Getting Pregnant with PCOS: Understanding Fertility Issues
Approximately one in seven couples struggle with infertility in the UKi. However, women with PCOS are more likely to experience problems falling pregnant, with research suggesting between 70 and 80 per cent of cases are affected by fertility issuesii. According to the NHS, many women only discover they have PCOS as a result of trying to conceive but failingiii.
Verity, the UK PCOS Charity, reported that one in five women is currently living with PCOSiv. Though symptoms tend to vary from woman to woman, excess facial and body hair, weight gain, acne, irregular periods and infertility can make PCOS a physically and emotionally demanding condition to live with.
PCOS and fertility
PCOS is one of the most common triggers of female infertility. Generally, infertility is rooted in a lack of regular ovulation, which causes irregular, infrequent and absent menstrual cycles. Irregular ovulation is known to affect seven in 10 women with PCOSv. Find out more about the different ways PCOS can cause ovulation problems here.
Many women with PCOS manage to get pregnant using a combination of fertility treatment and lifestyle changes. If you want to refrain from going down the medical path just yet, fine-tuning your lifestyle is something you can do right now to boost your chances of conceiving naturally.
Here are some of the measures you can take to support your overall wellbeing and fertility if you have PCOS.
Getting pregnant with PCOS
Manage your weight
Since PCOS leads to higher concentrations of oestrogen in the body – which causes fat to cling in stubborn places – studies report a greater prevalence of overweight and obesity amongst women with PCOSvi. If you’re affected, losing weight could help rebalance your hormones and restore regular monthly ovulation. Remarkably, empirical evidence purports losing weight can recover ovulation within a matter of weeksvii.
Although PCOS is known to make weight loss notoriously difficult, losing even a small amount could deliver huge benefits for your fertility. According to some experts, shedding just five per cent of your body weight is enough to aid ovulationviii.
Crucially, maintaining a healthy weight during conception and pregnancy can also promote a healthier pregnancy. Indeed, obesity has been linked to higher miscarriage rates, as well as an increased risk of developing pregnancy problems, such as gestational diabetes and pre-eclampsia (high blood pressure in pregnancy)ix.
It’s worth noting that overweight and obese women may have less success with fertility treatments, like IVF, toox. Learn more about how to lose weight with PCOS and maintain your motivation here.
Because PCOS can affect your ability to achieve restorative sleep, finding the energy to exercise may be the last thing on your mind. But being physically active can have an extremely positive effect on your cycle – not to mention it may also help with weight loss. Studies have found moderate-intensity exercise may improve ovulation and reduce insulin resistance – another symptom of PCOSxi.
Notably, the type of exercise you perform isn’t important. The main point to stress is to avoid exercising too frequently or too intensely, as both could compromise your fertility. Try to find an activity you enjoy. That way, you’ll be motivated to stick to it. Exercising doesn’t have to be a sport, either. It can be anything that gets your heart pumping and leaves you slightly out of breath – dancing, gardening or washing the car, for instance.
However, it’s also important to note you shouldn’t overdo it in the gym, either. In particular, be careful of performing too much cardiovascular activity. High intensity exercise, like spin or aerobics, may lead to a surge in stress hormones in the body. Stress hormones are secreted by the adrenal glands – responsible for the production of 20-30 per cent of your androgenic hormones. Androgens – testosterone, for instance – cause many of the PCOS symptoms, such as hair growth, acne, and ovulation issues. Aim to move moderately most days of the week.
Finally, physical activity releases ‘feel-good’ hormones called endorphins. This floods the brain with a euphoric rush and is a powerful weapon for fighting stress. Supporting your emotional health is another vitally important component of managing PCOS, especially if you’re trying to conceive.
There’s no doubt that everyone can benefit from eating a healthy, balanced diet that packs in at least five portions of fruit a vegetables a day. But eating healthily is even more of a priority for women with PCOS. Following a nourishing diet is a simple yet effective measure to manage insulin resistance, which is another common symptom of the condition.
Insulin resistance occurs when the body fails to respond to insulin normally, prompting the pancreas to pump out higher levels of insulin to compensate. Keeping your insulin levels balanced and healthy could prove useful for your fertility since higher amounts of insulin may lead to ovulation problems.
A diet abundant in foods with a low glycaemic index (GI), for instance, may improve the body’s utilisation of insulin. The GI system rates carbohydrates on a scale of 0 - 100 based on how quickly and how much they raise your blood glucose levels after eating. Low-GI foods – which have a rating of 55 or lower – are digested more slowly, so your blood glucose level rises gradually. As a result, your pancreas doesn’t have to produce as much insulin as when you eat foods with a high GI.
Oats, whole grain bread, sweet potatoes, quinoa, and brown rice are just some examples of nourishing low GI foods.
Track your cycle
Having unprotected sex around the time of ovulation will increase your chances of getting pregnant. If your cycle is regular, you can calculate when you’re likely to ovulate; ovulation usually happens around 10-16 days before your period starts. You can use a period tracking App to note your fertile window.
But what if your cycle isn’t regular? It’s not uncommon to experience period issues if you have PCOS. You may have infrequent periods or, plausibly, no periods at all. Tracking your cycle can help you to figure out when you’re ovulating if you’re having periods – however infrequently. Unfortunately, this strategy won’t work if you aren’t bleeding at all.
One helpful way to track ovulation is by taking your body temperature on a daily basis; your body temperature will be higher when you’re ovulating. Take your temperature using an oral thermometer at the same time every morning, before you get out of bed, and write it down. After taking your temperature for a while you should start to notice a pattern. For instance, your temperature may lower a little just before ovulation, then rise slightly higher than your normal temperature during ovulation and stay higher for much of the second half of your cycle. The rise can be sudden or gradual.
For more holistic ways to improve your fertility with PCOS, read our tips for natural conception. To find out more about tracking your cycle, speak to your GP.
Boost your emotional wellbeing
Many women find PCOS stressful, which is often amplified by the pressures of trying to conceive. But the more stress you experience, the more severe your PCOS symptoms can become, perpetuating a negative feedback loop. Long-term stress can also affect your hormone balance and even trigger an increase in insulin production, with one study proposing chronic stress may contribute to the development of insulin resistancexii.
The take-home message is to try to carve out some ‘you-time’ every day. Of course, there’s no single way to de-stress and unwind. It’s important to establish what works for you: spend more time on hobbies or activities you enjoy; listen to soothing music; practice regular meditation; go for a lunch-time walk; simply take a relaxing bath at the end of a busy day. Be mindful that relaxing doesn’t always mean being slow and sedentary. It can be an active endeavour, too. Some people find exercise restful.
The subject of fertility is always a sensitive one. And remember, every woman is different. What may work for someone else, may not chime with you. Before embarking on a new exercise regime or dietary plan, we highly recommend speaking to your GP for bespoke advice. For more information on improving your fertility and managing your PCOS symptoms, explore the rest of our resources on our hub.
NHS Choices: Infertility. Available online: https://www.nhs.uk/conditions/infertility/
Melo, A.S., Ferriani, R.A., Navarro, P.A. Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics. (Sao Paulo). (2015). ;70(11): 765–769. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642490
NHS. HPolycystic ovary syndrome - Symptoms. (2020). Available online: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms
Verity. Homepage statistic. Date accessed 13/07/2018. Available online: https://www.verity-pcos.org.uk
Harding, D. Polycystic Ovary Syndrome. Symptoms and treatment. Obes Manag. (2020). Available online: https://patient.info/womens-health/polycystic-ovary-syndrome-leaflet
Limm, S.S., et al. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. (2012). ;18(6): 618–637.
Kiddy, D.S., et al. Diet-induced changes in sex hormone binding globulin and free testosterone in women with normal or polycystic ovaries: correlation with serum insulin and insulin-like growth factor-I. Clin Endocrinol (Oxf). (1998). ;31(6):757-63.
Pasquali, R., et al. Clinical and hormonal characteristics of obese amenorrheic hyperandrogenic women before and after weight loss. J Clin Endocrinol Metab. (1989 Jan). ;68(1):173-9.
Stubert, J., et al. The Risks Associated With Obesity in Pregnancy. Deutsches Arzteblatt international. (2018). ;115(16), 276–283
Clark, A.M., et al. Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women. Hum Reprod. (1995). ;10(10):2705-12.
Clark, A.M., et al. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Hum Reprod. (1998 Jun). ;13(6):1502-5.
Yan, Y.X., et al. Investigation of the Relationship Between Chronic Stress and Insulin Resistance in a Chinese Population. J Epidemiole. (2016). ;26(7): 355–360.
Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.