PCOS and Your Fertility -- and What You Can Do About It

One of the most common reasons a woman has trouble getting pregnant is a condition called polycystic ovary syndrome (PCOS).

It’s a hormone problem that interferes with the reproductive system.

When you have PCOS, your ovaries are larger than normal. These bigger ovaries can have many tiny cysts that contain immature eggs.

Hormone Differences

PCOS causes a woman’s body to produce higher-than-normal levels of androgens. These are hormones that are usually thought of as male hormones, because men have much higher levels of androgens than women.

Androgens are important in the development of male sex organs and other male traits.

In women, androgens are usually converted into the hormone estrogen.

Ovulation Problems

High levels of androgens interfere with the development of your eggs and the regular release of your eggs. This process is called ovulation.

If a healthy egg isn’t released, it can’t be fertilized by sperm, meaning you can’t get pregnant. PCOS can cause you to miss your menstrual period or have irregular periods. This can be one of the first signs that you may have a problem such as PCOS.

Regulating Your Period

Fortunately, there are some treatments that can help women with PCOS have healthy pregnancies.

Your doctor may prescribe birth control pills that contain man-made versions of the hormones estrogen and progestin. These pills can help regulate your menstrual cycle by reducing androgen production.

If you cannot tolerate a combination birth control pill, your doctor might recommend a progestin-only pill.

You take this pill for about 2 weeks a month, for about 1-2 months. It’s also designed to help regulate your period.

Medicines to Help You Ovulate

You won’t be able to get pregnant while you’re taking birth control pills for PCOS. But if you need help ovulating so that you can become pregnant, certain medicines may help:

  • Clomiphene is an anti-estrogen drug that you take at the beginning of your cycle.
  • If clomiphene doesn’t help with ovulation, you may be prescribed the diabetes drug metformin.
  • If clomiphene and metformin don’t work, your doctor may prescribe a medication containing a follicle-stimulating hormone (FSH) and a luteinizing hormone (LH). You get this medicine in a shot.
  • One other drug that helps with ovulation is letrozole. It’s sometimes used when other medications aren’t effective.

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If you have PCOS and you want to get pregnant, you should work with a doctor who is a specialist in reproductive medicine. This type of doctor is also known as a fertility specialist.

A specialist will help make sure you get the right dose of medicines, help with any problems you have, and schedule regular checkups and ultrasounds to see how you’re doing. (An ultrasound is a machine that uses sound waves to create images of the inside of your body. It’s a painless procedure that can track the growth and development of your baby).

Lifestyle Changes

For some women, gaining a lot of weight can affect their hormones. In turn, losing weight, if you’re obese or overweight, may help get your hormones back to normal levels. Losing 10% of your body weight may help your menstrual cycle become more predictable. This should help you get pregnant.

In general, living a healthier lifestyle with a better diet, regular exercise, no smoking, less stress, and control of diabetes and other medical conditions should improve your fertility odds.

Remember, if your period isn’t happening when it should, or you’ve already been diagnosed with PCOS, work closely with your doctor to help get it under control. And if you want to get pregnant, talk with a fertility specialist.

WebMD Medical Reference Reviewed by Kecia Gaither, MD, MPH on March 25, 2017

Sources

SOURCES:

Cleveland Clinic: “Polycystic Ovary Syndrome.”

Hormone Health Network: “Polycystic Ovary Syndrome.”

Women’s Health Resource Center: “Androgens.”

U.S. Office on Women’s Health: Polycystic Ovary Syndrome.”

Mayo Clinic: “Polycystic Ovary Syndrome: Treatments and Drugs.”

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