Polycystic ovary syndrome (PCOS) is a hormonal disorder that has no cure and affects millions of women around the world. The World Health Organization estimates that PCOS affects up to 13% of women of reproductive age.

Interestingly, the Centers for Disease Control and Prevention (CDC) reports that approximately 13% of women in the United States between the ages of 15-49 experience infertility, and there’s no question that PCOS is a leading cause of fertility issues.

With trusted OB/GYNs, endocrinologists, and fertility specialists in our network, TopLine MD Alliance can connect you with expert PCOS care and help you take control of your reproductive health and fertility.

Keep reading to learn the symptoms of PCOS, how PCOS impacts ovulation and fertility, and what PCOS treatment options are available. We’ll also share the best strategies for getting pregnant with PCOS, pregnancy risks associated with PCOS, and more.

The PCOS paradox

The cause of PCOS remains unknown, although it may be related to various factors working together:

  • Insulin resistance – When your body does not respond to the effects of insulin, the level of glucose in your blood increases.
  • High levels of androgens – All women produce androgens (male hormones). But if your androgen levels are too high, your ovaries may not be able to release eggs for fertilization. High androgen levels also cause the unwanted hair growth and acne experienced by many women with PCOS.
  • Irregular menstrual cycle – Irregular periods often lead to unpredictable ovulation, making it more difficult to get pregnant.
  • Cysts on ovaries – Some women develop small fluid-filled cysts with immature eggs on their ovaries after ovulation stops. These cysts are known to affect fertility.

There is no specific test for PCOS, so many women remain undiagnosed until they try to get pregnant. Unfortunately, between 70-80% of women with PCOS have fertility issues.

PCOS usually starts during adolescence, as early as your first menstrual period. However, the symptoms vary widely and often fluctuate over time, leaving many women unaware they have PCOS until they seek professional medical help.

Symptoms of PCOS

Some of the most common symptoms of PCOS include:

  • Intermittent, unpredictable, or absent periods
  • Heavy or prolonged menstrual bleeding
  • Acne
  • Oily skin
  • Excessive hair on your face or body
  • Thinning hair on your head
  • Baldness
  • Weight gain, especially around your belly
  • Enlarged ovaries

If you have (or recently had) any of these symptoms and are experiencing fertility struggles, find a TopLine MD Alliance affiliated provider today.

Other health conditions

Women with undiagnosed PCOS are also more likely to have other health conditions, such as:

  • Type 2 diabetes
  • Hypertension (high blood pressure)
  • High cholesterol
  • Heart disease
  • Endometrial cancer
  • Obesity

The sooner you find out if you have PCOS, the less risk you have of developing these potentially long-term health complications.

PCOS treatment options to improve fertility

Early diagnosis and treatment can help manage your PCOS symptoms, but what about your ability to get pregnant?

There are many fertility-friendly PCOS treatment options available, starting with medications. To help you ovulate so you can become pregnant, your TopLine MD Alliance affiliated provider may recommend:

  • Clomiphene – An oral anti-estrogen medication taken during the first part of your menstrual cycle
  • Letrozole – A breast cancer treatment that stimulates the ovaries
  • Metformin – A diabetes medication that improves insulin resistance and lowers insulin levels
  • Gonadotrophins – Hormone medications given by injection to stimulate the ovaries

Surgical options may include:

  • Laparoscopic ovarian drilling – A procedure that creates small holes in the ovaries to improve ovulation
  • In vitro fertilization (IVF) – A procedure where eggs are surgically retrieved, fertilized with sperm in a laboratory, and transferred back to the uterus

Lifestyle changes

Some PCOS treatment options don’t involve medications or surgical procedures. Making healthy lifestyle changes can dramatically increase the effectiveness of your PCOS medications, reduce your PCOS symptoms, and improve your fertility.

Weight loss

If you are overweight, losing even a small amount of body weight (5%) may help regulate your menstrual cycle. Weight loss has also been found to lower insulin levels, improve cholesterol levels, and even relieve symptoms like excess hair growth and acne.

Diet

The best diet for PCOS includes small, healthy meals throughout the day. Incorporate foods that contain more protein and fiber, which help slow the release of glucose into your bloodstream. Whole grains, lean proteins, leafy/non-starchy vegetables, and fiber-rich fruits are excellent options.

Exercise

Regular exercise helps with weight loss and can improve insulin sensitivity, which is often an issue for women with PCOS. Aim for at least 150 minutes of moderate-intensity activity each week, such as brisk walking, jogging, cycling, or swimming.

PCOS and belly fat

It’s especially frustrating for a woman struggling with fertility to look pregnant when she isn’t. Unfortunately, PCOS often leads to higher fat deposits in the abdominal area – a condition sometimes referred to as “PCOS belly.”

Belly fat caused by PCOS doesn’t usually look like other weight gain. Many women with PCOS report having a large, bloated stomach while the rest of their body stays the same.

Several factors likely play a role in PCOS-related belly fat, including elevated androgen (male hormone) levels, insulin resistance, inflammation, metabolism issues, and genetics. But how can you get rid of it?

The same diet changes above can also help you target belly fat. Eat foods that are high in protein and fiber, such as whole grains and lean proteins, and avoid foods that are processed or packaged. Anti-inflammatory foods (such as nuts, berries, and leafy vegetables) can also help reduce PCOS symptoms, including belly fat.

Other strategies for getting pregnant with PCOS

In addition to weight loss, diet, and exercise, other strategies can improve your chances of getting pregnant with PCOS.

Track your menstrual cycle.

Monitor your menstrual cycle closely to know when you are ovulating so you can time your pregnancy attempts accordingly. Period tracking apps, over-the-counter ovulation predictor kits, and measuring your basal body temperature (which rises slightly after ovulation) may also help.

Manage stress

Stress can negatively impact your fertility, especially when you are dealing with PCOS symptoms and pregnancy test disappointments at the same time. Use stress reduction techniques like deep breathing, meditation, and yoga to relax your mind and body.

Take supplements

Taking supplements like inositol, vitamin D, fish oil, and magnesium may improve your fertility. Ask your TopLine MD Alliance affiliated provider for recommendations.

Be patient

The simplest strategy is likely the hardest, but getting pregnant with PCOS often takes time. Be persistent but patient in your efforts. TopLine MD Alliance’s trusted network of providers is here to support you every step of the way.

Pregnancy risks with PCOS

If you have PCOS and you’re pregnant, congratulations! PCOS can increase your risk of several pregnancy complications, so it’s important to notify your OB/GYN of your symptoms or diagnosis. These risks include:

  • Miscarriage – Pregnant women with PCOS have a higher risk of early miscarriage (less than 12 weeks of gestation) due to hormonal imbalances and ovulation irregularities.
  • Gestational diabetes – Pregnant women with PCOS are also at a higher risk of developing gestational diabetes during pregnancy due to insulin resistance and higher blood sugar levels. Babies born to mothers with gestational diabetes are often large.
  • Preeclampsia – Pregnant women with PCOS are more likely to develop preeclampsia (persistent high blood pressure), which can lead to serious health concerns for both mother and baby.
  • Preterm birth – Due to these complications, pregnant women with PCOS are more likely to deliver their baby prematurely (before 37 weeks of gestation).
  • Cesarean delivery – Pregnant women with PCOS are more likely to have a Cesarean delivery for the same reasons.

Again, you can minimize these risks by seeing your TopLine MD Alliance provider regularly and making the lifestyle changes recommended above.

Your resource for PCOS care

The TopLine MD Alliance was created by physicians who came together to make healthcare experiences better for patients. We help patients navigate the healthcare system, connecting them with top-of-the-line healthcare providers, practices, diagnostic centers, and imaging centers we trust. TopLine MD brings together high-quality care and exceptional service while ensuring that you are always satisfied with your choice of doctors and healthcare providers.

Topline MD Alliance’s women’s health specialists include obstetrics, gynecology, reproductive endocrinology, fertility, and more – everything you need to manage PCOS and achieve your fertility goals. Learn more about TopLine MD Alliance and get started today.

The TopLine MD Alliance is an association of independent physicians and medical practice groups who are committed to providing a higher standard of healthcare services. The members of the TopLine MD Alliance have no legal or financial relationship with one another. The TopLine MD Alliance brand has no formal corporate, financial or legal ties to any of the affiliated physicians or practice groups