Polycystic ovary syndrome, commonly known as PCOS, is a hormonal disorder that affects 20% of women worldwide. With ovulatory dysfunction as its primary characteristic, PCOS causes a high level of male hormones and irregular periods, and in many cases, it impacts a woman’s chances of getting pregnant.
The root cause of PCOS is unknown but there are several drivers that influence its presence. These drivers point us toward solutions for curing PCOS and increasing fertility. Regardless of the type of PCOS, getting pregnant with the condition is possible, and it requires a good understanding of the risk factors.
Included here is some of the most current research on PCOS and seven evidence-based tips for increasing your chances of getting pregnant with PCOS. Knowing your PCOS type and understanding why ovulation is impaired are the fundamental steps to implementing some simple lifestyle solutions. Discover how having a healthy gut, knowing the risks associated with conventional treatments, and discovering the benefits of certain minerals can help treat PCOS and restore fertility naturally.
7 Evidence-Based Tips for Fertility
Getting pregnant with PCOS doesn’t have to be the hardest achievement you’ll ever make, contrary to what you might have read. Yes, it’s harder for you than for a woman without PCOS. And yes, it relies more on you than your doctor.
While it may seem like your body’s preventing you from having the thing you want most, it’s actually communicating what it needs. That’s right, your PCOS symptoms are signaling a hormonal imbalance that needs your attention.
There are plenty of natural solutions for addressing not only your symptoms but the underlying contributors to your PCOS. They’ll also target how to get pregnant with PCOS. We’re going to look at seven of the most actionable ones here, and they might surprise you (hint hint #4). This is all to help you kick some PCOS butt and prepare your maternal bod for new life.
But just in case you don’t yet have a diagnosis, let’s get a little intro on what PCOS is and how it affects fertility.
What is PCOS?
PCOS, also known as polycystic ovary syndrome, is the most common hormonal disorder in women in their reproductive years. It affects as many as 20% of women, and, as you might be experiencing, it can cause infertility (1, 2).
PCOS has two main symptoms: irregular periods and excess androgens (male hormones). Both occur because of a problem with ovulation. Why that problem occurs as it relates to PCOS is up for debate in the medical community. There are different criteria for diagnosing PCOS because behind it are distinct drivers. So while there isn’t a single cause of PCOS, there are several factors influencing it.
If you have a PCOS diagnosis already, then probably know at least a little about it. However, because health professionals don’t understand it well, it pays to gather as much information as possible to work on teasing out those discrepancies. One way to do that is to start with the fundamentals and connect the dots as you go. Don’t worry, we’ll help.
Let’s start with the most obvious connection––how PCOS affects ovulation to better understand why it impacts fertility.
The Challenge in Getting Pregnant with PCOS
You’ve probably realized the hard reality: getting pregnant with PCOS isn’t easy. That’s because the hormones that control ovulation are out of balance and creating several symptoms, one of which is infertility.
Keep in mind that several factors can affect PCOS and pregnancy success. When you’re looking for causes and solutions, a holistic mindset is key for unlocking real, workable answers.
Restoring regular ovulation every month is essential for eradicating PCOS and improving fertility. That said, you can still get pregnant with PCOS. A variety of treatments increase a woman’s chances of conceiving even without specifically addressing PCOS.
However, fertilization is just the first step. A healthy pregnancy is one that experiences a normal gestation period and delivers a healthy baby. Women with PCOS are three times more likely to have a miscarriage, they’re at risk for developing preeclampsia and gestational diabetes, and they may deliver a larger baby, or prematurely (3).
That means the ideal way to increase your chances of getting pregnant with PCOS is to target the condition, not just the symptoms. We’re going to give you all the info you need to do that. But first let’s look at what should happen during ovulation compared to what does happen in the presence of PCOS.
How Does Normal Ovulation Occur?
Each month during the follicular phase of your cycle, approximately 12 follicles, or immature eggs, develop into tiny cysts. Your body chooses one egg from its finite supply and reabsorbs the rest. In a properly-functioning reproductive system, the dominant egg is released during ovulation and awaits fertilization. But in women with PCOS, ovulation is irregular so all those immature eggs remain cysts. PCOS derives its name from the presence of these multiple cysts. While they aren’t specific to PCOS, they are a symptom, in combination with other signs, because their presence indicates that ovulation didn’t occur. That prompts the question–
What Disrupts Ovulation?
The brain signals the reproductive system every month to prepare for possible pregnancy. But in some cases, that communicative mechanism between the brain and the ovaries known as the female reproductive axis, is impaired, causing hormonal disruption. The ovaries and adrenal glands are central to this dysfunction because they don’t secrete the right type or level of hormones required for ovulation to occur. High levels of androgens, one of the primary symptoms of PCOS, insulin resistance, inflammation, synthetic hormones, and your environment all interfere with ovulation. What you eat, how much you exercise, and toxins impact it too.
You must balance your hormones to increase your chances of getting pregnant with PCOS. That begins with knowing what’s driving your symptoms and specific actions you can take.
One thing to keep in mind: if you achieve pregnancy in spite of having PCOS, the change in hormones can alter the severity of your symptoms.
Through these seven helpful tips, we’ll explore what might be causing your PCOS and what you can do to improve your chances of getting pregnant.
#1 Find Out What’s Causing Your PCOS
Dr. Lara Briden identifies four types of PCOS, each with a different driver: insulin-resistant PCOS, post-pill PCOS, inflammatory PCOS, and adrenal PCOS (3).
The most common driver of PCOS is insulin resistance, a metabolic condition in which your body doesn’t respond properly to insulin. Your pancreas produces too much of the hormone, which disrupts ovulation and causes your ovaries to secrete testosterone instead of estrogen. The main symptoms are impaired ovulation and elevated male hormones. In addition, there will be insulin resistance. We’ll take a more detailed look at insulin resistance in #3.
Post-pill PCOS is another type characterized by the same base symptoms (irregular ovulation and excess androgens), but doesn’t include insulin resistance. If you were fine before taking the birth control pill but experience symptoms coming off it, you may have post-pill type PCOS. Contrary to popular belief, hormonal birth control doesn’t regulate your periods; instead, it masks an underlying problem. It suppresses ovulation (which you want to regulate) and can worsen insulin resistance (which is a common driver of PCOS). As your body attempts to regulate your cycle after discontinuing the pill, you may experience PCOS symptoms.
If you have the two main symptoms of PCOS, but you aren’t insulin resistant, and you don’t have any issues with the pill, inflammation may be the reason. Inflammatory PCOS is driven by inflammation and environmental toxins. It produces these signs of inflammation: unexplained fatigue, digestive issues, joint pain, skin conditions, and headaches. Identifying your food sensitivities and eradicating inflammatory foods and substances from your life can help relieve symptoms.
Adrenal PCOS occurs when testosterone levels are normal but the adrenal glands produce too much of the male hormone DHEAS. Diagnosing it involves ruling out the other types and other causes of high androgens. The reason? Your adrenal glands are too fired up because of high stress levels or a magnesium or B vitamin deficiency.
You can probably identify with one of these types of PCOS. Now let’s move on to what you can do about it.
Understanding what’s driving your PCOS is the first step to treating it.
#2 Balance Your Hormones
It sounds easy enough, right? Hormones are chemicals so stabilizing them is like a science experiment. While conventional treatments such as androgen blockers or the diabetes drug metformin can temporarily balance them, your body may revert back to an imbalance when you discontinue them if you haven’t identified the driver.
There are several natural approaches you can take to balance your hormones and address your concerns about how to get pregnant with PCOS. One of the most effective but underestimated ways is to adjust your lifestyle. Reducing stress and getting enough sleep keeps the adrenal glands balanced. A healthy, anti-inflammatory diet and regular exercise moderates body weight. And most importantly, a commitment to sustainable and regenerative lifestyle behaviors is far more effective than going on a month-long crash-course health improvement trip.
Don’t underestimate the impact of food and exercise on your hormones.
Let’s look at the evidence:
Researchers in the United States conducted a randomized study to determine the pregnancy outcomes of 149 women of reproductive age with PCOS. The participants were overweight but without other health conditions. Researchers assigned them to three groups and administered the following controls: the birth control pill (BCP), a lifestyle intervention involving diet and exercise, or a combination of both. Women in the lifestyle group had better insulin sensitivity and fewer triglycerides (a type of fat found in the blood) than those in the BCP group. The women in the combination group were more likely to ovulate than the women in the BCP group. While that lends some credibility to the pill for helping fertility, it demonstrates the power of diet and exercise on overall health and fertility (4).
#3 Reduce or Eliminate Sugar
Attention all sugar junkies: we’re not out to get you, we only want to help. Understanding the chaos sugar causes your endocrine system will help reframe your food choices.
This is what we know about sugar and PCOS: Sugar increases insulin levels, stimulates the secretion of cortisol (our stress hormone) and DHEAS (the male hormone secreted by the adrenal glands) (5), and causes inflammation. Let’s look at how this happens.
Sugar causes major hormonal imbalances. It keeps your blood glucose level perpetually elevated and causes your body to manufacture destructive molecules, which trigger inflammation. The thing is, we don’t feel bad eating sugar, we feel good because it also releases dopamine, a neurotransmitter that makes us feel happy. But we know what too much happy can lead to: addiction. And in the case of sugar, weight gain and a long list of other health conditions may show up.
Sugar is also one of the primary dietary causes of insulin resistance. When we consume a lot of sugar, our body produces a lot of insulin. When there’s too much insulin, it gets stored as visceral fat (the unsightly belly kind of fat) and churns out inflammatory chemicals causing major inflammation throughout the body. This is not the kind of inflammation that happens with an injury. It’s the insidious low-grade inflammation that many health experts believe causes human diseases.
Too much insulin also impairs ovulation because it prompts your ovaries to make testosterone instead of estrogen. It also causes the pituitary gland to make more luteinizing hormone (LH), leading to excess male hormones, one of the primary symptoms of PCOS (2).
There are a few causes of insulin resistance. Consuming too much sugar perpetuates a vicious cycle of carb-dependency. Glucose, the sugar in carbohydrates, does one of three things: it provides immediate energy or it converts to glycogen and gets stored in the liver and muscles for later use. When we exceed the capacity of those storage sites, it gets stored as fat. Once the body is used to this cycle of quick, fast energy, it never has a chance to burn stored fat.
But hang on––that doesn’t mean carbs are bad or that you shouldn’t eat them, you just want to get the right ones your diet. As a general rule, you want to stay away from refined sugars and reach for the good starches. Unhealthy gut bacteria, environmental toxins, sleep deficiency, and poor lifestyle habits such as smoking and alcohol consumption can also cause insulin resistance (6).
This doesn’t mean that you can cut out sugar and––abracadabra––everything’s hunky dory. Long-term solutions for how to get pregnant with PCOS are a combination of small fixes and fundamental lifestyle changes based on sound knowledge (that’s why there are seven tips here!).
Keep this in mind: we don’t fall into our eating habits because we know better; we eat the way we do because it’s familiar. Culture, family, and supermarket options (total overwhelm) all shape the choices we make when it comes to food. So if you are a sugar junkie, don’t feel bad, most of the world is.
#4 Improve Your Gut Bacteria
This may be the most surprising tidbit out there in the research on PCOS. When you consider that our gut bacteria outnumber our cells 10 to 1 (say what?!) you start to wonder if we can actually consider ourselves human anymore (7). You also realize how critical healthy gut bacteria are. If those bad guys take over, we’re destined to be in a lot of trouble because they have an army!
More and more research is discovering that unhappy gut flora may be the culprit behind a number of conditions like PCOS, obesity, diabetes, autism, and depression, to autoimmune diseases like Type 1 diabetes, Hashimoto’s thyroiditis. Unhealthy or homogenous gut bacteria may result from not being breastfed, antibiotic use in childhood, a diet low in resistant starch, taking the pill and anti-inflammatory drugs. Popping an Advil isn’t as harmless as it seems!
Studies have shown that women with PCOS have more bad bacteria and fewer good guys. Although health experts know that PCOS impacts gut bacteria, they’re starting to acknowledge that the microbiome may play more of a causal role in PCOS (8).
Excess androgens worsen the microbiome, and that poor gut bacteria cause high levels of insulin, leading to inflammation and insulin resistance. An excess of bad bacteria speeds up our body’s absorption of carbohydrates and increases fat stores.
So what can you do for your gut that will improve PCOS and pregnancy success?
Probiotic intervention to target gut microbiota can improve symptoms of PCOS, insulin resistance and elevated androgens, and improve your menstrual cycle (8). You can also:
- Remove inflammatory foods from your diet (gluten and dairy, and sugar) and any foods you may be intolerant to.
- Take a prebiotic (they’re food for the gut bacteria).
- Eat resistant starches. These prebiotics feed the healthy gut bacteria so it can grow and prosper; without it, it starves.
- Consume fermented foods that help reduce the breakdown of carbohydrates.
Eat a minimum of 25 different plant species
every week to boost healthy gut flora
(knock off 10 with just one salad)
#5 Implement A Fertility Diet For PCOS
You have loads of choice when it comes to creating a flexible, satiating diet that not only alleviates symptoms of PCOS but can actually help prevent them.
Inflammatory, sugary, processed (junky) foods are the worst foods for a woman with PCOS, but in many cases, the ones we love to eat. Did you know that the body tends to crave the foods its most averse to? It’s how our bodies warn us what not to eat before we eat it. Cheeky, isn’t it?
We’ve already touched on sugar and the reason why you want to minimize it or quit it altogether. So, it makes sense that the best foods for PCOS and fertility are ones that have a low glycemic index. Once you’ve ditched the refined sugars, take a look at the fruit you’re eating. Fructose doesn’t have the same effect as glucose on insulin and blood sugar levels but it does contribute to overeating. Why? While eating glucose causes leptin, our satiety hormone, to rise, fructose has the opposite effect in that is lowers leptin (9). That explains why we still feel hungry not long after gobbling up a fruit salad.
Micronutrients are an important inclusion in any diet, and ensuring you’re getting an abundance of essential minerals can make a huge impact on PCOS (10). Women especially need magnesium, for example, for bone and heart health, alleviating anxiety and PMS symptoms, fighting inflammation, and much more. The problem is, most of us don’t get enough from our diet because so much in our everyday environment depletes it. Magnesium deficiency can cause insulin resistance, which is a primary driver of PCOS. Stock up on magnesium-rich foods and consider taking a high-quality supplement.
The fundamental foods for PCOS and fertility are:
low GI, anti-inflammatory, and magnesium-rich
(that includes chocolate, ladies––the sugar-free kind)
Obviously, you want to know more. An article isn’t enough to cover all the options available to you. Find out everything you need to know about creating a PCOS diet that’s right for you, and get awesome recipes, totally free.
Know this: a PCOS diet for fertility is not about creating a ton of restrictions. It’s about implementing a lifestyle that works for you and responds to the needs of your body.
#6 Know the Drawbacks of Conventional Fertility Treatments
Doctors regularly prescribe the birth control pill for women who are experiencing irregular periods. It may seem counterproductive to take a contraceptive when you’re trying to get pregnant. But some research suggests that a short-term course of the pill can raise pregnancy rates among women with PCOS because it helps reduce androgens (4).
However, there are several drawbacks to taking the pill, in addition to the commonly-known side effects. The pill doesn’t help regulate periods. It gives you a fake period, known as a “pill bleed”, and may mask the underlying cause for a messed-up cycle (3). It also disrupts the good gut bacteria, which we’ve learned can cause inflammatory gut conditions and PCOS.
While fertility treatments like the pill may help you get pregnant, they don’t necessarily address what’s causing PCOS. Once you’re pregnant, you still have PCOS and all the issues that go with it. And, most importantly, you’re still at risk for all those conditions associated with a PCOS pregnancy: miscarriage, gestational diabetes, preeclampsia, and premature delivery (3).
A nutritious diet and regular exercise lead to a healthier body weight, which can improve breastfeeding and breastmilk quality (11).
#7 Take Myo Inositol During Pregnancy
Myo-inositol, also known as vitamin B8, is a type of sugar that occurs naturally in many foods, and your body produces it when you consume carbohydrates. It’s an important component of cell membranes, and as you might have discovered in your research, it’s a natural fertility treatment. Indeed, it has been the object of several studies on women with PCOS who are struggling with fertility (see 12, 13). So, while you want to consider taking myo inositol during pregnancy, if you’re not growing that bump yet, you’ll definitely want to know this:
In a study that evaluated the data of 3602 patients with PCOS, combined myo-inositol and folic acid treatment restored healthy ovulation for 70% of participants after just 16 weeks of treatment. What’s more, the women experienced no side effects (14). These results are as good as those in studies that tested the effects of metformin, a diabetes drug, on PCOS infertility, but this combination is a safe, natural alternative (14).
Taking myo inositol during pregnancy has major benefits, but you don’t have to wait until you’re expecting. It can actually boost your chances of getting pregnant with PCOS naturally, so adding it to your preconception health plan has some pretty big benefits.
Myo-inositol helps to improve both egg and sperm quality and balances the hormones that control ovulation.
In addition, it may improve insulin function in women with PCOS and prevent gestational diabetes in pregnant women (15).
Get more information about myo-inositol and other natural science-backed supplements for women with PCOS.
Myo-Inositol Plus™ with D-Chiro-Inositol (Caronositol®) from Omnibiotics is a 100% pure vegan source free of GMOs and gluten. Click here for more information.
How To Have a Healthy Pregnancy
A healthy, happy pregnancy starts before conception. By nourishing your body with high-quality, organic foods, you’re laying the groundwork, or shall we say, prepping the nest, for your little one. But as we know, getting pregnant with PCOS poses some complications, and they aren’t all diet related. Conventional fertility treatments may be an option for you, or you may choose to take some high-quality supplements that will increase your chances of getting pregnant with PCOS naturally. The choice is yours, and it’s a personal one. The information is there to guide you, but only you know what’s best for your body.
The research does show this: a healthy lifestyle is the primary factor in treating PCOS symptoms, and one of the easiest, long-term solutions. To cure PCOS, you have to treat the drivers, not the symptoms. This is the difference between coping and thriving. Choose to thrive. Once you address all the factors contributing to your PCOS, your fertility will be on the up and up, and your little one will thrive right along with you.