According to the Centers for Disease Control and Prevention, polycystic ovary syndrome, also known as PCOS, is the most common cause of infertility in women in the United States of reproductive age. PCOS affects as many as 5 million people, and the CDC link it to many other serious health problems, such as diabetes, heart disease, and high blood pressure. People with PCOS have high levels of the male hormone, androgen. This can stop ovulation and cause excess hair growth, thinning scalp hair, acne, and irregular periods.

When it comes to pregnancy, people with PCOS have options. A PCOS diagnosis may make it more difficult to become pregnant, but a combination of fertility or hormonal treatments like fertility acupuncture and healthy lifestyle changes can improve the chances of conceiving a baby.

Read on for everything you need to know about pregnancy and PCOS.

Pregnant woman cradling her belly
  1. What is PCOS?

PCOS is an incredibly common condition that affects the ovaries. Three main features of PCOS are irregular periods, an excess of androgen hormones, and polycystic ovaries. Irregular periods mean that the ovaries do not release eggs regularly, and abnormally high levels of androgens (a male hormone) can cause abnormal hair loss or growth. Polycystic ovaries contain a lot of follicles (fluid-filled sacs, which are up to 0.3 inches in size) that surround the eggs. People with at least two of these three features may receive a PCOS diagnosis.

  1. Signs of PCOS

Signs of PCOS vary significantly. Many people with PCOS do not show signs of any symptoms at all, whereas other people may show obvious signs of this condition. Symptoms of PCOS may include anovulation (absent or irregular ovulation), amenorrhea (absent monthly period), acne, and abnormal hair growth on the abdomen, nipples, chin, or upper lip. Other signs are obesity, resistance to insulin, hyperandrogenism, polycystic ovaries, recurrent miscarriage, and infertility.

  1. Testing for PCOS

Some people may not realize they have PCOS until they attempt to get pregnant. When diagnosing PCOS, your doctor may look for polycystic ovaries using an ultrasound, determine if you have absent or irregular periods, and test your blood for signs of androgens. In addition, your doctor may perform tests for lipid levels, hormone levels, and blood sugars. 

Those who are not trying to get pregnant may be prescribed birth control to manage symptoms such as hair growth and acne. People who wish to get pregnant have a variety of options, which are discussed further below.

  1. Natural Conception and PCOS

Although it is not impossible, conceiving naturally can be difficult for people with a PCOS diagnosis. Due to the abnormal hormone levels, the menstrual cycle and ovulation can be unpredictable. One factor that can impact a person’s ability to conceive naturally is their lifestyle. Some studies suggest that regular exercise and a balanced diet can help regulate periods, improve insulin resistance, and increase the chances of natural conception. However, in some cases, it isn’t just PCOS that is preventing a person from getting pregnant. Therefore, consulting a reproductive endocrinologist can help you figure out the root of your problem, and they can create a treatment plan that is tailored to your needs.

  1. Risk Factors Associated with PCOS and Pregnancy

One risk factor associated with PCOS is recurrent miscarriage. In addition, pregnant people with PCOS have a higher risk of developing high blood pressure, gestational diabetes, preeclampsia, and preterm labor. More research is needed to prove if these risks are related to PCOS specifically, or if one’s lifestyle choices make a difference. Therefore, it is recommended that you regularly exercise (after getting approval from your doctor) and eat a healthy, balanced diet.

Other Ways to Build a Family

People who want to build a family but do not want the associated risks that come with PCOS can turn to donated eggs or surrogacy:

  1. Donor Eggs

A person with PCOS can use the donated eggs, or donated embryos, of another person to get pregnant. If you choose to go down this route, you will need to prepare your uterus for conception with specialist medication. This is a great route to take if you want to experience carrying a baby and childbirth.

  1. Surrogacy

Surrogacy is a popular way of creating a family if you have PCOS. It involves a person willingly carrying a child for people who intend to become its parents once it has been conceived. With surrogacy, the embryo could be created using a donated egg and a donated sperm, or it can be created from one or both of the intended parents. 

Surrogacy is a favorable option for people with PCOS because the intended parents have the opportunity to raise a child that is genetically related to themselves. ConceiveAbilities are an egg donor and surrogacy agency who have been around for almost 25 years. They have many resources to help and guide people who want to be parents.

Alternative Ways to Get Pregnant With PCOS

Even if the chance of natural conception is low, people with PCOS have alternative ways to get pregnant:

  1. Oral Medication

Oral medication, such as Clomid, may be prescribed to stimulate hormone production and induce ovulation. When it comes to ovulation, this oral drug has a high (80 percent) success rate. Another oral pill that can be prescribed to induce ovulation is letrozole.

  1. Injectable Medication

Injectable fertility medications, such as gonadotropins, are often prescribed if oral medication isn’t successful. Gonadotropins are drugs that are often given to patients who are undergoing IVF. These injectable medications help to stimulate egg production; however, they can also induce negative side effects such as mood swings, rashes, swelling, and headaches.

  1. Surgery

Depending on individual circumstances, your doctor may suggest a minor surgical procedure to treat PCOS. This procedure is called laparoscopic ovarian drilling (LOD), and it involves a small incision on your lower abdomen and then passing through a microscope called a laparoscope. Following this, your doctor will use a laser or heat to eliminate the tissue that produces androgens. 

This surgical procedure can lower testosterone and LH (luteinizing hormone) levels, and elevate FSH (follicle-stimulating hormone) levels. Ultimately, the LOD should restore the regular function of the ovaries and correct any hormone imbalances.