How PCOS Affects TTC

After struggling for years with irregular periods, painful, horrific cramps, and unexplainable weight gain, I was finally diagnosed with Polycystic Ovarian Syndrome (PCOS) in 2013. At first, it was enough to get those symptoms under control and to not have to call out sick from work whenever I would have my period. When my husband and I decided we wanted to have a baby, I started to worry about PCOS and my fertility since I heard that some women are infertile because of their PCOS. Should you see a fertility specialist if you have PCOS? Would I have a harder time getting pregnant, if I could get pregnant at all?

Thankfully, there’s hope for those of us with PCOS who really want to become pregnant. Dr. Peter Rizk, a fertility expert with Fairhaven Health, tells Romper, "80 percent of women with PCOS will conceive on their own, and of the remaining 20 percent, half of them will be able to conceive using fertility medications like Clomid or Femara. The other half tend to be resistant to Clomid and require the assistance of a fertility specialist and perhaps different fertility medications or fertility interventions."

So how many women have to consider these statistics? A good bit. Women’s health acupuncturist Kristen Burris, L.Ac, says in an email to Romper, "PCOS is the most common infertility diagnosis, affecting an estimated 15 to 20 percent of women who are of reproductive age, according to the National Institute of Health."

"It is estimated that nearly all women diagnosed with PCOS are able to have children eventually," she continues. "It’s not really a matter of if she will get pregnant, it’s how, and with what treatment, a woman with PCOS will conceive. Treatment options vary considerably, with strong evidence supporting that many women will regulate their menstrual cycles and begin ovulating on their own if they lose 5 to 10 percent of their current body weight."

So what's happening with fertility and the symptoms of PCOS? The weight gain has to do with insulin resistance, and Rizk notes there is a cluster of symptoms that women tend to have, although not all of the following symptoms need to be present to be diagnosed. "Tiny cysts on the ovaries, infrequent or irregular menstrual cycles (and infrequent ovulation), acne, an increase in facial hair, and thinning hair on their head … all of these symptoms are caused by hormonal imbalances, which stem from insulin insensitivity," Rizk says.

"Simply put, the cells of women with PCOS tend to not be receptive to insulin, which means that insulin cannot get into cells. High levels of circulating insulin leads to higher testosterone levels, which is believed to be the cause of many of the symptoms," he adds. "Specifically related to fertility, some women with PCOS have trouble getting pregnant because they ovulate infrequently and unpredictably."

If you have PCOS and have been trying to conceive (TTC), how long is long enough before you should seek help from a fertility specialist? Rizk says, "Typically, couples won't be referred to a fertility specialist until they have tried to get pregnant naturally with no success for a minimum of six months, and most often one year … however, if you know you have PCOS, it certainly doesn't hurt to consult with your healthcare provider even before you start [TTC] to be sure you are doing everything you can to increase your chances of conceiving."

Burris agrees and tells Romper that "the gold standard in the fertility world is if a woman is under 35 years old, she should try to conceive with her partner for one year, and if she is over 35, only try for six months prior to seeing a reproductive endocrinologist or an acupuncturist and herbalist whose expertise is infertility."

If you have been trying, what fertility treatments are available? Especially if, like me, you’re unable to afford (and don’t really want to try) IVF treatments? Rizk says there is a dietary supplement route. "Dietary supplements like OvaBoost or Myo-Inositol, and changes to your diet and exercise routines, can prove to be extremely beneficial in improving your fertility and chances of conceiving naturally," he says.

According to Burris, "Many studies support using acupuncture and herbal medicine as their first choice for fertility enhancing treatments. In fact, it’s been proven that women who receive acupuncture and herbal medicine are twice as likely to conceive in a third of the time compared to IVF and fertility drugs, and at a fraction of the cost, with a significant reduction in miscarriage." She suggests women seek the expertise "of both a fertility specialist who exclusively uses acupuncture and herbal medicine, and a traditional fertility specialist who uses drugs and surgical procedures for infertility, better known as a reproductive endocrinologist."

For 17 years, I had been struggling with my periods, unexplainable weight gain (even though I had a healthy diet), and weird hair growth. Finding the right OB-GYN who listened to me and didn’t dismiss my symptoms helped me immensely, because not knowing what was going on in my body was a horrible feeling.

It’s important to me that people know what PCOS is, and that women who do have it know they’re not alone — it’s not necessarily a nail in the coffin of TTC. In fact, people should be talking about infertility more often in general, because it happens to more women than you might think. Though my husband and I are still TTC, it’s comforting to know that you don’t necessarily have to see a fertility specialist after being diagnosed with PCOS, but it is a great option if you choose to go that route.