Getting Pregnant With PCOS
Polycystic ovarian syndrome (PCOS) is the commonest hormonal disorder in women of reproductive age, occurring in approximately one in seven women. PCOS causes irregular ovulation and periods. The main factor of infertility is PCOS can make it difficult to get pregnant. When you have PCOS, your ovaries will be larger than normal. These bigger ovaries may have many tiny cysts that contain immature eggs. In addition, PCOS causes hormonal imbalances that lead to a cascade of symptoms, including weight gain and obesity. Furthermore, weight gain and obesity is also a risk for the individual on can’t get pregnant.
Although the etiology of the syndrome is not completely understood yet, PCOS is considered a multifactorial disorder with various genetic, endocrine, and environmental abnormalities. PCOS often begins soon after the first menstrual period, as young as age 11 or 12. It can also develop in the 20s or 30s. The most well-known reason that causes PCOS is overproduced androgens by ovaries. Research also suggests that high insulin levels in the blood can result in the overproduction of testosterone.
Chances of Getting Pregnant With PCOS
Recent studies show in PCOS pregnancy is possible. Many women with PCOS got pregnant and gave birth to healthy babies readily by the right treatment and small changes in their lives. Changing lifestyle in a positive way, medication, and fertility treatments can increase the chance of getting pregnant with PCOS.
PCOS pregnancy is possible but you should work with a fertility specialist in reproductive medicine. If you have long menstrual cycles and ovulate irregularly, your doctor can prescribe medication to help you ovulate. Ovulating is the key to success when it comes to getting pregnant with PCOS.
Whether you have PCOS or not, every pregnancy carries risks. While the range risk for miscarriage or early pregnancy loss is about 10-15% if you have PCOS, the risk will be three times more. As we mentioned above women with PCOS syndrome do not ovulate regularly and therefore have irregular menstrual cycles. But the miscarriage is another case caused by pregnancy complications. Having PCOS is not directly but may indirectly be the reason for a miscarriage. Obesity, hyperinsulinemia, inappropriately raised LH and endometrial blood flow is common feature of PCOS. Having one or more of these features may cause miscarriage.
Trying to Get Pregnant with PCOS
While you are trying to get pregnant with PCOS one of the first suggested treatments for infertility is weight reduction.
If you’re overweight or obese and additionally you have PCOS, that means you have a higher risk of pregnancy complications. PCOS pregnancy may end with the risk of high blood pressure (hypertension), pre-eclampsia, gestational diabetes, and miscarriage.
Another risk of being overweight is that it decreases the chance of getting pregnant. To increase the chance of spontaneous ovulation and menstruation it is recommended to go on a healthy diet and start an exercise program to lose weight.
PCOS is favorable to most modern treatments. Studies prove that In vitro fertilization (IVF) is an effective therapy for PCOS patients and also, embryo transfer (ET) and frozen embryo transfer (FET) are effective alternatives in PCOS patients at high risk for severe OHSS.
Which Treatment Increases the Chance of Getting Pregnant with PCOS?
The main subject that needs to be focused on is to stimulate the development of one or more mature follicles by “induction of ovulation”. The treatments for PCOS pregnancy can be classified as;
Medication: Clomid, clomiphene citrate; Metformin; Clomid and metformin together; Femara, letrozole
Injections: Injectable gonadotropins
Procedures: IVF (In Vitro Fertilization)
The average success of medications monthly changes between %2-%15 due to ovulating or not and the medication treatment plan.
The average success of injections monthly is approximately %20.
In general, IVF success rates are excellent with the results %60 for a live birth rate with the women under age 35 having PCOS.