For women with PCOS, pregnancy can be a lot more challenging than it should be. Let’s learn more about PCOS, how it affects pregnancy, and how you can boost your chances of becoming pregnant, even with this condition.
What is PCOS?
Polycystic Ovary Syndrome or Polycystic Ovarian Syndrome (PCOS) affects nearly 6 to 15 percent of women in their reproductive age. Women who have PCOS have disturbed reproductive hormones. Their ovaries tend to release an increased amount of androgen, which should only be higher among males because it helps develop the male reproductive organ. The increased levels of this hormone interfere with their ovulation and menstrual cycle, and thus, makes it more difficult for them to conceive.
PCOS Signs and Symptoms
Because many of its symptoms are also related to other conditions, many women are unaware that they already have PCOS. Almost 50 percent of women with PCOS remains undiagnosed and most of them only discover the condition by the time that they begin to plan their pregnancy.
Alongside, not every symptom is present with a woman with PCOS. An excellent example is regarding weight problems or obesity. Though approximately 60 percent women with PCOS are obese, 40% of women with PCOS experience no weight problems.
The increase in androgen gives rise to the characteristic symptoms of PCOS. Since androgen is responsible for the male reproductive development, most of its typical symptoms mimic the traits of males.
The signs and symptoms of PCOS include:
- Excessive growth of body hair
- Irregular menstruation
- Weight problems
- Excessive fat distribution in the waist
- Insulin resistance
- Dark patches in the skin of the neck, thighs, breasts and arms
- Pelvic pain
- Sleep problems
- Small cysts in the ovaries (seen in ultrasound)
Can you get pregnant with PCOS?
Getting pregnant with PCOS is possible, but it will be a lot tougher since your hormonal levels become erratic.
Women tend to have lower androgen levels since this hormone is typically converted into the female hormone estrogen, which is responsible for regulating their menstrual cycle and ovulation. However, in a woman with PCOS, the hormone androgen tends to spike up. This will make their menstrual cycle unpredictable and prevents mature egg cells from being released from her ovary.
For pregnancy to occur, a viable egg cell needs to be released and unite with a sperm cell. Women with PCOS have very unpredictable ovulation, making it harder for them to time unprotected sex and thus, decreasing their chance of conception.
Polycystic ovaries are one of the primary reasons why women find it hard to get pregnant. The chances of getting pregnant with PCOS without any problems is around 30 percent. Around 70 percent of women with this condition have difficulties getting pregnant. But don’t lose hope! With treatment and lifestyle modifications, you can still have a baby with PCOS.
How to get pregnant with PCOS
If you have problems getting pregnant, the first step is to talk to your doctor. Your doctor will perform a thorough examination and series of tests to confirm if your condition is PCOS. Once diagnosed, your doctor will design a treatment plan depending on your symptoms and general health condition.
For women who are planning to have a baby, treatment plans for PCOS are primarily focused on the following:
Regulating the menstrual cycle
A regular menstrual cycle will make your ovulation more predictable and will make it a lot easier to plan the best time to have a baby. To do this, your doctor may advise you to take birth control pills.
Birth control pills contain the synthetic form of the female hormones estrogen and progesterone. These hormones play a major role in regulating a woman’s menstrual cycle. Taking the pills will also help control the production of androgen, which is causing the symptoms of PCOS.
Typically, you will be advised to take birth control pills for around 2 weeks each month to regulate your menstrual flow. If the regular combination of pills becomes intolerable, you may be advised to take the progestin-only pill which can produce the same effects but is more tolerable for some women.
Take note that you can’t get pregnant while taking birth control pills, but you need to take them first to regulate your menstrual cycle. Once your cycle becomes more predictable, your doctor may prescribe another set of medications to help you get pregnant.
Women with PCOS can be given medications that will help stimulate ovulation. The common fertility medications for PCOS include:
This is the drug of choice when treating infertility associated with PCOS. This medication has been used for a long time to help women ovulate.
This is a medication for diabetes. Women with PCOS who are insulin resistant may be given Metformin to aid in losing weight. Sometimes, women do not respond well to Clomid only, so Metformin is also used as a combination therapy.
Letrozole is a medication used to treat cancer. However, it was found useful to stimulate ovulation among women.
Injectable fertility drugs/ Gonadotropins
Gonadotropins are comprised of the synthetic hormones LH (luteinizing hormone), FSH (follicle stimulating hormone), or both of these female hormones that are responsible for ovulation.
Your doctor will advise a shot of gonadotropins depending on your condition. It may be used alone or in combination with some oral medications. It is also used together with a procedure called artificial insemination.
Doctors use gonadotropins with extra caution since these medications can trigger overstimulation of the ovaries, which will further make treatment more challenging.
As mentioned earlier, women with PCOS may also have problems with their weight. Obesity is linked with problems with ovulation and pregnancy. This is why weight management is one of the priority goals in the treatment of women with PCOS.
For some obese women, losing around 5 to 10 percent of their body weight helped regulate their menstrual cycles.
Some of the things that can help you lose weight are:
There is no specific diet that can help a woman with PCOS lose weight. Generally, eating a healthy and well-balanced meal and avoiding salty, sugary, and processed foods are advised. Some women with PCOS also found these tips beneficial:
- a low-carbohydrate diet
- eating a heavier breakfast and a lighter dinner
- including more green vegetables and protein in your meals
- selecting complex carbohydrates (sweet potatoes, beans nuts and whole grains) over simple carbs (sugar, baked goods, fruit juices)
Just like anyone trying to lose weight, combining diet with exercise has been found utmost effective. Being less sedentary and incorporating some exercise routines in your daily activities will help you shed off extra pounds.
For women who are insulin-resistant, the anti-diabetic drug Metformin may also be prescribed to aid in losing weight.
These treatment plans work well for most women with PCOS. However, if treatment seems to take too long for you to get pregnant naturally, some procedures may be offered to help you conceive faster. These include:
This procedure involves injecting your partner’s sperm directly into your cervix, fallopian tube, or uterus to facilitate faster fertilization. In women with PCOS, this is used in combination with injectable gonadotropins that are used to stimulate ovulation.
In-Vitro Fertilization (IVF)
This is a more popular technique for couples who would like to conceive. Similarly, women with PCOS need help from to stimulate their ovulation via a gonadotropin shot. The eggs that are released will then be collected and assisted to be fertilized by the sperms in a laboratory setting. After a successful fertilization, it will be injected back to a woman’s uterus where it can implant and grow into a fetus.
In-Vitro Maturation (IVM)
Both of the previous procedures involve the use of gonadotropin. Remember that gonadotropins should be used cautiously as it can overstimulate your ovaries. That’s why some doctors offer another procedure to minimize this risk and it is the IVM.
In an IVM, the immature egg cells that are naturally present in a woman’s ovaries were the ones taken. This will eliminate or minimize the need to use any drug stimulating their release.
These egg cells are then matured in a laboratory where they can be fertilized and injected back into a woman’s womb for conception.
PCOS Pregnancy Risks
Getting pregnant with PCOS is coupled with risks for both the mom and her baby.
Mothers have a greater tendency to develop pregnancy-related complications like high blood pressure, gestational diabetes, and the life-threatening preeclampsia.
The babies of mothers with PCOS may be larger than the average if they developed gestational diabetes. It is a lot harder to have a normal spontaneous delivery with large babies and may require you to have a Cesarean delivery. These babies are also more at risk of prematurity, miscarriage, and lower APGAR scores.
Baby girls that are born to mothers with PCOS also have up to 50 percent chance of getting the same condition.
So if you got pregnant with PCOS, you may need to work closely with your doctor to manage not only your condition but also the possible complications.
Most of the health risks associated with your pregnancy may resolve once your baby and the placenta are successfully delivered. However, you will still need treatment to manage your symptoms of PCOS after giving birth, especially if you plan to breastfeed your baby.
PCOS is a condition that affects the normal reproductive cycle of a woman, so getting pregnant can be more difficult than the rest. However, with some lifestyle modifications and treatment, most women with PCOS can successfully get pregnant. Whether you conceived spontaneously or with help of fertility treatments, it is essential to have regular prenatal visits so that your doctor can help prevent or minimize the complications related to your pregnancy and assist you in giving birth to a healthy baby.
This article is for informational purposes only and should not be considered medical advice. Always consult with a doctor or licensed medical professional before making any medical decisions.