Getting Pregnant with PCOS
Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Written on 9/3/21
While many women with PCOS experience irregular cycles and lack of ovulation, it is totally possible to conceive with PCOS.
If you have PCOS, you may have heard that it can be more difficult for you to get pregnant. While this can be true since many women with PCOS experience irregular cycles and lack of ovulation, it is totally possible to conceive with PCOS.
In fact, tools like Proov Confirm have made it easier than ever for women with PCOS to track their cycles and ovulation. Keep reading to learn how to get pregnant faster with PCOS!
What is PCOS?
Polycystic ovarian syndrome is an endocrine disorder that is extremely common among women of reproductive age. It officially affects between 5 and 10% of women of childbearing age.
But the amount of women with PCOS may be much higher due to the fact that it may be highly underdiagnosed. This is because it can have a variety of symptoms that can seem unrelated and there is a lack of consensus surrounding diagnostic guidelines.
Contrary to the name, PCOS is not always characterized by polycystic ovaries (meaning your ovaries are enlarged and may contain more follicles than normal). PCOS is more generally characterized by excess androgens (male sex hormones) that cause an overall hormonal imbalance.
Being the most frequent cause of anovulatory cycles (a cycle in which ovulation does not occur), PCOS is one of the most common causes of female infertility. But luckily, it’s also one of the most treatable.
The cause of PCOS is unknown, although there are some hypotheses. A few potential causes of PCOS include excess insulin, low-grade inflammation, genetice, and excess androgens.
How do I know I have PCOS?
A PCOS diagnosis comes from your doctor. As we mentioned, PCOS is thought to be incredibly underdiagnosed, likely because doctors tend to look at symptoms individually versus holistically.
The latest recommendations for diagnosis require a patient to have 2 of the 3 following issues:
- Excess androgens
- Irregular periods
- Polycystic ovaries (shown via ultrasound)
If you suspect you have PCOS, you may want to look out for the following symptoms:
- Excess androgens, like free and circulating testosterone and DHEAs
- Irregular periods, especially if your cycles last longer than 35 days (this can be a sign of anovulation)
- Hirsutism, which is excessive hair growth, especially on the chin, upper lip, chest, and abdomen
- Obesity and difficulty losing weight due to insulin resistance
- Hair loss and male pattern baldness
- Polycystic ovaries seen on ultrasound, often referred to as a “string of pearls”
- High AMH levels
- High LH levels throughout the cycle or an LH to FSH ratio higher than 2
A PCOS diagnosis requires a patient to have at least two of the following: excess androgens, irregular periods, or polycystic ovaries.
How is PCOS treated?
Unfortunately there is no definitive cure for PCOS, but several treatments are available to help alleviate symptoms. A few options are listed below:
Birth control pill: The birth control pill is a common method for managing PCOS symptoms. Many teenagers are prescribed birth control pills to keep acne and hirsutism at bay, and may stay on the pill for years until they’re ready to start a family. However, once you stop using the pill, you may experience your PCOS symptoms once again, including anovulation or infertility.
Inositol: Supplements like inositol have been proven to be very effective in decreasing androgen levels in PCOS patients. Studies show that myo-inositol increases insulin sensitivity and lowers the levels of androgens thus improving irregular cycles. If you’re looking for an Inositol supplement, we like Ovasitol because it contains both forms of inositol.
Diet: Diet is extremely important because PCOS is associated with obesity in up to 80% of cases. Maintaining a balanced diet may help you lose some weight. This includes cutting out sugars, limiting carbohydrate intake, and adding lean proteins, vegetables, fruits, and healthy fats. Luckily, we know now that reducing body weight with as little as 5 to 10% may help improve hormonal balance, regulate cycles, and improve fertility outcomes.
Exercise: Exercise is extremely efficient when it comes to improving insulin resistance. When you are regularly active, insulin becomes more efficient in cleaning the blood from sugar. When exercise is paired with a healthy diet, your PCOS symptoms are more likely to improve.
Metformin: Metformin is a drug that is often prescribed to women suffering from PCOS. Metformin is usually used in treating Type 2 diabetes, but is useful in lowering blood sugar levels and regulating insulin in PCOS patients too. It also has been found to help induce ovulation in PCOS patients who struggle with anovulation.
How can I get pregnant with PCOS?
Getting pregnant with PCOS may be a challenge, but as we mentioned it is one of the most treatable causes of infertility. It’s important to note that due to hormonal imabalances, women with PCOS may also be at a higher risk of miscarriage.
Cycle tracking is extremely important for anyone, but it is especially essential for those with PCOS who can’t rely on predictable and consistent ovulation dates to time intercourse. However, excess androgens can cause a hormonal imbalance that leads to elevated LH levels throughout one’s cycle. This means tracking peak fertility with an LH test can be more difficult as PCOS patients may never observe a true LH surge.
In this case, cervical mucus monitoring may become very helpful. Right before ovulation, your cervical fluid will become wet and stretchy, with a raw egg white consistency. The presence of fertile cervical mucus indicates the opening of your fertile window.
Cervical position may be another useful method of tracking your fertile period. To do this, you’ll need to insert your finger (ideally freshly clean!) into your vagina. If you can feel your cervix, then you likely have not yet reached your fertile window as the cervix lifts up before ovulation.
If you cannot feel your cervix, then it’s safe to assume you’re in your fertile window and ovulation is coming soon. Tracking cervical position becomes easier with time and practice as you get used to your body.
Once you have identified peak fertility, you can confirm successful ovulation with Proov PdG tests — the first and only FDA cleared PdG test kit. Unlike traditional ovulation tests, Proov Confirm measures PdG, a marker of progesterone in urine, that is only released after ovulation occurs. Elevated and sustained PdG levels after ovulation are necessary to support implantation and conception.
Proov Confirm is the first and only FDA-cleared PdG test kit to confirm successful ovulation at home.
Since PdG is only present after ovulation occurs, our PdG tests work for women with PCOS. Not only do they confirm ovulation, but they also offer a new way to track your cycle and identify anovulatory cycles.
Additionally, Proov Confirm helps you confirm “successful” ovulation, meaning an ovulatory event in which an egg was released and PdG levels remained adequately elevated for long enough to allow for the best possible chance at conception. Women with PCOS may experience low PdG levels after ovulation due to their hormonal imbalance, so Proov can help you ensure that low PdG is not hurting your chances at conception.
It is totally possible to get pregnant naturally with PCOS, although lack of regular ovulation and the difficulties identifying the fertile window can make it more difficult. If you have PCOS, have been TTC naturally, and are struggling to successfully conceive, we recommend consulting your doctor. Luckily, there are plenty of at-home tests like Proov to help you manage your PCOS!