Women with the condition of PCOS can suffer from infertility but that does not mean you cannot get pregnant. There are many fertility treatments such as IVF, gonadotropins, Clomid, etc. Some of the women can get pregnant by making some lifestyle changes and taking fertility drugs whereas most of them need fertility treatment.
Losing weight to get your ovulation cycle on track
Women with PCOS have obesity. The reason behind gaining weight is that PCOS negatively impacts the way the body processes insulin. They cannot conceive because they either do not ovulate regularly or at all. Women with PCOS and obesity have high chances of going without getting periods for months.
Many studies state that losing weight can straighten up your ovulation cycle. You do not need to lose a lot of weight but 5 – 10 % of your current weight can help to start the menstrual cycle. But losing weight might not be the only solution you will have to pair it up with taking fertility pills or fertility treatment.
On the contrary, there are many women with PCOS that do not have obesity. For them, weight loss is not the solution.
Proper diet and exercise routine
Women with PCOS should eat a healthy diet because of the risk of gaining excessive weight. There are a few studies that suggest a low carb diet is the best for PCOS but there are studies that contradict this.
The most important thing about your diet is that it should include nutrient-rich food and a proper amount of protein. You should avoid junk and processed food.
Here are a few eating tips:
- Have a bigger portion in breakfast and a smaller portion in dinner
- Include greens and protein-rich food items
- Eat whole grains and beans
- If you eat sweets or food containing high carb then you should combine it with healthy fat items like avocado, nuts and olive oil so that you can slow down the rise in sugar levels
Some studies also state that regular exercise also helps PCOS symptoms. Proper diet and exercise alone might not help you but having a healthier lifestyle will help your fertility treatment respond better.
Metformin is a medication used for diabetes. But sometimes, it is prescribed to women with PCOS to help them get pregnant. Though, this is a safe drug still it is considered to be prescribed to women with PCOS off the label.
Metformin helps to lose weight, regulate the menstrual cycle, improve the effectiveness of the fertility drug and reduce the rate of miscarriage.
Clomid is a commonly used fertility drug and commonly used by women with PCOS. It helps many women to conceive but does not work on everyone. Some might experience Clomid resistance where Clomid does not trigger ovulation as it is expected.
Fertility treatment with Letrozole
Letrozole is a cancer medication that is frequently used by women with PCOS. Though it is a cancer drug you do not need to worry. This drug has mild side effects and is effective for conceiving.
Gonadotropins for PCOS
If the above does not help then you should try injectable fertility drugs or Gonadotropins. Gonadotropins are made of FSH, LH or the combination of two. You doctor might give you an option of a combination of oral and injectable fertility drug to help you to conceive.
One of the risks of Gonadotropins is ovarian hyper stimulation syndrome (OHSS). In this situation, the ovaries overreact to the fertility medication. It can be dangerous if it is not treated properly or becomes severe. Women with PCOS have higher chances of developing OHSS so your doctor might use small doses of injectable fertility drugs to avoid this to take place.
IVF or IVM
If Gonadotropins does not work then you should go for IVF or IVM. In IVF, you use injectable fertility drugs to stimulate the ovaries to provide more fertile eggs. The eggs are retrieved from the ovaries during the egg retrieval process. These eggs are then placed with the sperms into Petri dishes. If it works well then the sperm will fertilize some of the eggs. After 3 -5 days, the fertile eggs divide and grow and 1 – 2 are placed into the uterus. This is called the embryo transfer. After two weeks, a pregnancy test is done to confirm if the process worked.
One of the risks of IVF in women with PCOS is the over stimulation of the ovaries. SO to avoid this IVM is used. IVM is in vitro maturation. Instead of giving a high dose of the fertility drugs to force the ovary to mature many eggs, IVM is done where less quantity of fertility drug is used or it might not be used at all. The doctor will retrieve immature eggs from the ovaries and then mature it in the lab.