PCOS and getting pregnant

Never or rarely getting your period, mood swings, acne, and excessive hair growth. All symptoms of Polycystic Ovary Syndrome, better known as PCOS. That isn’t all: PCOS is an important cause of infertility. People with PCOS can often struggle with getting pregnant. But, it is possible in most cases!

What is PCOS?

PCOS is a disruption of the menstrual cycle, in which cysts (which actually is the wrong thing to call them, since they’re the follicles that are meant to be there) are in the ovaries. The cysts are caused by hormones. The LH hormone (luteinizing hormone), which prompts ovulation, is increased and the FSH (follicle stimulating hormone), which ripens the follicles, is lowered. This prevents the follicles from ripening properly, which causes them to heap up in the ovaries. The disrupted follicle ripening is the cause of postponed ovulation, which makes your periods more irregular. This also explains the most recognizable symptom of PCOS, which is irregular blood loss.

What is the treatment of PCOS with a child-wish?

Like we’ve already mentioned, PCOS is an important factor for reduced fertility, since ovulation doesn’t happen, or only happens rarely. When there’s a child-wish, you’ll often be prescribed ovulation inducing medication, such as etrozole or clomiphene. Besides that, there are many other things that you can do to increase your chances of getting pregnant with PCOS. Before we delve into what those things are, it’s good to have a grasp on one of the factors that can aggravate PCOS. That would be being overweight or obese. As a result of this, people become insulin resistant, which means that you need more insulin to maintain your blood sugar than people who aren’t overweight. Insulin deficiency leads to diabetes. Diabetes type II or "old age diabetes” is also often caused by obesity and incorrect nutrition, often in combination with a lack of exercise and possibly also chronic stress. PCOS often comes paired with being overweight, since 65% of all women+ with PCOS are overweight, while only 35% of the rest of the population are. You probably get the gist of it: those with PCOS symptoms that wish to get pregnant, can benefit from adjusting their diet, level of exercise and relaxation. Even if you aren’t necessarily overweight! It’s truly worth the effort, since the results start to become noticeable between 4 and 12 weeks!

Fewer carbs and sugar

Those who eat and drink a lot of snacks that contain sugar and carbs (that latter one is turned into glucose by the body, which makes it sugar) - and yes, that includes a latte macchiato and a fruit juice - will maintain their insulin resistance. This causes you to produce more and more insulin to keep having the same effect. So: take it easy on the bread, pasta, rice, potatoes, fruit juice, lattes, and cappuccinos. Try to switch to a balanced diet, like is advised by the Nutrition Centre, and try to drink mostly water (about 2 liters a day).

More unprocessed vegetables

The fiber in vegetables will keep your guts balanced, which might keep your blood sugar levels more stable. You can use vegetables in more ways than you might think of: a green smoothie for breakfast, a salad or soup for lunch, and veggies to snack on with a yogurt dip or hummus as a snack. There’s a golden rule when it comes to vegetables: the more color on your plate, the better. You should have at least 250 to 500 grams of vegetables a day.

Healthy fats and protein

If I reduce the amount of bread, pasta, rice, and potatoes in my daily meals, what’s left for me to eat? The answer: plenty! Carbohydrates should be replaced by healthy fats and protein. Treat yourself to eggs, nuts, fatty fish (skip the fried stuff, but choose salmon, mackerel, or herring), avocados, and salads with a hefty bit of olive oil in the dressing. Try to get pure and fresh ingredients. Of course, you don’t have to fully ban carbs from your diet. One cup of rice or pasta and two slices of bread per meal is perfectly fine.

An added benefit of exercise is that it improves your mood, and also makes you lose weight.

(weight) training

Three hours of exercise a week can reduce the insulin resistance, which benefits your PCOS - and thereby also your chance of getting pregnant. Weight training in particular gives great results. This appears to be the case because your muscles are able to absorb insulin better if they’re used more actively. Three hours of exercise sounds like a lot, but if you do fifteen minutes before breakfast every morning, you’ll already be halfway there! Try to go on the occasional walk during lunch, opt for the stairs whenever you can, bike to work, and you’ll have met your goal. An added benefit of exercise is that it improves your mood, and also makes you lose weight. You can do this!

Supplements

Certain studies have shown that some supplements can help to reduce the complaints related to PCOS. Vitamin D, for example, if you have a shortage of it. Dutch researchers found that many women with PCOS have a vitamin D deficiency. So, supplements that contain vitamin D seem to be a helpful way to solve this deficiency. Myoinositol or D-Chiroinositol are also commonly used nutritional supplements that improve insulin sensitivity. They are also widely used by women with PCOS and also appear to have effects on the regularity of the menstrual cycle. It’s also important to highlight the fact that, while there are many good stories about the effects of vitamin D and other dietary supplements, there has been no proper research on the direct effect that these supplements have on PCOS and the chance of conceiving. If you want to try them out, we advise you to look into getting expert guidance, and to always buy high quality supplements that don’t have any added harmful ingredients. It’s true that these supplements are usually more expensive, but the dosage per tablet is often higher, and the ingredients tend to be more pure.

lowering your stress levels

Stress and PCOS aren’t a good match. If you have long-term stress, you’ll produce (too much) of the hormone cortisol. This has an unfavorable effect on your blood sugar levels. That’s why it’s important to reduce the amount of stress you experience. That can be hard, we know. Still, meditating a few minutes a day and trying to focus on your breathing is a possible start. 

Can you get pregnant naturally if you have PCOS?

Yes, certainly! It does occur that people with PCOS get pregnant naturally. On average, this happens for 3 out of 10 people with PCOS. It can take somewhat longer, since you don’t have an ovulation as frequently as people without PCOS.

To sum up

These tips aren’t a magic cure for getting pregnant when you have PCOS. Still, it’s been proven that changing your lifestyle has a positive effect on your chance of conceiving, of having a healthy pregnancy, and of having a healthy baby. You might miss out on these benefits if you don’t change your lifestyle. By the way, it’s always best to consult a medical expert - don’t start experimenting on your own.

Want to read more about PCOS? You can do so here. On our website, under the header ‘video’ you can find some great videos in which various subjects related to PCOS are covered.

[An expert’s webinar on PCOS and lifestyle. Watch it here]