Fertility and PCOS

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Studies show that the majority of women with PCOS will be able to conceive and go on to have healthy babies. 

People with PCOS are more likely to seek out and require fertility treatments than people who don’t have it. But research shows that over their lifetimes, both people with and without PCOS have a similar number of pregnancies and children. In fact, the majority of people with PCOS who are trying to conceive will become pregnant and give birth without any fertility treatment.

It’s common for people diagnosed with PCOS to worry about their ability to become pregnant, even if they don’t want to be pregnant any time soon. Knowing that there are options available to become pregnant can help reduce anxiety.

Ovulation

Ovulation, the release of an egg from the ovary, typically happens about once a month. Pregnancy is technically only possible if you have sex during the five days before ovulation or on the day of ovulation. But the most fertile days are the three days leading up to and including ovulation. 

People with PCOS may ovulate less frequently and because of irregular cycles it is harder to predict when ovulation happens which can make conceiving harder. 

How to determine when you’re ovulating with irregular periods

… TBC …

Visiting your doctor

If you have PCOS and are thinking about becoming pregnant or are struggling to conceive it is a good idea to visit your GP.

Your GP can help you optimise your health and PCOS prior to trying to conceive. There are also some tests they may want to do before you start trying.

If you are struggling to conceive your GP can refer you for further investigations or to a specialist. NICE (The National Institute of Health and Care Excellence – a body that informs best medical practice in the UK) advises that women be investigated for infertility if they have been trying for a year. However they say that if there is a known predisposing factor for infertility (such as PCOS) then doctors should make an earlier referral.  

We’ve included the relevant excerpt from the NICE Guidelines below in case you want to show them to your doctor.

1.2.13.7 Offer an earlier referral for specialist consultation to discuss the options for attempting conception, further assessment and appropriate treatment where:the woman is aged 36 years or over

• there is a known clinical cause of infertility or a history of
• predisposing factors for infertility. [new 2013]

NICE Guidelines: Fertility problems: assessment and treatment, Clincial Guidance [CG156]

When you visit your GP they may arrange the following initial tests:

  • test to confirm ovulation (mid-luteal phase progesterone) 
  • serum gonadotrophins (in women with irregular menstrual cycles)
  • thyroid function tests (if needed), prolactin measurement (in women with an ovulatory disorder), and screening for chlamydia.
  • An oral glucose tolerance test should also be offered preconception (or should be offered before 20 weeks)

Management options

If you are having difficulty conceiving with PCOS you should speak with your GP or specialist and take their advice on the best approach. 

General advice

Making sure your general health is optimal can help improve your chances of conceiving.

  • Taking folic acid supplements
  • Stopping or reducing smoking and cutting down on alcohol
  • Reviewing any medications with your doctor or pharmacist
  • Having sexual intercourse every 2 – 3 days or timing intercourse around ovulation can help maximise chances of conception

For women with PCOS that are overweight even a modest amount of weight loss can improve symptoms although we realise this is easier said than done. Aiming for a 5% weight reduction can help improve ovulation and increase chances of pregnancy.

Medication

Medical treatment in PCOS usually aims to restore ovulation

  • Metformin: Metformin can be used on its own to improve ovulation although there are more effective medications to stimulate ovulation 
  • Medications to stimulate ovulation: : Clomiphene citrate, letrazole or gonadotrophins are medications that can be used in women with PCOS to stimulate ovulation. These are usually prescribed by a fertility specialist and may require ultrasound scans to monitor the ovaries

Assisted conception

If medications haven’t been successful then other forms of fertility treatments might be considered in women with PCOS. These include intrauterine insemination (IUI) or IVF.

Any general advice given by our care team or posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical advice, diagnosis, or treatment. Béa Fertility, the trading name for StepOne Fertility Ltd. makes no representations or warranties and expressly disclaims any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app.