If you've ever tried to conceive, you've probably experienced your share of anticipation, frustration, and disappointment. In short, the entire process can really mess with your mind. For people with Polycystic Ovary Syndrome (PCOS), however, the process of getting pregnant can be even more intense, involved, and heartbreaking. It's natural to wonder if you can get pregnant with PCOS, and what exactly it will take for you to conceive.
The answer, according to the American College of Obstetricians and Gynecology (ACOG), is a solid "maybe," and treatments are not one-size-fits-all. While PCOS is the main cause of infertility in people with uteruses, the condition is not fully understood. The American Society for Reproductive Medicine explains that it's associated with an overproduction of male hormones, resulting in symptoms like acne, excess body hair, suppressed ovulation, and fluid filled sacs in your ovaries. And according to the PCOS Awareness Association, PCOS can interfere with other hormones, too, like insulin, causing weight gain and an increase in male hormones, and progesterone, which can cause irregular periods. Essentially, people with PCOS can experience an endless, self-perpetuating cycle of irregular periods, ovulation issues, infertility, and difficulty staying pregnant, along with other symptoms.
Worse, while PCOS impacts over 10 million people, medical science hasn't produced any effective treatments for it. While hormonal birth control can be effective, that doesn't really help if you are trying to conceive. And since ACOG reports that over 80 percent of people with PCOS are obese, health care providers often recommend weight loss as the first line of treatment, which might help but is easier said than done. According to Mayo Clinic, PCOS treatment options for people who are trying to conceive include progesterone to help you ovulate, medications for insulin resistance like Metformin, and fertility medications like Clomiphene (Brand name: Clomid), Letrozole (Brand: Femara), and Gonadotropins.
While it seems like the deck is stacked against people with PCOS who hope to get pregnant, with the right treatment many are able to conceive. Others rely on reproductive technology like intrauterine insemination (IUI) or in vitro fertilization (IVF) to get pregnant. Romper spoke with six moms with PCOS to find out about what trying to conceive with PCOS is like. Here are their stories:
"I didn't get my period and went to the doctor to find out what was going on. I was diagnosed after I was transferred to a reproductive endocrinologist. We did six rounds of IUI, unsuccessfully, followed by IVF, which lead to one miscarriage, followed (at last), by two live births through frozen embryo transfer.
I bleed on and off most of the month, or I go months without bleeding at all. It makes trying 'naturally' almost impossible, even if I do manage to ovulate, because timing my cycle can't be relied upon. I was told I would never conceive on my own (we had some other fertility troubles as well), but then I had a surprise pregnancy with my third and last child."
"I suspected I had PCOS from age 23 to 26 when I wasn’t getting pregnant, but I wasn’t diagnosed until we saw a fertility specialist when I was 26.
I conceived in 2014 when I was 27. We did three rounds of Femara and the ovulation trigger shot. Then I did a fourth round, and they added Follistim injections. (I also rubbed the fertility statue in Orlando at Ripley’s Believe It or Not). I was also not eating carbs at that time, and I think it was the perfect storm.
I got pregnant with quintuplets. It was irresponsible, but my health insurance was about to run out and my doctor thought he was doing me a favor."
"I was only diagnosed with PCOS in the last six years. I told the first doctor I went to that I thought I had PCOS, but she said I didn’t because I didn’t currently have any cysts.
The next doctor I went to saw cysts and ran blood work, but wanted to treat my insulin resistance first and didn’t believe in prescribing fertility medications. It took me two years to conceive on Metformin. My newest doctor who I adore treated the insulin resistance and prescribed Clomid on top of the Metformin. It only took one cycle to conceive."
"I was diagnosed with PCOS a year ago — finally. We had difficulty getting pregnant three years ago and my doctor dismissed PCOS for me because I don’t check all of the boxes. If my doctor would’ve done a scan of my ovaries they would’ve seen the cysts. I complained about painful periods and other issues for a long time to my gynecologist, only to be blown off.
We did end up conceiving our first child after 14 months, I feel very lucky now. When we were ready to try for our second child, I started seeing a fertility specialist on my own without referral. I finally felt my concerns were being heard, got the diagnosis of PCOS, and began an appropriate plan to conceive again. After seven rounds of fertility medications and IUI, we are pregnant with twins."
"I was diagnosed with PCOS at 16 after a rather dramatic year of significantly irregular periods. I was told then by my male family doctor that I may never be able to have children. I started hormonal birth control, which I ended up taking in one version or another for my entire adult life. I stopped at 33, though, because I wanted to get pregnant. About seven months went by and I didn’t get a period.
I went to my general practitioner, who suggested that I see a fertility specialist. She started by having me make some lifestyle changes — moderate my exercise, give up caffeine and alcohol, shoot for eight hours of sleep, and meditate. After four months of no caffeine, she wrote me a script for progesterone to bring on a period. We set up an appointment for two months later to get me started with Clomid. I got pregnant with my daughter the first time I ovulated after starting the progesterone. She said that this actually happens a lot."
"I was diagnosed with PCOS in 2012. I did three rounds of Clomid with my OB-GYN that were unsuccessful. In 2013 we started seeing a reproductive endocrinologist. I did another three rounds of Clomid, and one round of Clomid and an ovulation trigger shot. Nothing worked. In November of 2014 I ended up pregnant 'naturally,' but I lost my baby at eight-weeks gestation.
I took a break from assisted trying. In December of 2016, I started seeing a new OB-GYN who put me on Femara. The first round was unsuccessful, but the second round worked. I had an uncomplicated pregnancy and our daughter is now a happy, healthy 8-month-old. It was over six years from starting TTC to the birth of our daughter start to finish."