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Let's talk about it: Getting pregnant with PCOS

Let's talk about it: Getting pregnant with PCOS

Let's talk about it: Getting pregnant with PCOS

Did you know that 1 in every 10 women in the UK will have polycystic ovary syndrome (PCOS) and it’s also believed that almost 70% of women with PCOS have not had a formal diagnosis. If you’ve been told you have PCOS, then you may be feeling a little confused about what this might mean for you and your fertility. If, however, you haven’t had a diagnosis but are worried that you might have PCOS, then you too are probably wondering what this means for you if you’re trying to conceive. 

First things first, if you are concerned about your symptoms and think that you may have PCOS, you should speak to a doctor. Although there is no cure, the symptoms can be managed. And it’s important to bear in mind that being diagnosed with PCOS doesn’t mean that you won’t be able to conceive. In fact, most women with PCOS, when appropriately managed, are able to get pregnant, but it may mean that it’s harder to conceive and may take a little longer. 

Whatever your situation, getting knowledgeable will help you to feel empowered to take back some control of your PCOS, and can help you to take steps to improve your chances of conceiving. 

The science bit 

Let’s talk about what exactly is PCOS? 

PCOS is a common hormonal condition among women of childbearing age. It is a chronic condition where the ovaries develop many tiny cysts caused by the egg follicles that have not been able to develop as they should. It is also accompanied by a hormonal imbalance, which in turn makes it more difficult for the eggs to mature adequately and be released at the time of ovulation. 

PCOS is a complex condition with various symptoms, and how women are affected can differ from woman to woman. The condition can be divided in to two distinct groups – polycystic ovaries (PCO) and polycystic ovary syndrome (PCOS). Women diagnosed with PCO will have many cysts on their ovaries. However, they may not have the severity of cysts or the hormonal imbalance and symptoms seen in women with PCOS. 

The exact reason why PCOS develops is unknown but we do know that it can run in families. Many women notice the symptoms of PCOS after stopping a hormonal contraceptive to start trying to conceive. It’s not being on contraception that has caused PCOS, but that the hormones in the contraception have masked the symptoms and these become more obvious once you stop your hormonal contraception. 

The symptoms 

Just like how the condition can vary from woman to woman, so too can a woman’s experience of PCOS. Below are the most common symptoms, but you don’t have to experience them all to have PCOS. 

  • Irregular or absent periods 
  • Ovarian cysts 
  • Weight gain or difficulty losing weight 
  • Fatigue 
  • Excess body hair and thinning of hair on the scalp 
  • Acne or oily skin 
  • Insulin resistance – seen by raised insulin levels in the blood stream 
  • Infertility 
  • Acanthosis nigricans – a condition involving dark dry patches on the skin  
  • Mood changes, low self-esteem and mental health issues 

PCOS and your fertility 

A common symptom of PCOS, and often the first hint that something might not be quite right, is irregular or long cycles or, sometimes, no periods at all. This is because your hormone imbalance and potentially the cysts on your ovaries affect ovulation. Ovulation is the process of a mature egg being released from the ovary. Some women with PCOS may ovulate irregularly or, in severe cases, not at all. To get pregnant naturally you need to ovulate, and it might be that you need to get advice from a doctor to help you with this. 

The best way to optimise your fertility when you have PCOS is to make the right lifestyle changes and my PCOS action plan below details changes you might like to make. 

Remember, it is possible to get pregnant with PCOS. You might just need a little bit of help from a healthcare professional and a bucket load of motivation from yourself to make some healthy lifestyle changes! 

PCOS Action Plan 

1. Nutrition 

    • Reduce your intake of sugars and refined carbohydrates, such as white bread, white rice and white pasta or sugary drinks, cakes and biscuits 
    • Enjoy high protein such as eggs, chicken, fish and lentils, green leafy vegetables such as spinach or kale and fruits low in sugar  
    • Seek specialist dietary advice and support if needed 

    2. Exercise 

      • Do 150 minutes of moderate intensity exercise per week to help with weight loss, if needed, or just to improve your fitness levels 
      • Enjoy a mixture of cardiovascular exercise, muscle strengthening and a lovely walk in nature 
      • Reduce your time spent doing sedentary activities such as watching television or working on your PC

      3. Lifestyle 

      • Reducing your intake of alcohol and, if possible, try to avoid alcohol altogether whilst trying to conceive
      • If you smoke, seek support to quit smoking 
      • Aim for a BMI range below 30, but ideally between 18.5-24.9  - If you aren’t sure you can calculate your BMI here
      • Even just losing 5% of your body weight can improve your symptoms and your fertility
      • Avoid recreational drugs 
      • Limit caffeine to 1 or 2 cups per day
      • Keep hydrated as the amount of water in your cervical mucus can increase or decrease the ability of the passage of sperm to the egg 
      • Take action to try to reduce your stress levels 

      4. Get empowered 

        • Start tracking your cycle to understand when you’re fertile 
        • See a doctor or specialist nurse and get as much information about PCOS as you can 
        • Take a folic acid supplement, as recommended by the NHS. You can find out more about this in our blog ‘Why is folic acid important in pregnancy and when trying to conceive?’ 
        • Have regular sex. Ideally every 2-3 days throughout your cycle 

        If you can, start making the healthy changes above. You might not need to do them all, just the ones that are appropriate for you and your current lifestyle. However, as well as concentrating on your lifestyle, it is important to talk to a doctor and get the help you need to prepare your body to conceive.

         

        A little about the author… 

        Kate Davies is a Fertility Nurse Consultant and Fertility Coach with over 20 years’ experience in the field of fertility and women’s health, in both the NHS and private practice, specialising in PCOS. 

        When she’s not consulting, Kate can be found indulging in her passion for podcasting, using it as a platform to help break the silence surrounding infertility and promote positive and accurate fertility messages and information. 

        How can we support you?

        If you have been diagnosed with PCOS or believe you may have the condition and are trying to conceive, our fertility doctors and nurses are here to help you take control of your fertility journey. You can access the medical, lifestyle and emotional support you need, when it’s the right time for you

        Call us on 0330 330 3849

         

        References
        1. VerityOnline content[Last accessed 30/11/20] https://www.verity-pcos.org.uk
        2. March W.A, MooreV.M, Willson K.J, Phillips D.I, Norman R.J. and Davies M.J. (2010) The Prevalence of Polycystic Ovary Syndrome in a Community Sample Assessed under Contrasting Diagnostic Criteria. Human Reproduction, 25, 544-551[Accessed 30/11/20] https://academic.oup.com/humrep/article/25/2/544/6730023.
        3. TreatmentPolycystic Ovary Syndrome [Last accessed online 20/10/20] https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/
        4. NHS UK / conditions / polycystic ovary syndrome  [last accessed online 10/11/2020] https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/
        3. TreatmentPolycystic Ovary Syndrome [Last accessed online 20/10/20] https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/
        5. Adam Balen, The Polycystic Ovary Syndrome: Guidance for Healthcare Professionalshttps://www.adambalen.com/pcos/the-polycystic-ovary-syndrome-guidance-for-healthcare-professionals/
        6. NHS[Online content accessed 11.20] https://www.nhs.uk/live-well/exercise/
        7. Drinkaware[Online content accessed 31.11.20] https://www.drinkaware.co.uk/facts/alcoholic-drinks-and-units/latest-uk-alcohol-unit-guidance
        8. NHS [Online content accessed 31.11.20] https://www.nhs.uk/common-health-questions/pregnancy/should-i-limit-caffeine-during-pregnancy/
        9. Katz DF, Slade DA, Nakajima ST. Analysis of pre-ovulatory changes in cervical mucus hydration and sperm penetrability. Adv Contracept. 1997 Jun-Sep;13(2-3):143-51.doi: 10.1023/a:1006543719401. PMID: 9288332.https://pubmed.ncbi.nlm.nih.gov/9288332/

        Last updated on: 01.12.20   Review by: 01.12.23