Can I get pregnant with PCOS? Yes, but there are risks

Polycystic ovary syndrome (PCOS) is a common reason why women in the US can’t get pregnant.
Losing weight, taking medication, or in vitro fertilization are ways that you can get pregnant with PCOS.
This article was reviewed by Julia Simon, MD, who is an assistant professor with the Department of Obstetrics and Gynecology at UChicago Medicine.
Visit Insider’s homepage for more stories.

Polycystic ovary syndrome, or PCOS, is a common hormonal disorder that disrupts the menstrual cycle. It’s one of the most common causes of infertility in women in the US, according to the Centers for Disease Control and Prevention.

That said, getting pregnant with PCOS is not impossible, and with the right approach, your chances may even be pretty good. Though it’s important to note that women with PCOS are prone to developing certain complications during pregnancy, like gestational diabetes.

“They are also at higher risk of hypertensive disorders of pregnancy,” says Nanette Santoro, MD, professor and E. Stewart Taylor Chair of Obstetrics and Gynecology at the University of Colorado School of Medicine. For example, a woman with PCOS may be more likely to develop high blood pressure that could lead to preeclampsia.

With that in mind, here are the three common ways that women with PCOS can improve their chances of getting pregnant.

Shed excess weight

"Because ovulation is infrequent in women with PCOS, and you cannot conceive if you do not ovulate, this winds up being the chief barrier to fertility," says Santoro.

Santoro usually advises her patients with PCOS to first lose weight if they're carrying more than a few extra pounds around.

That's because research has shown that even a 5% loss of total body weight has helped some women begin to ovulate again.

Medication may help

You might need to start taking medication to stimulate ovulation because even if you are having menstrual periods, you might not be ovulating.

"Usually, I go straight from the pill to medications to help them ovulate," says Richard Legro, MD, Professor of Obstetrics and Gynecology and Public Health Sciences at Penn State College of Medicine and Penn State Health.

Clomiphene citrate (Clomid) and letrozole (Femara) are often used to stimulate ovulation and are pretty successful, says Dr. Santoro.

Clomid, which stimulates your body to produce hormones that encourage ovulation, has been used as a first-line treatment for many years. But letrozole, which also works by convincing your body to produce more follicle-stimulating hormone (FSH), may be more likely to help you get pregnant.

Consider in-vitro fertilization

If meds don't work, then there's the option of intrauterine insemination or also in vitro fertilization (IVF). IVF is an assisted reproductive procedure in which some of a woman's eggs are taken from her ovaries, fertilized by sperm in a lab, and then transferred into her uterus.

"Fortunately, because women with PCOS have such a large endowment of eggs and follicles, modern fertility treatments are usually highly successful and can often be very simple," says Dr. Santoro.

It's not clear how successful IVF is at helping women with PCOS get pregnant. However, one study, published in 2015 in the International Journal of Clinical and Experimental Medicine, found that women with PCOS had an equal chance of getting pregnant through IVF as women without PCOS. In general, factors like age and weight will affect your chances of getting pregnant through IVF.

So, if you have PCOS and you want to get pregnant, it wouldn't hurt to make an appointment with your OB-GYN. Your doctor might want to make sure there aren't any other factors that could be contributing to infertility. And start you on a prenatal vitamin that contains folate, just like other pregnant-women-to-be are advised to do, says Santoro.

"If a woman is under 35 and she's having at least one period every three months, she may want to try on her own for up to six months to a year to see if she can get pregnant," says Santoro. "But if she can't, it's time to go to an obstetrician."