PCOS and Pregnancy: Can You Get Pregnant With PCOS?

If you have polycystic ovary syndrome (PCOS) and are trying to conceive, you may have heard that the condition is linked to infertility. But while PCOS might make it trickier to get pregnant, thankfully there are treatment options that can help. Read ahead for advice on how to get pregnant with PCOS and more frequently asked questions about PCOS and pregnancy.

What Is PCOS?

Polycystic ovary syndrome (PCOS) is a health condition caused by an imbalance of reproductive hormones that affects about one in 10 women of childbearing age, according to the US Department of Health and Human Services (HHS). PCOS can cause irregular periods, which can lead to infertility and development of cysts in the ovaries. Most women find out they have the condition in their 20s or 30s, when they experience difficulty getting pregnant, but it can occur anytime after puberty.

Can You Get Pregnant with PCOS?

The short answer is yes—but it could be more difficult due to lack of regular ovulation. “Successful ovulation is required in order to get pregnant,” explains Lindsay Drew, MD, MS, an ob-gyn at Dartmouth Hitchcock Clinics Specialty Care in Bedford, New Hampshire. “Achieving pregnancy is also more successful when intercourse can be timed properly around ovulation, so it can be hard for patients with PCOS to figure out this timing with unpredictable cycle length.”

With PCOS, the ovaries produce an excess of androgens (aka male hormones), which “stimulates many small [ovarian] follicles to grow and prevents normal maturation of one dominant follicle that will go on to release its egg during ovulation,” says Drew. This is why you may not ovulate or get your period during some menstrual cycles.

What are the chances of pregnancy with PCOS?

“Pregnancy rates vary tremendously in PCOS and depend on the clinical presentation of the syndrome and its severity,” says Alexis P. Melnick, MD, a reproductive endocrinologist at NewYork-Presbyterian/Weill Cornell Medicine in New York City. Research estimates that about 70 to 80 percent of women with PCOS struggle with infertility.

PCOS pregnancy rate—aka your chance of conceiving—depends on several factors, notes Julianne Lauring, MD, an ob-gyn and maternal-fetal medicine expert at NewYork-Presbyterian/Weill Cornell Medicine. “No two individuals with PCOS are identical,” she says. “How PCOS impacts pregnancy will depend on how PCOS is expressed in your body combined with your age, your weight, your chronic health conditions [and more].”

How to Get Pregnant with PCOS

Getting pregnant with PCOS is challenging, but entirely possible. Because of the increased risk of infertility with PCOS, Drew recommends working with a specialist in reproductive endocrinology and infertility as soon as you decide you want to get pregnant. The following options can also help your chances of conceiving, according to HHS:

• Ovulation-stimulating medicine. Your doctor may prescribe the oral medications clomiphene or letrozole to help induce ovulation, says Drew. (Letrozole has been associated with higher rates of ovulation and live birth, Drew adds.) If these don’t work, your provider may put you on gonadotropins, which are injectable hormones that directly stimulate the ovaries, says Melnick. Research suggests that about 70 percent of women with PCOS who use ovulation-stimulating medications eventually have a baby. Melnick notes that all of these medications lead to a higher possibility of having twins or multiples.
• Losing weight. People with PCOS are predisposed to weight gain, as well as diabetes and unhealthy cholesterol, says HHS. “Even losing a small percentage of body weight can help to restore normal ovulation in many patients and can also greatly reduce incidence of insulin resistance, diabetes and hypertension, all of which can have major effects in pregnancy,” says Melnick.
• In vitro fertilization (IVF). Your doctor may recommend IVF if medication doesn’t work, says HHS. With IVF, you can also better minimize your risk of having twins or multiples, if you wish to do so, says Melnick.
• Surgery. If other options don’t work, your doctor might suggest a surgery called ovarian drilling, which can temporarily restore ovulation, according to HHS.

PCOS Pregnancy Risks for Mom and Baby

PCOS can increase the risk for several pregnancy complications, including gestational diabetes, miscarriage and preeclampsia, says HHS. It can also increase the chances of having a c-section. Research says that an estimated 40 to 50 percent of pregnant people with PCOS have gestational diabetes.

It’s important to be aware that PCOS also increases the risk of mood disorders, including postpartum depression, Drew says. If you think you might have symptoms of anxiety or depression, make sure to speak with your provider. “If negative alterations in mood are noticed, it’s important to address them proactively, as pregnancy and postpartum periods are very emotionally vulnerable times for patients which can take a toll on stress, anxiety and depression,” says Drew.

If you work with a specialist, you’ll be more likely to overcome the challenges PCOS can bring. “While there may be increased chances of complications, the majority of people will have a healthy and successful pregnancy despite living with PCOS,” says Lauring.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.