How to Get Pregnant With Polycystic Ovary Syndrome (PCOS)

Before You Conceive

Reduce your circulating insulin levels with lifestyle changes. Eat healthfully and get regular exercise to help your body decrease circulating insulin levels. PCOS can result when your body develops an increased resistance to insulin, which effectively suppresses ovulation. Vitamin D supplementation as well as some medications may also help you get your hormones and insulin levels in balance for easier conception. Consult your doctor to see if this makes sense for you. Talk to your doctor about taking a prenatal vitamin that includes at least 400-800 micrograms of folate.

Notify your obstetrician when you are ready to start trying to conceive. Many people with PCOS will need help regulating their ovulation and protecting against miscarriage, which requires supervision of a trained doctor. Your doctor will help you with this, as well as monitor you early in your pregnancy. Medications you are taking to manage your PCOS may not be safe for use in pregnancy, and they will need to be changed or discontinued. This is another excellent reason to see your doctor right away.

Establish how frequently you get your period. PCOS causes many people to have infrequent periods. Infrequent periods mean infrequent ovulation, which means lower chances of sperm fertilizing an egg. Chart your period, using an over-the-counter ovulation test or basal body temperature thermometer to make note of the days you ovulate. If you are ovulating regularly, try to time intercourse to occur on your most fertile days. If you are not ovulating, or your ovulation is irregular, your basal body temperatures and ovulation predictor results are erratic, or you have not conceived after 6 months of regular ovulation, schedule an appointment with your obstetrician. Explain your concern and ask for a referral to a reproductive endocrinologist.

Consult your endocrinologist about regulating your monthly periods. The biggest problem those with PCOS face is irregular ovulation. If you're not ovulating when you think you're ovulating, or you're not ovulating at all, getting pregnant is going to be a Sisyphean task. Luckily, doctors — and the magic of science — can help. Many doctor prescribe drugs like Metformin and Clomid to help produce regular periods and regulate ovulation, respectively. Metformin is primarily a drug used to treat diabetes, but is used for those with PCOS because they often have difficulty absorbing insulin. High insulin levels produce high androgen levels, which complicates periods. Clomid is an infertility drug that stimulates the production of hormones that cause ovulation. If you're having trouble getting a period at all, your doctor might suggest a drug like Provera.

Talk to your doctor about in-vitro fertilization if a non-invasive drug regimen doesn't produce a pregnancy. Some patients with PCOS use in-vitro fertilization to conceive when other methods do not offer results. In some rare cases, PCOS affects the quality of the person's eggs and donor eggs must be used.

Explore other options if none of the other regimens work. A surgical procedure called laparoscopic ovarian drilling has shown promise and may help some people with PCOS conceive. It involves a surgeon inserting a camera through a small incision in your abdomen and using it to identify follicles on the surface of your ovaries and burn holes in them. This alters your hormone levels and may allow you to conceive naturally.

After You Conceive

Address the possibility of miscarriage with your doctor. Expecting mothers with PCOS are about three times as likely to miscarry than expecting mothers without PCOS. Many doctors will recommend continuing to take metformin throughout the pregnancy in order to lower the likelihood of miscarriage.

Talk with your obstetrician about getting regular exercise. Many doctors will stress the importance of consistent light exercise for expecting mothers with PCOS. Exercising will improve the body's use of insulin, normalize hormone levels, and keep your weight in check. In fact, regular exercise is often recommended for those who are trying to conceive, as this improves their chances of regular ovulation. Talk with your doctor about which exercises are allowed and which ones you may want to stay away from. Walking and light strength training are often ideal for expecting mothers.

Eat a balanced diet high in protein and green vegetables, and low in simple carbohydrates. Because PCOS limits your body's ability to regulate insulin, you may need to be as vigilant about what you eat as a person with diabetes is. A diet high in protein and fiber can help lower your insulin levels, which mitigates the impact PCOS has on your body. Avoid overly processed foods or foods with added sugar.

Be especially vigilant throughout your pregnancy. Unfortunately, PCOS carries with it several other risks even after you've managed to conceive. Talk with your doctor about protecting again pregnancy-induced high blood pressure, preeclampsia, and gestational diabetes, which are all more common for those with PCOS. Keep your pregnancy healthy by seeking out good prenatal care, such as regular doctor’s visits, good blood glucose management, and a daily prenatal vitamin. Understand that those with PCOS often deliver their babies by Cesarean section. C-section is more common for expecting mothers with PCOS because complications more often arise.