Updated: Dec 24, 2021
This article summarises 7 tips for increasing your chances of pregnancy if you have Polycystic Ovary Syndrome (PCOS).
PCOS is the most common cause of infertility in young women. This means it may take longer to get pregnant than you hoped.
The World Health Organisation defines infertility as ‘a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse’.
Going through infertility can be stressful emotionally, physically and socially.
Let’s do what we can to help others who are going through this. Please share this article with friends or family members, who may be affected, or may have daughters in their 20’s or 30’s who are not planning to start a family now but may want to do so in the future. Doing so can prevent delays in getting much needed help and support.
The information in this article applies to adults aged 18 or over.
1. Get a diagnosis as soon as possible
Visit your GP for assessment if you have any of the following symptoms, or history of:
Are having difficulty getting pregnant
Have symptoms that may be related to excess testosterone in your blood such as acne, facial hair, excess body hair
Other members in your family having PCOS
Excess body weight and fat particularly with the bulk of your weight centred around your abdomen, and middle of the body, and less so on your arms and legs.
Dark or brown pigmented areas of skin that could be dry, thick and rough in your armpits, back of elbows, knuckles, genital area or neck.
Your GP can arrange some investigations which usually begins with blood tests and an ultrasound scan.
Other conditions that can affect your period or cause high levels of androgens in the blood should be excluded, such as thyroid problems or medication.
If you already have infrequent periods, no periods or no evidence of ovulation, PCOS can then be diagnosed if you have symptoms related to high testosterone as mentioned above or a blood test that shows high levels of testosterone in the blood.
An ultrasound scan will be needed if you have either high testosterone OR any disturbances in your periods as mentioned above. You will be diagnosed with PCOS if you have one of these AND if the scan shows the presence of lots of small follicles in one or both ovaries, and/or increased size of the ovaries.
2. Have A Healthy Lifestyle That Includes Nutritious Food and Exercise
Once you have been diagnosed, even if you are not considering getting pregnant soon, incorporating regular healthy lifestyle habits can improve your overall health, reduce the risk of getting diabetes in the future, and increase your chance of getting pregnant now or in the future, or your response to assisted reproductive technology (ART) if it’s needed.
If you are overweight, losing weight through good nutritional habits and gentle exercise can benefit your blood pressure, improve sugar levels and have some impact on your mental health.
It’s important to include strategies and techniques to encourage healthy change and sustainable habits whilst also working to improve and resolve any concerns with body image and self-esteem if they exist.
Therefore, do not go on any crash or fad diets. Intensive or rapid weight loss should be avoided just prior to conception and as it may impact your ability to conceive naturally or through ART.
As much as possible, do not wait until you are trying to get pregnant, or until you have problems getting pregnant to try to optimise your weight. Optimising your weight means avoiding being underweight as well. Being underweight can affect your ovulation.
You don’t have to do this alone. You can ask your GP for a referral to a dietician or see a dietician privately. You can obtain ongoing support from your practice nurse or from a health coach.
3. Look after your mental health
Minimising stress, worry and low mood will improve your general health whilst you are trying to conceive.
Do as much as you can to get sufficient sleep. Ensure you spend some dedicated time doing things that you love, that make you feel relaxed, or that make you happy. You can read tips to monitor your mental health, and tips on self-care in our blog.
See your GP if you are having difficulty having sex, or if you don’t feel like having sex. If you are feeling low, having difficulty enjoying things, are worrying excessively, having difficulty sleeping, overeating or have a reduced appetite, feel like life isn’t worth living, you may have anxiety and/or depression.
You can find more information and a list of symptoms of depression and anxiety in the links at the end of this article.
4. Have a preconception review
Visit the practice nurse at your GP surgery for a preconception review, if possible at least 6-12 months before you decide to start trying to get pregnant. This is to make sure that any relevant or required health checks are done in advance, such as your smear test, to ensure you’ve had a rubella vaccination, as well as to check your blood pressure, give you support with stopping smoking and any other general advice.
You may require tests, or a referral for genetic consultation if there is a potential risk of cystic fibrosis, thalassemia or sickle cell anaemia.
NICE recommends that women with PCOS are offered a glucose tolerance test to check how their body is breaking down sugar. This is a test that will let you know whether you have diabetes or prediabetes.
It’s not essential to have a preconception review, but it is a good idea to have one especially if you have any health conditions such as PCOS, to ensure that you get as much relevant advice as possible.
5. Have Sex Regularly
If you are having regular periods you are likely to be ovulating regularly so having regular sex is the best way to increase your chances of pregnancy with PCOS.
As yet, there isn’t conclusive evidence to support that only having sex during your ‘fertile window’ gives you the best chances of getting pregnant. If it’s possible to do so, having sex 2-3 times a week is the best way to ensure that sperm is always ready inside of you for when you ovulate. This is also true if you do not have periods, or have infrequent periods because you could occasionally ovulate at any time.
Time, work, relationship and family pressures may make this hard to do, so if this is the case, have sex as often as is practical and enjoyable for you.
If you have infrequent periods or do not have periods, it is not recommended to try to estimate your fertile window using basal body temperature charting, or period tracker apps, because they may not be accurate.
It is more accurate to have one or more serum progesterone blood tests arranged by your GP, or a gynaecologist.
If you have PCOS and have not become pregnant after having regular sex for 6 months, visit your GP for assessment.
Find tips on trying to get pregnant in our blog.
6. Limit your alcohol intake, and if you smoke, stop smoking
If you drink alcohol, slowing down to low to moderate amounts of alcohol is recommended before trying to conceive, ideally up 3 months before. For women no more than 1-2 units of alcohol once or twice a week, and for men, up to 3-4 units a day. A small glass of wine is 1.5 units, a pint of beer is 2 units.
If you drink alcohol in higher quantities than this, it can affect the quality of your eggs and the development of your baby. And if your partner drinks in excess, it can affect the quality of his sperm.
Smoking is detrimental to your health and fertility. You can obtain help to stop smoking from your pharmacist, or the practice nurse at your GP practice.
7. Get an early referral to a specialist
If you have a known diagnosis of PCOS and have not become pregnant after having regular sex for 6 months, visit your GP for assessment. You may receive a prompt referral to a reproductive endocrinologist or fertility specialist. Your GP will refer you based on your assessment.
Anxiety, Mental Health Foundation
Depression, Mental Health
PCOS Challenge for support
Verity for support
PCOS Awareness for support
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DOWNLOAD YOUR FREE GUIDE : A GUIDE TO THE FERTILITY CONSULTATION WITH YOUR GP
Is it taking longer than you hoped to get pregnant? Have you been assessed by your GP?
Written by GP, Dr Belinda Coker, our free guide will help you prepare for the fertility assessment consultation with your GP.