Updated on 11/28/22
Polycystic ovarian syndrome (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).
But, successfully conceiving with PCOS is absolutely possible! Keep reading to learn how you can get pregnant with PCOS.
Getting pregnant with PCOS is absolutely possible! Keep reading to learn how.
How does PCOS make it harder to get pregnant?
Higher levels of androgens (male reproductive hormones) 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, the ovary may never be stimulated to release an egg during any given cycle.
This imbalance can make getting pregnant harder in 2 main ways:
- It’s more difficult to figure out when to have intercourse.
- No ovulation means no chance of getting pregnant, since sperm has no egg to meet.
Additionally, when ovulation does not occur, the ovary does not produce progesterone. This hormone is responsible for making the uterine lining “sticky” enough so a newly fertilized egg (also called an embryo) can implant into the uterus and pregnancy can begin. Without enough progesterone for long enough after ovulation — during the aptly named implantation window — 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 understanding ovulation and PCOS, 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 or chronically elevated LH levels that don’t actually result in ovulation. Do ovulation tests work with PCOS? Due to this, traditional ovulation tests that measure LH can be harder to use.
So what is one way how to predict ovulation with PCOS? 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.
It may take a little bit of trial and error to figure out which method works best for you. The good news is that if you have regular intercourse every few days during your cycle, you’re bound to hit your most fertile window at some point!
Women with PCOS often experience surges in luteinizing hormone that don’t actually result in ovulation.
How do I know if I'm ovulating?
Of course, you can have all the intercourse in the world but you still won’t get pregnant if you’re not actually ovulating! Women with PCOS often experience cycles in which ovulation does not occur, but the good news is that there is an easy way to confirm ovulation from the comfort of home.
PdG tests measure a urine marker of the hormone progesterone. A presence of PdG after ovulation confirms that ovulation did in fact occur. You can use a PdG test after your ovulation prediction method of choice to confirm that it actually resulted in ovulation.
With Proov Confirm — the first and only FDA cleared PdG test — you can also confirm successful ovulation. Do you remember the implantation window we mentioned earlier? Elevated and sustained PdG levels during this window (meaning your PdG rises and remains high) confirms successful ovulation, which gives you a better chance of getting pregnant.
Proov Confirm is the first and only FDA cleared PdG test to confirm successful ovulation from home.
Even if a woman with PCOS does ovulate, her greater hormonal imbalances may cause an imbalance in progesterone levels after ovulation. Confirming successful ovulation helps you understand your post-ovulatory levels and have a higher possible chance of conception.
Elevated and sustained PdG levels after ovulation confirm that successful ovulation did in fact occur. If you're ovulating successfully and still not getting pregnant, we recommend consulting your doctor to explore other reasons you may not be conceiving.
If your test results confirm ovulation, but you’re not seeing a sustained PdG elevation during the implantation window, this could be a sign that you need additional progesterone support for a truly successful ovulation. This is a great conversation to have with your doctor.
And finally, if you never get a positive PdG test, this could be a sign that you’re not ovulating. The good news is that you now have powerful information to get the appropriate treatment!
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, your Proov test results serve as powerful evidence of this, and can help you have better conversations with your doctor.
There are several treatments and lifestyle changes that have been proven effective for promoting successful ovulation 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.