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Everything you should know about PCOS and fertility

Polycystic ovary syndrome (PCOS) is a condition affecting many women around the world. In women with PCOS, the ovaries contain lots of small harmless follicles or underdeveloped sacs. This is where the eggs develop, but often they can’t be released which may mean that ovulation doesn’t take place. Naturally, this can affect your chances of conceiving.


Can I get pregnant with PCOS?

Most women with PCOS can get pregnant - but it may take longer or be more difficult. PCOS makes ovulation unpredictable, which causes irregular periods. Many women find out they have PCOS this way, because period trackers help to highlight irregularities in the menstrual cycle. However, women with PCOS do ovulate, so getting pregnant is possible.

Since ovulation is irregular in women with PCOS, it can be hard to plan a pregnancy. Commonly used methods such as having sex during the fertile window might not work because you may not be able to accurately identify the timeframe of ovulation. It is possible that you could go several months without ovulating.

There are also other things that can impact your chances of conceiving on top of PCOS. Women who are over the age of 35 naturally have a lower chance of conceiving because they have fewer eggs left and therefore fewer remaining chances for fertilisation. Those who are overweight or have high blood sugar levels may also find it harder to get pregnant.

Fortunately, there are things you can do to make conceiving easier regardless of PCOS.


What helps you to get pregnant with PCOS?

From what you eat to how much you exercise, your lifestyle can play a big role in getting pregnant - even for women who don’t have PCOS. It may also help to learn more about fertility so you understand how conception works.

Here are some of the lifestyle changes any woman should consider when trying to conceive:

  • Reaching a healthy body mass index (BMI) - between 18.5 and 24.9
  • Eating a healthy, balanced diet
  • Getting more exercise
  • Taking vitamin supplements such as folic acid, vitamin B12 and vitamin C

If you’re diagnosed with PCOS and trying to conceive, doctors may suggest monitoring your blood sugar levels. PCOS can often affect the levels of insulin in your blood, which can cause high blood sugar or type 2 diabetes. High blood sugar can reduce egg quality, so keeping it at a healthy level may improve your chances of getting pregnant.

In some cases, your doctor may suggest a type 2 diabetes drug such as metformin to help manage your blood sugar levels. This usually happens if you can’t lower your blood sugar levels through eating healthily and getting plenty of exercise. You may need to monitor your blood sugar levels at home while you take metformin.

PCOS can also affect how much oestrogen and testosterone your body produces. This can affect ovulation amongst other things, so may impact your ability to conceive. If this is the case, your doctor may prescribe medication to help balance your hormone levels, such as clomiphene citrate, which helps to increase your oestrogen levels.

Clomiphene citrate - also known as Clomid - works by tricking your body into thinking your oestrogen levels are lower than they actually are. This causes the pituitary gland to release more follicle-stimulating hormone (FSH) and luteinising hormone (LH). Higher levels of FSH encourage the ovaries to produce new egg follicles to develop and later be released during ovulation. LH, in turn, encourages ovulation.

If none of the above techniques lead to successful conception, you may need to look into fertility treatments such as in-vitro fertilisation (IVF) or intrauterine insemination (IUI) in order to try and get pregnant. Like with other fertility treatments, there is no guarantee that you will get pregnant with IVF or IUI.


How to detect pregnancy with PCOS?

For many women, one of the most obvious signs that they should take a pregnancy test is a missed period. However, if you have PCOS, your menstrual cycle can be irregular - so it can be hard to tell whether or not your missed period is something to check up on. Taking a pregnancy test after every missed period can be frustrating for a woman and her partner.

In addition, PCOS can also lead to false negative pregnancy tests - where the result comes back as negative even though you are pregnant. The most common reason for this is that the level of human chorionic gonadotropin (hCG) in your urine is too low for the test to detect.

The hCG hormone is often referred to as the ‘pregnancy hormone’ and is how tests decide whether or not you’re pregnant. This can happen to any woman, particularly in cases where the test is taken too early in the pregnancy, or if the woman ovulated late in the month. This is  common in women with PCOS.

Treatment for PCOS may make detecting pregnancy easier, but there are also other signs aside from a missed period that you can watch out for. These include:

  • Tender or sore breasts
  • Increased fatigue
  • Mood swings
  • Aversions to certain foods or drinks (either when consuming or smelling them)
  • Nausea
  • Frequent urination
  • Bloating in the abdomen
  • Lower back pain
  • Headaches
  • Increased body temperature

If you suspect you are pregnant, you should avoid drinking alcohol, using drugs or smoking.