormone testosterone, which can hinder ovulation and is associated with irregular or absent periods.[2]
What causes PCOS?
Doctor's aren't sure what causes PCOS, but there are some factors that have been linked to the condition, including:[3]
- Genetics. PCOS appears to run in families, so if your mom or a close female relative has PCOS, your chances of also having it are higher.
- More androgens. Women with polycystic ovary syndrome often have higher levels of androgen hormones, which can interfere with ovulation. Androgens are sometimes called "male hormones" because they control traits such as male-pattern baldness, but women naturally produce androgens too.
- Excess insulin. Researchers have found that women with PCOS often have high levels of insulin (the hormone that regulates how your body breaks down sugar) because their bodies have a hard time using it properly. Insulin also controls ovarian function, and too much insulin in the body can cause irregular or absent ovulation.
- Being overweight or obese. While overweight women are at greater risk for PCOS and women with PCOS are at greater risk of becoming overweight, the jury is out on whether excess weight causes PCOS or vice versa. Even so, if you're trying to conceive, it’s a good idea to start eating a diet with plenty of whole grains and complex carbohydrates over simple carbs and processed foods, as well as exercising if you aren't already.
What are the symptoms of PCOS?
PCOS often develops after puberty, but sometimes it can appear later. The most common symptoms of PCOS include:[4]
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- Irregular menstrual cycle (though you can still have PCOS if you have a regular period)
- Acne
- Excessive hair growth on the face or other parts of the body
- Thinning hair on the scalp
- Weight gain
- Prolonged vaginal bleeding (occasionally)
- Insulin resistance or prediabetes (impaired glucose tolerance), which develops in more than 1 in 2 women with PCOS before the age of 40
Because many women who don’t have PCOS may also have these symptoms, you’ll want consult your doctor if you have irregular periods or suddenly develop any of the symptoms above.
Your practitioner will consider whether you’ve had them in the past and look carefully at your family history. They may also examine areas of increased hair growth, conduct blood tests and perform a pelvic exam or ultrasound to check for ovarian cysts (though it’s totally possible to have PCOS but no cysts).
What are your treatment options for PCOS?
While PCOS can’t be cured (nor does it go away on its own or with age), a healthy lifestyle can help manage your symptoms. Your practitioner can help determine the best treatment for you based on your medical history.
A well-balanced diet that’s rich in complex carbs and low in refined carbs and sugar may help restore ovulation and regular periods in women with PCOS.
Losing weight can also help treat PCOS. Studies suggest that losing 5 to 10 percent of your weight can improve insulin levels, normalize your hormone levels and regulate your menstrual cycle.[5] Get a personalized weight-loss recommendation from your practitioner.
Can you get pregnant with PCOS?
Yes, it's possible for women with PCOS to get pregnant on their own or with the help of medications that can help cause ovulation or with IVF.
What are the possible risks of PCOS to the mother and baby?
Both women who have PCOS and their babies are more likely to have certain complications, including:
Miscarriage
Women who have PCOS are more likely to have a miscarriage during the early months of their pregnancy than women who don't have the condition, but some research indicates that taking the medication metformin may reduce this risk.
Gestational diabetes
Gestational diabetes, which only appears during pregnancy, is a condition in which the hormones from the placenta block the body's production of the hormone insulin, resulting in high blood sugar levels. Gestational diabetes is often treatable, and will usually go away after delivery (although some women will later develop type 2 diabetes).
Preeclampsia
Preeclampsia is the sudden onset of high blood pressure and swelling of the hands and face. It usually develops after week 20 of pregnancy, and when caught early, it is usually straightforward to manage, though it may lead to earlier delivery.
Mood disorders
Having PCOS is also linked to conditions such as depression and anxiety, possibly due to the higher levels of androgen hormones, as well as binge eating.
Can PCOS complicate your delivery?
Because women who have PCOS are more likely to have complications like high blood pressure, they're also slightly more likely to require a C-section.
How to increase your chances of getting pregnant with PCOS
If you have PCOS, you can boost your chances of getting pregnant with medication. Some treatment options include:
- Metformin. Although this type 2 diabetes medication, which helps regulate the amount of insulin in your blood, isn’t approved by the Food & Drug Administration (FDA) for treating PCOS, research suggests that it and other diabetes medications may help with fertility, so ask your doctor if it’s right for you.[6]
- Clomiphene citrate (Clomid). This drug stimulates ovulation and has been a standard infertility treatment for years, including in women with PCOS. Clomid might sometimes be used in conjunction with metformin to help women with PCOS conceive.
- Letrozole (Femara). This ovulation inducer is being used more and more often to treat ovulation issues, and can work very well for women with PCOS. Femara can also be used with metformin to help boost the odds for conception success.
- In vitro fertilization (IVF). If none of the above treatments work, IVF can help make pregnancy a reality for women with PCOS.
While PCOS can have an impact on your fertility and your pregnancy, with the right care and treatment, conception and a healthy pregnancy are completely possible — and even probable!
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