PCOS & Fertility
PCOS pregnancy success rate: Everything you need to know

PCOS pregnancy success rate: Everything you need to know

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What is PCOS pregnancy success rate? PCOS might affect your fertility but it doesn’t strike out your chances of getting pregnant. Read this article to learn more!

Basma Faris, MD, CCMS, OB-GYN & Nutritionist

Although PCOS is a frequent cause of fertility challenges and potential pregnancy complications, PCOS pregnancy success rate can be increased through relevant treatment.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormone-induced condition that may affect your menstrual cycle and overall health. This condition implies having many small sacs of fluid (cysts) develop along the outer edge of your ovary, hindering your ability to regularly release mature eggs (ovulate). It often develops around the time you have your first period, albeit symptoms commonly develop years later.

How common is this condition? PCOS affects an estimated 8-13% of women of reproductive age. However, with up to 70% of cases being undiagnosed, it’s hard to predict the real number of women with PCOS.

Possible symptoms include:

  • Prolonged, heavy, unpredictable, intermittent, or absent periods
  • Acne or oily skin
  • Weight gain
  • Excessive hair on the face or body
  • Hair thinning or male-pattern baldness
  • Infertility

While PCOS might have an effect on your daily life and there may be some difficult days, living with this condition doesn't have to be overly complicated. You can manage symptoms and improve your quality of life through awareness and helpful recommendations. But then, there are also fertility concerns that might be bothering you.

PCOS and fertility: Why is it hard to get pregnant with PCOS?

Research suggests that between 70% and 80% of PCOS women are struggling with conception.

Typically, there are two primary reasons that might get in the way of your TTC (trying to conceive) journey:

  • Cycle irregularity and lack of ovulation. PCOS may affect the regularity of your menstrual cycle, making it unpredictable or intermittent. This could mean irregular ovulation. On top of that, in PCOS, the sacs in which eggs develop might be unable to release them, meaning that ovulation cannot happen.
  • Hormonal imbalance. PCOS hinders hormone production in your body and can cause anomalies in progesterone production, in particular. An insufficient amount of progesterone (which is needed to prepare the womb for implantation) could mean the inability of your body to support pregnancy in its early stages.

Can you get pregnant with PCOS?

Yes. Having PCOS doesn’t mean that you can’t conceive and have a child. This condition might cause hormonal imbalance, menstrual cycle irregularity, and ovulation difficulty. Due to these reasons, it’s one of the most common reasons for infertility in females. However, it’s also a treatable cause of infertility, which means that getting pregnant with PCOS is possible, albeit can take more time or require some specialized treatment.

What is PCOS pregnancy rate?

Although PCOS might affect conception time and fertility, it’s important to understand that two PCOS cases can’t be identical. It's a unique journey for every woman and, respectively, PCOS pregnancy success rate depends on a variety of individual factors.

The main factors that may affect your ability to conceive with PCOS include:

  • Your age
  • How PCOS is expressed in your body
  • Your weight
  • Overall health and lifestyle
  • Other chronic conditions

Additionally, the treatment you receive may also affect your conception. A study of PCOS pregnancy success rate among women using letrozole (LE) versus clomiphene citrate (CC) treatment has shown that females receiving LE treatment generally have a higher pregnancy rate of 41.7%, compared to 32.0% among those receiving CC treatment. Furthermore, females with LE treatment have been shown to need fewer (two) cycles to achieve pregnancy compared to those on CC treatment (three cycles).

PCOS pregnancy risks and considerations

Apart from hindering conception, PCOS can also cause a number of pregnancy issues and complications both for you and your baby. Experts emphasize that females with PCOS might be more prone to the following risks

  • Miscarriage
  • Preeclampsia
  • Gestational diabetes
  • Cesarean section (C-section)
  • Macrosomia (heavy baby weight)
  • A risk of spending more time in a neonatal intensive care unit (NICU)

These are the potential risks you should be aware of when planning pregnancy. However, the good news is that you can lower the risks and prevent many PCOS-related pregnancy problems by communicating openly with your healthcare provider, accepting the necessary treatment, and following other personalized guidelines.

4 ways to increase your chances of pregnancy with PCOS

As you now know, getting pregnant with PCOS is possible, though it might take longer and require some extra effort.

A few things you can do to boost your chances of conception include:

1. Weight loss and blood sugar control

PCOS can make your body more insulin resistant, making your pancreas produce more hormones. As a result, you might have an increased sense of hunger, promoted fat storage, and respectively, excess weight gain.

Excessive body weight, in turn, can further suppress your ovarian function, making it harder to conceive. Hence, women who are looking to get pregnant might need to restore their ovarian function first through healthy weight loss and blood sugar control.

To do this, PCOS women might need to adjust their diets and exercise routines, and, sometimes, even start tracking insulin and consuming specialized drugs to lower it.

2. Folic acid and other supplements intake

Folic acid is known as one of the most important supplements for people trying to conceive and pregnant. It’s particularly important for PCOS women as folate is known to support the development of healthy eggs. Additionally, this supplement is widely associated with: 

  • Lower risk of anovulation
  • Lower risk of ovulatory infertility
  • Shorter time to pregnancy
  • Improved efficacy of infertility treatment

Hence, integrating folic acid into your diet can have a beneficial effect on your conception chances.

On top of that, you can consider adding other beneficial supplements, such as B vitamins, known for their benefits for fecundability and fertility. 

3. Infertility treatment

When entering your TTC journey with PCOS, infertility treatment might not be the very first solution you’ll try. Typically, your healthcare provider will suggest you try to conceive for at least 6 months and see a fertility specialist after this if you don’t get pregnant. Depending on your unique situation and health condition, a fertility specialist might refer you for treatment, either medical or surgical.

Medical

Medical infertility treatment implies using special medications to stimulate ovulation. Common medication types used for this purpose include:

  • Clomiphene or clomiphene citrate
  • Letrozole
  • Gonadotropins or human chorionic gonadotropin (hCG)
  • Bromocriptine or cabergoline
  • Clomiphene or clomiphene citrate

Surgical

Surgical treatment is less frequent in PCOS but it is still an option, typically, if other treatment methods don’t work. In this case, a surgery called ovarian drilling is performed. During the surgery, a doctor makes a few holes in the surface of your ovary to restore ovulation. Typically, the result is retained for around 6 to 8 months.

4. IVF

In vitro fertilization or simply IVF is one of the assisted technologies meant for people with fertility challenges. This procedure consists of several stages, including:

  • Ovulation stimulation
  • Progress monitoring
  • Retrieval of mature eggs
  • Eggs fertilization in a laboratory medium
  • Embryo transfer
  • Pregnancy confirmation
In PCOS women, IVF might be a suitable option if medical or surgical treatment doesn’t work as expected. Compared to natural chances of pregnancy with PCOS, IVF offers a higher likelihood of getting pregnant thanks to ovulation stimulation, controlled fertilization performed in a laboratory, and subsequent pregnancy support.

Final verdict

There are no two females with identical PCOS situations. This condition might be expressed differently in every woman, and a combination of the specific symptoms you’re dealing with, as well as individual factors like your age and pregnancy history, all affect your chances of conceiving.

As you now know, PCOS may complicate pregnancy and require a longer time to conceive a child. There also might be certain health risks for a baby and mother-to-be. Nevertheless, PCOS does not mean that you can’t get pregnant.

There are a number of ways to boost your chances of pregnancy with PCOS, including losing weight, taking supplements, receiving infertility treatment, and even trying IVF. Use this guide as your roadmap to ensure the success of your TTC journey and don’t hesitate to talk to your healthcare provider to receive personalized advice.

References:

  1. "Polycystic ovary syndrome (PCOS)." Mayo Clinic, 8, Sep. 2022. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439 
  2. "Polycystic ovary syndrome." The World Health Organization, 28, Jun. 2023. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome#:~:text=The%20condition%20affects%20an%20estimated,particular%20related%20to%20metabolic%20problems
  3. Melo AS, Ferriani RA, Navarro PA. "Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice." Clinics (Sao Paulo), Nov. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642490/ 
  4. "Polycystic ovary syndrome." The National Health Service (NHS), 11, Oct. 2022. https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/#:~:text=Polycystic%20ovaries%20contain%20a%20large,ovulation%20does%20not%20take%20place
  5. Doldi N, Gessi A, Destefani A, Calzi F, Ferrari A. "Polycystic ovary syndrome: anomalies in progesterone production." Hum Reprod, Feb. 1998. https://pubmed.ncbi.nlm.nih.gov/9557824/ 
  6. Bahawi YO, Radwan EM, Khouj MA, Alotaibi RK, Bajuwaiber NA, Baghlaf LF, AlFaraj WF, Oraif AM. "Pregnancy Rates in Women With Polycystic Ovary Syndrome (PCOS) Using Letrozole Versus Clomiphene Citrate: A Retrospective Record Review." Cureus, 21, Jul. 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440068/ 
  7. "Polycystic ovary syndrome." U.S. Department of Health & Human Services, Office on Women's Health, 22, Feb. 2021. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome#:~:text=Having%20PCOS%20does%20not%20mean,you%20can%27t%20get%20pregnant
  8. Balen AH, Rutherford AJ. "Managing anovulatory infertility and polycystic ovary syndrome." BMJ, 29, Sep. 2007. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1995495/ 
  9. "Why should you monitor your insulin?" Aspect, 20, Aug. 2024. https://www.aspect-health.com/post/why-should-you-monitor-your-insulin?utm_source=blog&utm_medium=blog&utm_campaign=blog_main&landing_from=%5B%2F%2C%2Fblog%2C%2Fpost%2Fscientists-have-found-a-link-between-the-activity-of-the-memory-center-in-the-brain-and-blood-sugar-levels%2C%2Fpost%2Fwhy-should-you-monitor-your-insulin%5D 
  10. Kadir M, Hood RB, Mínguez-Alarcón L, Maldonado-Cárceles AB, Ford JB, Souter I, Chavarro JE, Gaskins AJ; EARTH Study Team. "Folate intake and ovarian reserve among women attending a fertility center." Fertil Steril, Jan. 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714696/#:~:text=More%20recent%20studies%20also%20confirm,with%20infertility%20treatment%20(12)
  11. "Fertility Treatments for Females." Eunice Kennedy Shriver National Institute of Child Health and Human Development, 31, Jan. 2017. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/treatments/treatments-women 
  12. “In vitro fertilization (IVF).” MedLine Plus, Medical Encyclopedia, 31, Mar. 2024. https://medlineplus.gov/ency/article/007279.htm 

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