This article has been medically reviewed by Dr. Aimee Eyvazzadeh, host of the Egg Whisperer Show
When you’re trying to start a family, and it’s just not happening – month after month – some start to wonder: “Is there something wrong with me? Why is it so easy for everyone else?” The first thing to realize is that you aren’t the only one battling infertility right now - 10 percent of people with anatomically female bodies in the United States have difficulty getting or staying pregnant.
There are many things that can cause infertility – ranging from a simple timing issue, to a more complex medical diagnosis. Here we’re going to talk about one of the most common causes of infertility: PCOS.
What is PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 6 to 12 percent of people with ovaries in the US.
PCOS Signs and Symptoms
- PCOS often causes irregular, infrequent, or long-lasting menstrual periods. For example, if your period comes more than every 35 days, if you have less than nine periods each year, or if your periods are very heavy and last longer than one week.
- Those with PCOS may have a higher than normal level of androgens. If this is the case, you might notice more hair growing on your face and body, at the same time less hair is growing on your head, or hair is falling out in patches. Sometimes, you’ll also get acne breakouts.
- The cysts in PCOS are actually not cysts, they are tiny fluid-filled pockets in your ovaries.
- These PCOS signs and symptoms are typically more severe if you’re more than 100 pounds over a normal weight for your height.
PCOS and infertility
According to the National Institute of Health (NIH), 70 to 80 percent of those diagnosed with PCOS struggle with infertility. While not all people with PCOS have difficulty becoming pregnant, for those that do, the common cause is irregular ovulation.
Can I get pregnant with PCOS naturally?
The short answer is yes! PCOS can make it harder to get pregnant, but not impossible. The first thing to figure out is if you’re ovulating. If you are able to ovulate regularly, there’s no reason you can’t try to conceive on your own. If not, you’ll first want to get your ovulation started, or regulated, before trying to conceive. There’s a lot you can do on your own to improve your health, and PCOS symptoms- which might be all you need to get your ovulation back on track.
Tips for trying to conceive with PCOS
Making improvements to your diet, lifestyle and physical activity level can sometimes cause ovulation to regulate on its own. These changes may also increase your overall chances of getting pregnant, even if you end up needing the help of medications or fertility treatments later.
- Track Your Cycles: The only way to know if you have regular or irregular cycles is to track them. A normal menstrual cycle lasts 28 days, plus or minus seven days. If your cycle falls outside of this range, you don’t have a period, you have periods too frequently, or they last for eight days or more - you have an irregular cycle.
- Confirm Ovulation: In order to conceive, you need to time intercourse with ovulation. So it’s important to know if ovulation is occurring, and if so, how regularly. You can chart your basal body temperature or use an ovulation prediction kit .
- Work towards a healthy BMI: The ideal Body Mass Index (BMI) for fertility is 20-25. If your BMI is above 30, the good news is that as little as a 5-10 percent weight loss can significantly improve pregnancy rates. A BMI lower than 18 can also contribute to irregular ovulation. Tracking your BMI is fairly simple and can be done using a calculator like this: CDC.gov BMI calculator
- Improve Your Diet: Getting to that healthy BMI may mean changing up your grocery list. Your mindset shouldn’t be that you’re only doing this to improve chances at conception, or to maintain a healthy pregnancy – eating healthy is a long-term lifestyle change.
What to eat: lots of veggies and fruits, along with hormone-free meats and dairy, wild-caught fish, legumes, and 100% whole grains (unless you’re gluten-free). It’s great to add some antioxidant-rich fruits such as berries, folate-rich veggies like spinach, and unsaturated vegetable oils like olive and avocado. What not to eat: cut back on saturated fats, fried foods, excessive alcohol, caffeine, and sugary drinks.
- Drink lots of water throughout the day. Health experts say you drink between half your body weight, to two-thirds your body weight - in ounces of water each day. So, if you’re 140 pounds, you would try to drink between 70 and 85 ounces of water a day. This is a tough one for some, but the added benefits of upping your H20 - is feeling less hungry, and great skin!
- Fight your sugar addiction: High blood sugar can be damaging to egg quality and cause inflammation in the body, while also promoting insulin resistance - a common problem in people with PCOS. So, you should try to avoid food with a lot of added sugars, artificial sweeteners, and especially sugar-sweetened drinks like soda, sweetened teas, and sports drinks.
- Exercise: Move your body – at least 30 minutes a day. Make it fun – like having a dance party, going on long walks with your dog, taking bike rides, or exercise classes … whatever gets your heart rate up, and keeps you motivated. The more you do it, the easier it gets, and the better you will start to feel.
As you start to make healthy lifestyle changes, make notes of any positive changes or reductions in your PCOS symptoms that you experience. Keep in mind that if diet, weight loss, and lifestyle changes don’t regulate your ovulation, there are medications your doctor can prescribe to induce ovulation and regulate your hormone levels.
Early pregnancy symptoms with PCOS
Irregular periods are common when you have PCOS. That’s why it can be difficult knowing if a missed period is a symptom of early pregnancy, or PCOS. If you’re not sure when, or if you ovulated, it can also be a challenge knowing when to take a pregnancy test.
Beyond a missed period, other signs of early pregnancy include fatigue, nausea, and needing to urinate more than usual (which also happens when you’re drinking all that water). Other pregnancy symptoms are the same ones you might experience when your period is on its way – like sore breasts, and mood swings. That’s why it’s important to track your cycle, and confirm ovulation, before you start trying – otherwise it can be really hard to know where you are in the cycle.
If you think you might be pregnant, and you’re not sure if the pregnancy test results are right - your doctor can do a blood test to confirm. PCOS pregnancies can be high risk – so it’s good to start working with your OB/GYN as early as possible, to get a plan in place to manage any complications that may come up.
No matter your path, we are here to support you. Please always feel free to reach out if we can be of any help to you on your journey. We truly wish you the best!