Is PCOS Infertility?
August 17, 2022 | By Heather Frame, BSN, RN
Being diagnosed with polycystic ovary syndrome (PCOS) can feel overwhelming and leaves many women, up to 10% of women in their childbearing years or over 5 million women in the United States, wondering what this means for their fertility. Though 70% of women with PCOS do experience some difficulty conceiving, there are many options that make it possible – both naturally and with some medical assistance!
PCOS does not end your trying-to-conceive journey – it might just make the road a little bumpy at times.
How does PCOS make it harder to get pregnant?
The main cause of PCOS-related infertility is due to the absence of ovulation. If the ovaries do not release an egg, pregnancy is not possible.
Women with PCOS typically have longer, irregular cycles making it difficult to know when they’re ovulating which makes achieving pregnancy difficult.
In many cases, insulin resistance is the root cause of PCOS, meaning the body cannot efficiently regulate blood sugar levels. These high levels of insulin can also contribute to higher levels of male hormones called androgens. Consistent blood sugar elevation can alter reproductive hormonal cycling which may cause irregular ovulation.
Around 60% of women who carry this diagnosis are overweight or obese, a significantly higher than average BMI has been shown to negatively impact fertility.
How to get pregnant naturally with PCOS
Though a natural approach may not work for every woman, the following information will prove beneficial no matter the circumstance.
- Follow a healthy diet
- 90 minutes of physical exercise weekly
- Good sleep hygiene
- Limit caffeine and alcohol
- Refrain from smoking or using drugs
- Track and confirm ovulation
- Check basal body temperature (BBT)
Vitamins and supplements
Being overweight or obese can intensify some symptoms of PCOS making it even more difficult to conceive. Weight loss, following a healthy diet, and physical exercise can not only make you feel better, but can improve insulin sensitivity, hormone regulation, and fertility!
Other lifestyle modifications include getting enough sleep, limiting alcohol and caffeine, and refraining from smoking or using drugs.
Why BBT, Cervical Mucus & Ovulation tracking is important
Tracking ovulation through the means of ovulation predictor kits (OPKs) and cervical mucus is helpful through long, irregular cycles. Ovulation tests detect luteinizing hormone (LH) levels in the urine. LH surges right before ovulation, so by testing daily you can see when you will most likely ovulate. Women with PCOS typically have elevated levels of LH at baseline, so fluctuations are not uncommon.
Cervical mucus tends to become more thin, clear, and stretchy (like raw egg whites) near ovulation making it the perfect consistency for sperm and is another indicator of fertility to observe while trying to conceive with PCOS.
Charting your BBT (basal body temperature) daily, in addition to LH testing, is so important for women with PCOS because it can confirm ovulation. To efficiently track BBT, you need a basal body temperature thermometer. After sleeping for at least 3 consecutive hours, check your temperature immediately upon waking before getting out of bed. Try to check at the same time each day to ensure accuracy and look for the spike in temperature that should occur after ovulation.
Take some of the guesswork out of charting by logging your ovulation symptoms, ovulation strips, and BBT into your Premom app! It uses all of the information about your cycle to pinpoint your most fertile window in hopes of helping you achieve pregnancy faster.
Supplements PCOS women can take for ttc
Prenatal vitamins are great to begin taking when trying to conceive. Be cautious with sugary gummy vitamins as they can affect insulin levels. Don’t hesitate to talk with your doctor about which prenatal may be best for you.
One particular supplement, myo-inositol, has been studied at length in women with PCOS. It has shown to improve ovarian function and egg quality. This promising supplement is definitely something to chat with your doctor about and works best when used over a long period of time in association with dietary changes.
When and how to seek medical treatments for PCOS
Difficulty losing weight with PCOS? Unable to find your ovulation day or get a positive LH test? Have you had success with these things but still haven’t been able to conceive within 6 months? It’s time to reach out to your doctor!
Typical first-line treatments include oral medications to induce ovulation, such as Clomid and Letrozole. They are prescribed to be taken at the beginning of a new cycle to stimulate ovulation. Not uncommonly, it may have been months since a woman with PCOS has had a period– a synthetic form of progesterone called Provera can be prescribed to induce a period for a fresh start.
Metformin is commonly prescribed to increase the body’s sensitivity to insulin. With decreased levels of insulin in the body, the goal is that hormones can be regulated to restart ovulation. Metformin can also help diminish some pesky side effects of PCOS such as acne, headaches, hair thinning and can even commonly assist with weight loss.
Gonadotropins are hormonal injections that are often prescribed if other methods are not successful at inducing ovulation. They can be self-administered at home, but require frequent monitoring of blood work and ultrasounds in the doctor’s office.
Living with PCOS
A PCOS diagnosis does not define you or your fertility. It can cause difficulty conceiving, but this does not mean you are infertile. PCOS doesn’t have to feel like a burden – it gives you a chance to learn about your body, your fertility, and how to lead a healthy lifestyle. By focusing on the root cause of PCOS, you can improve your overall health which simultaneously improves your fertility.
If you are struggling mentally with your diagnosis, please reach out to your doctor. There are also some amazing support groups just for PCOS due to its commonality. Our medical team is also available for virtual consultations if you would like to learn more about tracking your fertility with PCOS, you are not alone on this journey!
Heather Frame is a compassionate Women's Health nurse. She specializes in obstetrics, postpartum, newborn care, and lactation counseling. She is committed to providing women the support they need to achieve pregnancy and thereafter. As a personal user of Premom, she can attest to how important charting your cycles is in conjunction with achieving pregnancy. She would love to help you navigate your fertility journey. Schedule a consultation with Nurse Heather right through your Premom app!
Polycystic ovary syndrome and infertility: an update (degruyter.com)
PCOS (Polycystic Ovary Syndrome) and Diabetes | CDC
How to manage weight loss in women with obesity and PCOS seeking fertility? - Hazlehurst - 2022 - Clinical Endocrinology - Wiley Online Library