Getting pregnant with PCOS - What You Need To Know

Trying to get pregnant with PCOS? If you have polycystic ovary syndrome, getting pregnant naturally may be difficult. This is what you need to know if you're trying to get pregnant with PCOS.
How to get pregnant with PCOS
How to get pregnant with PCOS
It is estimated that up to 10% of women have polycystic ovary syndrome, referred to more commonly as PCOS.

Polycystic ovary syndrome is typically characterized by meeting at least two out of these three criteria:
👉hyperandrogenism (high free testosterone levels, hirsutism)
👉ovulatory dysfunction (irregular/no periods)
👉polycystic ovary as seen by ultrasound

Having PCOS can make getting pregnant difficult for some women.

👇Here’s what you need to know when trying to conceive with PCOS that may help you prepare to meet your fertility goals head on.

You can get pregnant with PCOS. Some women can get pregnant naturally while others may experience infertility due to PCOS and need help conceiving.
You can get pregnant with PCOS. Some women can get pregnant naturally while others may experience infertility due to PCOS and need help conceiving.


Not all women with PCOS experience infertility


Not all women with polycystic ovary syndrome experience infertility, however, PCOS is the primary cause of anovulatory infertility.
 
It’s been estimated that ~84% of women with PCOS present with ovulatory dysfunction, such as irregular periods or no period at all.
 
If you don’t have a period, then you didn’t ovulate. 🙅‍♀️

Ovulatory dysfunction can make it difficult to get pregnant naturally, as you are either not ovulating or unable to anticipate when you will ovulate.

Ovulation tests tend to be unreliable for women with PCOS. Ovulation tests detect the LH surge that signals ovulation in the body. Women with PCOS tend to have prolonged high LH levels that make these tests inaccurate at predicting ovulation in this case.
Ovulation tests tend to be unreliable for women with PCOS. Ovulation tests detect the LH surge that signals ovulation in the body. Women with PCOS tend to have prolonged high LH levels that make these tests inaccurate at predicting ovulation in this case.


Ovulation Tests May Not Work if you have PCOS

 
🧐Thinking of using ovulation test strips?
 
These tend to be a no-go if you have PCOS.

Prior to ovulation, the LH surge in the body signals the release of an egg from the ovary. This LH surge is what you are testing for when using ovulation strips.
 
These ovulation tests work by measuring the amount of LH in your urine to help you detect the increase in LH that triggers ovulation.
 
Women with PCOS tend to have increased levels of LH that may be higher than the baseline for these tests, making them unable to detect a change in LH or giving a false positive.

This can make timing ovulation to get pregnant difficult for women with PCOS.

Your doctor may prescribe you fertility medications to help you ovulate. That way, you can track when you will actually ovulate to help you get pregnant.
Your doctor may prescribe you fertility medications to help you ovulate. That way, you can track when you will actually ovulate to help you get pregnant.


Women with PCOS May Need Fertility Medications to Ovulate


👩‍⚕️You may need to consult an OBGYN or fertility specialist if you haven't been having a period or if your period is irregular and you're trying to get pregnant.
 
You can start with your OBGYN or you work with a fertility specialist known as a Reproductive Endocrinologist.
 
This doesn’t necessarily mean IVF! There are other treatment options you can usually try first.

Women with PCOS may just need a little extra help getting pregnant by taking fertility medications to induce ovulation.

These doctors can prescribe fertility medications to help you ovulate. Then you and your doctor can track ovulation and you can try to conceive by timed intercourse with your partner or doing an IUI (intrauterine insemination) cycle to help improve your chances of getting pregnant.

In some cases, if IUI does not work after several attempts, some women may need to do IVF (in vitro fertilization) instead.
 
Studies have shown that Letrozole has better pregnancy success rates for women with PCOS compared to using Clomid for ovulation induction.
Studies have shown that Letrozole has better pregnancy success rates for women with PCOS compared to using Clomid for ovulation induction.


📊Clomiphene vs Letrozole for PCOS

 
If you are doing infertility treatment such as a timed intercourse or an intrauterine insemination cycle, the current research on fertility medications may be useful to know.

There are two different medication options usually used for IUI or timed intercourse cycles, Clomiphene Citrate (Clomid) or Letrozole (Femara).

The current research has shown that there seems to be a difference in which medication performs best for women with PCOS when doing ovulation induction or an IUI.

A review of 42 randomized controlled trials including 7,935 women with PCOS found that Letrozole improved live birth & pregnancy rates over Clomid.

📊Studies have shown that women with PCOS have improved pregnancy success rates with Letrozole compared to Clomiphene.

Similarly, a 2019 review’s meta-analysis also found that Letrozole improved:

👉ovulation rate
👉pregnancy rate
👉live birth rate
 
per patient for women with PCOS compared to Clomid.

So you may want to bring this up when discussing with your doctor which fertility medication may be the best option for you.
 

🤔Looking for a fertility doctor?

 
Your OB may have a recommendation of a fertility specialist.
 
If you want to do your own research, you can search fertility doctors in your area with FertilitySpace to:
👉 compare clinic success rates
👉read reviews
👉find the best match for your fertility goals 💕