Getting pregnant with polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (commonly known as PCOS) is a condition caused by a hormonal problem that interferes with a woman’s reproductive system.

If you have PCOS, you probably know that it’s relatively common, affecting between 5% and 13% of women of reproductive age. You may also know that it can sometimes lead to fertility problems – but the good news is that there are various ways to overcome them and help you get pregnant.

How does PCOS affect fertility?

When you have PCOS, your ovaries are larger than normal and have many small ‘cysts’ (follicles) that contain immature eggs. Because these follicles don’t develop properly, ovulation may not occur – in other words, your ovaries may not release an egg during your monthly cycle. And if a healthy egg is not released from your ovaries, it can’t be fertilised by sperm, meaning you won’t have a chance of falling pregnant that month.

Most women with PCOS have irregular ovulation – some months an egg is released, some months an egg isn’t –  which reduces their overall chances of conceiving and often means that it takes them longer than usual to fall pregnant.

Fortunately, however, there are numerous options for improving your fertility if you have PCOS. Around 6 in 10 women with PCOS become pregnant without any medical intervention, and there are also several ways that fertility specialists can help if you do find yourself having trouble conceiving.

How can fertility be improved for women with PCOS?

If you have PCOS, potential options to improve your fertility and increase your chances of getting pregnant include:

Lifestyle changes

Maintaining a healthy weight is particularly important if you have PCOS and you’re trying to improve your chances of getting pregnant, because excess weight can affect your hormones. So if you are overweight or obese, losing weight may help get your hormones back to normal levels and should help you to get pregnant. And even if this is not enough on its own, maintaining a healthy weight will improve your chances of conceiving if you undergo fertility treatments.

Aside from managing your weight, you may also be able to improve your fertility with other lifestyle changes, such as a better diet, regular exercise, not smoking, reducing stress, and carefully managing diabetes or other medical conditions.

Medications to help you ovulate

If lifestyle changes alone are not sufficient, you may require some medication that stimulates your body to produce and release eggs. This is known as ‘ovulation induction therapy’.

In most cases, the first choice of medication is a tablet called clomiphene (Clomid). This has a good success rate – it can achieve 30%-50% pregnancy rates after 6 treatment cycles.

The next option for ovulation induction therapy, if Clomid is unsuccessful, is usually an injection of hormones known as follicle-stimulating hormone (FSH) and luteinising hormone (LH). These hormones, which are normally produced by your body, mimic the normal hormonal cycle to stimulate the growth and release of eggs from the ovaries.

Surgery to increase the chance of ovulation

In some cases, surgery may be an appropriate option for women with PCOS who have not become pregnant despite other treatments.

The surgical procedure, which is known as ‘ovarian drilling’ or ‘laparoscopic ovarian surgery’, involves removing some of the tissue from the surface of the ovaries – this can encourage your body to ovulate more regularly. Despite its somewhat ominous-sounding name, ovarian drilling is a minimally invasive ‘keyhole’ surgery that is performed via a small incision below your belly button.

IVF (in vitro fertilisation)

If other treatments have not been successful, IVF is another option for women with PCOS. With IVF, eggs are removed from the ovaries and fertilised in the lab (or ‘in vitro’), then the resulting embryo is returned to the uterus.

Patients with PCOS usually do very well with IVF. This is because the main problem in PCOS is ovulation (i.e. the release of eggs from the ovary), not the subsequent embryo formation and implantation. As each ‘cyst’ in the ovary is a potential egg, women with PCOS actually have very good egg numbers, which means we are usually able to retrieve a high number of eggs with IVF stimulation. Once an embryo has been created via IVF, most women with PCOS go on to have a successful pregnancy.

Need advice about PCOS and fertility?

If you have PCOS, there can be a lot to consider when it comes to fertility.

So if you would like expert advice about ways to improve your chances of getting pregnant, you can make an appointment with one of our fertility specialists by calling Newlife IVF on (03) 8080 8933 or by booking online via our appointments page.

Further reading