PCOS is the most common cause of infertility among women, due to the absence of ovulation. Most women don’t find out they have PCOS until they try to become pregnant and are unsuccessful. Research has shown, however, that the symptoms of PCOS begin to appear before a girl has her first menstrual period.
What is Infertility?
The American Society for Reproductive Medicine defines infertility as the inability of a woman younger than age 30 to get pregnant after 12 months of having unprotected intercourse; the inability of a woman older than age 30 to get pregnant after 6 months of having unprotected intercourse; or the inability to carry a pregnancy to delivery. Most women with infertility related to PCOS can be treated and do become pregnant. However, some women with infertility related to PCOS will not respond to treatment and don’t become pregnant
Women with PCOS who do get pregnant are at higher risk for pregnancy complications.
Treatment Options for Women with PCOS Who Want to Have a Baby
When I was diagnosed with PCOS, I was told that in my particular case, getting pregnant would be a very difficult process. The chances of me getting pregnant without help from fertility treatments will be highly unlikely. This is the case for many women like me who have PCOS, but there are some who are able to conceive on their own. Lifestyle changes, such as losing weight, can trigger body changes that improve pregnancy rates. For many women with PCOS who want to get pregnant, health care providers will recommend weight loss and other lifestyle changes before adding medications to see if fertility returns and pregnancy occurs naturally. In one study, lifestyle changes alone restored ovulation and improved pregnancy rates. Here are some of the most common medications physicians use to improve fertility in women with PCOS:
- Clomiphene (clomid): the most common treatment for infertility in women with PCOS. Women who received this treatment were six times more likely to get pregnant than women who didn’t get the treatment. Women treated with clomiphene were also more likely to have multiple pregnancies (twins, triplets, etc.).
- Metformin: an insulin-sensitizing drug currently used to treat diabetes has proven to be successful in treatment of infertility associated with PCOS. The treatment successfully restarted ovulation in significantly higher numbers of women with PCOS than among those who didn’t get the treatment.
- Gonadotropins: a category of hormones used to treat infertility in women with PCOS who do not respond to metformin or clomid. Low-dosage treatments have a high success rate and show fewer associated problems.
- Women with PCOS can also try other forms of assistive reproductive technology, such as egg donation and in vitro fertilization.
A surgical procedure—called ovarian drilling—was sometimes used in the past to start regular ovulation or to increase the likelihood of pregnancy. However, it is not clear that such a procedure is actually more successful than medication for treating infertility in women with PCOS.
Pregnancy Complications in Women with PCOS
- Miscarriage or early pregnancy loss
- Gestational diabetes
- Pre-eclampsia (sudden increase in blood pressure after 20 weeks)
- Pregnancy-induced hypertension
- Pre-term birth
- Cesarean delivery
For more information on infertility, pregnancy and PCOS, please visit the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)