Can You Get Pregnant with PCOS?

Dealing with polycystic ovary syndrome (PCOS) can make you feel alone, but it's more common than you might realize. According to the World Health Organization (WHO), PCOS affects 8 to 13% of reproductive-aged women globally, with up to 70% of cases going undiagnosed. Symptoms of PCOS include irregular menstrual cycles, weight gain, and difficulty losing weight. It's also a significant cause of fertility issues in women.

However, if you have been diagnosed with PCOS, don't lose hope of conceiving. There are effective medications and lifestyle changes that can improve your fertility, and fertility treatments with high success rates. So, can you get pregnant with PCOS? Andrea Sleeth, WHNP-BC, a board-certified women's health care nurse practitioner and medical advisor at Wisp, says yes, and here's how.

What is PCOS?

PCOS, or Polycystic Ovary Syndrome, is a condition where your ovaries create excess androgen hormones like testosterone. Androgen hormones are usually only found in large amounts in men, so this disrupts the balance of a woman's reproductive hormones, the menstrual cycle and ovulation.

As ovulation isn't regular, eggs stay in the ovaries, and fluid-filled sacks can form around them, causing the ovaries to become enlarged. These sacks are called "polycystic," although they are technically not cysts.

The most common symptoms of PCOS include:

• Irregular periods
• Increased facial and body hair
• Infertility or difficulty getting pregnant
• Obesity
• Hair loss on the head
• Acne

People with PCOS often exhibit higher insulin resistance, which raises their risk of developing type 2 diabetes. Thankfully, the CDC emphasizes that PCOS is manageable through lifestyle modifications and medications.

Although the exact cause of PCOS is not known, Sleeth mentions that some individuals are more prone to developing this syndrome, including women with mothers who had PCOS or type 2 diabetes and certain ethnic groups like South Asian, Black, and Hispanic women.

Can you get pregnant with PCOS?

PCOS and fertility are closely linked. PCOS can significantly impact fertility by disrupting the menstrual cycle and ovulation. Despite these challenges, there are numerous treatment options, including medication and assisted conception methods like in-vitro fertilization (IVF).

With treatment and the proper support, many women with PCOS can start a family. "PCOS is one of the most common but treatable causes of infertility in women," Sleeth says. "Those who encounter difficulties are usually successful with the help of a reproductive endocrinologist. Some medications may also help regulate ovulation and time conception more accurately."

Can I get pregnant with PCOS naturally?

Although people with Polycystic Ovary Syndrome (PCOS) often struggle with infertility due to irregular ovulation, Sleeth says that medical professionals can offer medications, recommendations, and treatments to help manage PCOS and improve fertility.

Making changes to your lifestyle may increase your chances of having a baby. According to NYU Langone Health, some changes include eating a balanced diet, maintaining a healthy weight, and exercising regularly. If these changes don't help, Sleeth mentions that your doctor might recommend further tests, treatments, and in vitro fertilization to help you conceive.

How likely will I get pregnant with PCOS?

Numerous medications can enhance fertility and increase pregnancy rates. "A medication called Clomid, which is used to help with ovulation, can increase ovulation rates by 75-80% and the chance of getting pregnant in each menstrual cycle by 22%, compared to the natural pregnancy rate of 25% in women under 30," explains Sleeth.

"Another medication called Letrozole has even higher success rates for helping with ovulation." You can also talk to your doctor about in vitro fertilization, which is an infertility treatment that has a high success rate for patients with polycystic ovary syndrome (PCOS)."

Is being pregnant with PCOS high-risk?

Sleeth explains that women with PCOS have a higher chance of facing specific problems during pregnancy. These complications can include giving birth too early, developing preeclampsia, needing a cesarean section, experiencing a miscarriage, and developing gestational diabetes. However, it's important to know that with the proper medical care and supervision, it is possible to have a healthy pregnancy even with PCOS.

FAQs

How does PCOS affect breastfeeding and postpartum health?

Sleeth says that polycystic ovary syndrome can impact breastfeeding and postpartum health in several ways. "PCOS can affect breastfeeding due to delayed lactation and insufficient milk supply from hormonal imbalances," explains Sleeth. "Infertility treatments may also impact hormone levels."

To address these challenges, Sleeth recommends promoting early skin-to-skin contact, teaching mothers how to hold the baby and help them latch on during breastfeeding, providing support around breastfeeding and nutrition, and scheduling regular check-ups with healthcare providers. She believes that these strategies can assist mothers with PCOS in successfully breastfeeding their babies.

What is the role of in vitro fertilization (IVF) in getting pregnant with PCOS?

In vitro fertilization (IVF) is a highly effective fertility treatment and is especially effective in women with polycystic ovary syndrome (PCOS). According to Sleeth, "IVF has a high success rate, with PCOS patients undergoing IVF having a 7.5% conception rate compared to 2.7% for non-PCOS patients."

IVF involves several steps, according to the Mayo Clinic, starting with stimulating the ovaries to produce mature eggs and collecting the eggs during a small surgical procedure. The eggs are then fertilized in the lab by combining them with sperm.

Once fertilization occurs, the resulting embryos are carefully placed into the uterus. Despite its potential benefits, IVF is not without risks. According to the Mayo Clinic, complications can arise, including ovarian hyperstimulation syndrome, ectopic pregnancy, and miscarriage.

How is PCOS diagnosed?

Sleeth says you need to meet specific criteria to be diagnosed with PCOS. She explains, "These include having symptoms such as irregular periods and ovulation, and signs of higher androgens male hormones. If these signs are present, you should see an endocrinologist, a doctor specializing in hormone disorders."

According to NYU Langone Health, the endocrinologist will conduct a physical examination and ask about your medical history, including your menstrual cycle regularity. After this, they may perform a blood test or a pelvic ultrasound to confirm the diagnosis of PCOS.

Can PCOS increase my risk of complications during pregnancy?

The National Institute of Child Health and Human Development (NICHD) says women with polycystic ovary syndrome (PCOS) have a higher chance of experiencing problems during pregnancy. These problems include miscarriage, C-section delivery, giving birth early, and high blood pressure caused by pregnancy.

Sleeth also points out that PCOS can make it more likely for you to get gestational diabetes and increases your risk for the birth of small gestational-age infants. However, she stresses the importance of remembering that polycystic ovary syndrome is treatable and that with proper medical care and attention, pregnancies for women with PCOS can be successful.

Experts

• Andrea Sleeth, WHNP-BC and Medical Advisor at Wisp