Pregnancy and PCOS - is it possible?

[Published September 2021] 

For women who suffer with PCOS, the most frequent question we are asked as Fertility Specialists is, ‘Can I still get pregnant?’, and the answer is YES! It is possible for women with PCOS to conceive but you may encounter some struggles when trying to start a family.

According to the World Health Organization (WHO), PCOS is the most common cause of anovulatory infertility, meaning that you don't ovulate, or release an egg to fertilise. Women with PCOS ​can​ get pregnant, but the odds of conception are lower because they tend to ovulate less.

What is PCOS?

PCOS, or Polycystic Ovarian Syndrome is a condition that occurs when a woman’s ovaries (one or both), contain 12 or more follicles (egg sacs) measuring 2-9 mm in diameter leading to hormone imbalances in the body which can result in the following symptoms:

• irregular periods or a complete absence of periods
• difficulty getting pregnant (because of irregular ovulation or failure to ovulate)
• excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
• weight gain
• thinning hair and hair loss from the head
• oily skin or acne
  
  

How does PCOS impact fertility?

In short, it’s all about hormones! PCOS changes the hormonal paths in the body which are responsible for producing, maturing and releasing the eggs and preparing the uterus for pregnancy.

The three most important reasons why becoming pregnant, or staying pregnant is more challenging for women with PCOS are: 

• Most women with PCOS often do not actually ovulate despite having very active ovaries
• Women with PCOS tend to have irregular periods rather than “reliable” cycles, which can also mean periods are non-existent or at the other end of the scale, very heavy.
• When (and if) an egg is released, the endometrium (lining of the uterus) may not be suitably prepared to sustain a successful implantation, or full-term pregnancy.
  
  

What are my next steps?

The good news is that many women diagnosed with PCOS have highly active ovaries, but they may just need support in the form of minor medical intervention, usually via special medication to help prepare their body for a healthy and sustainable pregnancy.

A fertility specialist can prescribe ovulation stimulants, such as Clomiphene citrate or FSH injections and will monitor your body’s response to their effectiveness. If you have been trying to get pregnant for more than a year, they can also advise whether it would be possible to consider a more intensive treatment such as IVF.

Would you like to speak to a specialist?

Dr Koita, our Fertility Consultant and Fellow of the Royal College of Gynaecologists is here to help and provide advice on how to proceed if you would like medical support to conceive. You can book a consultation with Dr Koita online from the comfort of your own home, at a time to suit you, to discuss your PCOS, cycle health and most appropriate pathway to success.