Fertility and Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is one of the leading causes of fertility issues in women. If you’re trying to conceive with PCOS, you might wonder how long it takes to get pregnant, and how easy it is. 

Most women with PCOS will be able to conceive. However, due to the effect that PCOS can have on ovulation - which is required for pregnancy - a little help may be needed. 

On this page, you’ll find the most frequently asked questions around PCOS and getting pregnant. If you don’t find what you’re looking for, we recommend booking a free call with one of our fertility advisors, who will advise the best next steps for you.  

PCOS is the most common endocrinological* disorder in women. It is characterised by altered levels of hormones, especially high levels of androgens (hormones that are more prevalent in males, such as testosterone).

The symptoms range from individual to individual, but there are three main features associated with PCOS. To be diagnosed, you would normally have at least two of the following:

*endocrinological disorders are issues with hormone production and/or function

It’s hard to tell exactly how many women have PCOS, but it is the most common endocrinological disorder in women of reproductive age worldwide. The NHS estimates that around 1 in every 10 women in the UK have PCOS. Other estimates place PCOS prevalence around 2-20%. 

The variation noted in literature is attributed to the variation of the criteria used to diagnose it (Royal College of Obstetricians, 2014).

Diagnosing PCOS can sometimes be difficult due to the wide range of symptoms and signs that it includes. You’ll likely undergo blood tests and an ultrasound scan. Because PCOS is not the only disorder which causes its symptoms, a diagnosis may also involve ruling out other conditions or factors. 

“The exact cause of polycystic ovary syndrome (PCOS) is unknown, but it's thought to be related to abnormal hormone levels.” NHS

We don’t know exactly what causes PCOS, but there is research that suggests that the following risk factors and associations are linked to a higher incidence of PCOS: 

Yes. Unfortunately, women with PCOS are more likely to have or develop a number of conditions, which can affect and influence each other. These include:

• Infertility

• Insulin resistance

• Obesity & metabolic syndrome

• Heart disease and high blood pressure (Cardiovascular disease)

• Non-alcoholic fatty liver disease

• Impaired glucose tolerance & type 2 diabetes

• Endometrial cancer 

• Obstructive sleep apnea 

• Inflammation

• Mood disorders 

The metabolic elements of the condition increase the risk of developing type 2 diabetes mellitus and cardiovascular disease later in life, especially if there are other predisposing factors, such as obesity, poor diet and lack of exercise. 

In women who have very irregular or no periods, there is a higher risk of developing endometrial cancer. These women should therefore receive treatment to induce menstruation at least once every three months.

If you have these conditions and believe that your PCOS may be a factor, seeing a doctor is advised. According to which symptoms and conditions you are experiencing, they can advise on the best next steps, whether that’s treatment or referral to another specialist.

If you think you might have PCOS and have not had a formal diagnosis, it would help to speak to your GP who may refer you to a specialist.

You should also speak to your GP or health care provider if you are struggling with the symptoms of PCOS, such as weight gain, hair growth and acne, or the conditions listed above. They may be able to help with the symptoms that affect you the most.

Ovulation Induction

Depending on how PCOS affects you, the first port of call could be ovulation induction with the help of medication. Drugs like clomifene (brand names include Clomid) or aromatase inhibitors (Letrozole) come as a short course of tablets at the beginning of each cycle, and encourage ovulation in order to make pregnancy more likely. Metformin may also help women with PCOS ovulate by treating insulin resistance. 

Gonadotrophins (brand names Menopur, Meriofert, Gonal F and Bemfola) are another type of medication to help stimulate ovulation. Gonadotrophins come as injections. If the idea of injections worries you, the Apricity app has a number of videos showing you how to self-inject. An Apricity advisor or nurse can also be available to do your first injections together.

With the help of ovulation induction, many women successfully conceive. 

IVF

In vitro fertilisation is offered to PCOS women when ovulation induction has failed or other indications for IVF warrant this.