Can I get pregnant with PCOS?
I see a lot of women with PCOS come through my door, often worried that their diagnosis will make it hard for them to conceive. While PCOS can complicate things, it doesn’t mean you’re infertile. There’s a lot more to fertility than just a PCOS diagnosis, and many women with PCOS do go on to conceive naturally.
In this post, we’ll focus on one of the most important factors in baby-making: ovulation. Let’s explore how PCOS affects ovulation, and what you can do to support regular, healthy ovulation.
What is Ovulation?
Ovulation is essential for conception. It’s the process where an egg is released from the ovary and becomes available for fertilisation. Typically, this happens about halfway through a menstrual cycle—usually between days 12 and 16 in a 28-day cycle. If sperm fertilises the egg, pregnancy can occur. If not, the egg is shed during your period.
How Does PCOS Affect Ovulation?
PCOS is caused by hormonal imbalances, particularly higher levels of androgens (male hormones) and insulin resistance. These imbalances can lead to issues with ovulation, such as:
Anovulation: This is when ovulation doesn’t occur at all, which is quite common in women with PCOS. No ovulation means no egg is released, so conception cannot happen without medical help.
Infrequent or Irregular Ovulation: In some cases, ovulation does occur, but not regularly. This means fewer chances to conceive naturally.
Delayed Ovulation: If you ovulate later than day 21 of your cycle, the quality of the egg may be compromised, which can reduce your chances of a successful pregnancy.
How Can You Tell If You’re Ovulating?
With PCOS, it can be tricky to pinpoint when or if you’re ovulating, especially with irregular cycles. However, there are some ways you can track ovulation:
Cervical Mucus: As ovulation approaches, you’ll notice changes in your cervical mucus. It becomes more slippery and stretchy, similar to egg whites, which indicates fertility.
Basal Body Temperature (BBT): Tracking your BBT involves taking your temperature each morning before getting out of bed. After ovulation, your temperature will rise slightly.
Ovulation Predictor Kits (OPKs): These kits measure levels of luteinising hormone (LH), which surges right before ovulation. However, because hormone levels can fluctuate in women with PCOS, OPKs aren’t always accurate.
Can You Ovulate Naturally with PCOS?
Yes, many women with PCOS do ovulate, either regularly or sporadically. If your cycles are irregular or you’re not ovulating, there are lifestyle changes that can help increase your chances of ovulation.
Supporting Ovulation Through Lifestyle Changes
Diet: Eating a balanced diet rich in whole foods—like fruits, vegetables, lean proteins, and healthy fats—can help regulate insulin levels, which is crucial for promoting regular ovulation. Try to avoid refined sugars and processed foods that can worsen insulin resistance.
Exercise: Regular physical activity improves insulin sensitivity and helps with weight management, which can boost ovulation. Activities like walking, swimming, or yoga can make a big difference.
Stress Reduction: Chronic stress can impact your hormones and ovulation. Finding ways to manage stress, like yoga, meditation, or acupuncture, can support a healthy cycle.
Weight Management: If you’re overweight, even a modest weight loss of 5-10% can restore ovulation and improve your chances of conceiving.
Tracking Your Cycle with PCOS
Keeping track of your cycle is essential when dealing with PCOS. It can help you spot ovulation patterns, even if your cycles are irregular. Here are some useful tools:
BBT Charting: By tracking your basal body temperature every day, you can identify when ovulation has occurred, although it won’t predict ovulation in advance.
Ovulation Predictor Kits (OPKs): These can help detect LH surges before ovulation. Although they might not be as reliable for women with PCOS, they can still provide helpful insights when used with other methods.
Cervical Mucus Observation: Noting the consistency of your cervical mucus gives a clear signal when ovulation is approaching.
I also recommend using apps like Kindara (not affiliated) to track your cycle. Kindara allows you to log your BBT, cervical mucus, and other fertility signs, helping you better understand your ovulation patterns. What’s great about Kindara is that, as a practitioner, I can access your data (with your permission) and use it to fine-tune any herbal or acupuncture treatments I prescribe. It’s a valuable tool for both you and your healthcare providers.
Medical Treatments to Stimulate Ovulation
I am not recommending the medications below, but it’s good to know what might be offered when you visit your doctor or consultant. Here are a few commonly used options:
Clomiphene Citrate (Clomid): This is usually the first-line treatment for women with PCOS who are trying to ovulate. It works by stimulating the ovaries to release eggs.
Letrozole: Another medication that’s often used off-label for ovulation induction.
Metformin: Although primarily used for managing diabetes, Metformin can help improve insulin resistance and restore ovulation in some women with PCOS.
Acupuncture & Herbs for PCOS
Now for my favorite part—this is where I can help you.
There is strong evidence and research supporting the effectiveness of acupuncture and Chinese herbal medicine in managing PCOS.
In Chinese medicine, your period is considered a fundamental vital sign. As a practitioner, I spend significant time understanding your menstrual health. Regulating cycles is a key goal when dealing with menstrual issues, and achieving healthy ovulation is a priority.
I recently worked with a young woman who had never ovulated naturally. She had only ovulated twice—once following a laparoscopic ovarian drilling procedure and once while taking Clomid.
By the time she came to me, she was in the final month of her 6-month course of Clomid. After seven weeks of weekly acupuncture and one month of Chinese herbs, she ovulated naturally.
Of course, every case is different, and treatment is tailored to your individual needs. However, in many cases, acupuncture and herbal medicine can play a valuable role in supporting ovulation and improving fertility.
Conclusion
PCOS may make ovulation more challenging, but it doesn’t mean conception is impossible. Many women with PCOS ovulate and conceive, often by making lifestyle changes or seeking support from natural or medical treatments. By understanding your cycle, improving your ovulation, and exploring all your options, you can increase your chances of success.
If you want to learn more about how I can help you manage PCOS and ovulation, feel free to reach out to me here.
Next Post: In the next post, we’ll look deeper into hormonal imbalances, especially insulin resistance and androgen excess, and how they affect fertility.
