How to Get 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 11/10/20
Polycystic ovarian syndrome (PCOS) is a common reproductive disorder that affects many women. It can lead to a variety of symptoms and sometimes can make it more difficult to get pregnant.
But, successfully conceiving with PCOS is absolutely possible! In fact, Proov may be able to help women with PCOS reach their fertility goals faster.
What is polycystic ovarian syndrome (PCOS)?
PCOS is a common reproductive disorder that affects as many as 5 million women in the United States. It is also one of the most common causes of infertility.
PCOS is characterized by an imbalance in reproductive hormones, specifically an excess amount of androgens or male sex hormones. Due to this hormone imbalance, women with PCOS may experience irregular menstrual cycles or anovulation (a lack of ovulation).
While many women associate PCOS with polycystic ovaries — enlarged ovaries that have many follicles containing eggs — PCOS is actually more commonly characterized by the hormone imbalance.
While many women associate PCOS with polycystic ovaries, PCOS is actually more commonly characterized by the hormone imbalance.
How does PCOS make it harder to get pregnant?
Higher levels of androgens in women with PCOS can alter luteinizing hormone (LH) and gonadotropin-releasing hormone levels, which is the hormone responsible for the release of follicle stimulating hormone (FSH). Because of this, a mature follicle may never be stimulated to release an egg.
As we know, conception cannot occur without an egg. Lack of ovulation in women with PCOS can make it much more difficult to get pregnant.
Additionally, when ovulation does not occur, there is no empty follicle (corpus luteum) to produce progesterone. A lack of progesterone in comparison to estrogen levels can lead to an even greater hormone imbalance. Progesterone is also responsible for stabilizing the uterine lining and preparing it to receive an embryo. Without enough progesterone, it can be more difficult to get pregnant.
But while PCOS can make it harder to conceive, it is actually one of the most treatable causes of infertility in women. Using various ovulation prediction and confirmation methods can help women with PCOS understand more about their cycles and get pregnant faster.
How do I predict ovulation and time intercourse with PCOS?
Predicting ovulation with PCOS can be a little tricky — but not impossible! This is because women with PCOS often experience surges in luteinizing hormone that don’t actually result in ovulation. Due to this, traditional ovulation tests that measure LH can be harder to use.
A different ovulation prediction method for women with PCOS is cervical mucus monitoring. Cervical mucus monitoring involves tracking the changes in consistency and texture of your cervical mucus throughout your cycle. During the majority of your cycle, cervical mucus is dry and sticky but leading up to ovulation, cervical mucus becomes wet and stretchy, often resembling egg whites.
Another ovulation prediction method for women with PCOS is basal body temperature (BBT) tracking. BBT tracking involves monitoring the slight changes in body temperature that occur just before and after ovulation.
Women with PCOS often experience surges in luteinizing hormone that don’t actually result in ovulation.
How do I confirm ovulation with PCOS?
In women with PCOS, it is especially important to confirm ovulation, as anovulatory cycles can be common. Additionally, women with PCOS should also confirm that ovulation was “successful,” meaning post-ovulatory hormone levels were adequately elevated and allow for the best possible chance at conception.
Proov is the first and only FDA-cleared PdG test kit to confirm successful ovulation at home. PdG is the urine metabolite of progesterone and only rises after ovulation has occurred. Since PdG is not present in urine if an egg is not released, Proov can confirm ovulation in women with PCOS.
When confirming successful ovulation with Proov, we recommend testing on days 7-10 after peak fertility. If you are a woman with PCOS who has difficulty tracking peak fertility with traditional LH tests, we recommend trying cervical mucus monitoring or BBT tracking. If neither of those methods work, you can start using Proov on cycle day 21 and repeat every three days until you get a positive result or your period.
We like to see four positive Proov tests during the testing window to confirm successful ovulation. If you never get a positive Proov test, this could be a sign of an anovulatory cycle in which case we recommend consulting your doctor. If 1, 2, or 3 of your Proov test are negative, this could be a sign of “unsuccessful” ovulation, which can make it more difficult to get pregnant.
What should I do if I’m not ovulating?
If you have PCOS and your Proov tests show that you are not ovulating, we recommend consulting your doctor. Luckily, you can show your doctor photos of your tests as Proov of anovulatory cycles — our app is a great place to track your test results over time!
There are several treatments and lifestyle changes that have been proven effective for improving ovulation quality in women with PCOS. A recent study conducted on women with PCOS showed that menstrual cycle regularity improved by 50% in women who were not cycling after lifestyle changes such as calorie reduction, carbohydrate reduction, increased brisk walking, and an increase in home or gym exercise.
If lifestyle changes do not help you ovulate, your doctor may recommend ovulation inducing medications, such as clomiphene or gonadotropins. One study found that ovulation inducing medications resulted in live births about 70% of the time in women with PCOS. If you are interested in ovulation inducing medication, we recommend consulting your doctor.
Women with PCOS can try lifestyle changes or prescription medications in order to improve ovulation.
Finally, if your Proov tests show you are ovulating, but ovulation may not be completely “successful” (meaning PdG levels did not remain elevated for an adequate amount of time), you may consider options to increase PdG such as seed cycling, diet changes, or herbal supplements.
Getting pregnant with PCOS is entirely possible and confirming ovulation with Proov can help you reach your fertility goals faster!