To help with pregnancy in PCOS, doctors often prescribe oral medications like Clomiphene Citrate (Clomid) or Letrozole (Femara) to induce ovulation, with Letrozole often showing better results, while Metformin might be added to improve insulin resistance and ovulation, though it doesn't directly boost pregnancy rates. These pills work by stimulating the ovaries to release eggs, a key step for conception when PCOS causes irregular or absent ovulation.
A medicine called clomifene may be the first treatment recommended for women with PCOS who are trying to get pregnant. Clomifene encourages the monthly release of an egg from the ovaries (ovulation). If clomifene is unsuccessful in encouraging ovulation, another medicine called metformin may be recommended.
How Can I Conceive with PCOS?
Having PCOS doesn't mean you can't get pregnant. In fact, PCOS is one of the most treatable causes of infertility in women. Initially, hormonal birth control pills may be recommended to help regulate ovulation and control some of your symptoms. However, you can't get pregnant when taking birth control pills.
The best option is combined oral contraceptives (COCs) with anti-androgenic progestins like CPA, dienogest (DNG), nomegestrol acetate (NOMAC), drospirenone (DRSP), or norgestimate (NGM) paired with estrogens that offer a more effective control of hyperandrogenic symptoms and endometrial protection.
To treat PCOS, doctors may prescribe medications. To assist manage androgen levels in the body and control a girl's menstrual cycle, a doctor may suggest that she initially try birth control pills. Birth control pills don't always work; some girls may use them to reduce acne and excessive hair growth.
Yasmin® has a slightly higher estrogen dose with a 21/7 schedule, which may improve cycle control. Both pills can help with acne, while Yaz® is FDA-approved for PMDD, and Yasmin® is often used for PCOS symptom management.
So women with PCOS are more likely to have trouble conceiving than other women. While most women who have PCOS become pregnant, they often take longer to fall pregnant and are more likely to need fertility treatment than women without PCOS.
PCOS and Egg Quality
Although women with PCOS might retrieve more eggs, studies suggest that their eggs may have lower quality, especially as women age (source). This can be due to hormonal imbalances affecting the maturation and release of eggs, (source).
For many patients with PCOS, lifestyle changes, such as achieving and maintaining a healthy weight, can be enough to resume ovulation and become pregnant.
Vitamin D plays a crucial role in glucose metabolism, improving insulin sensitivity, decreasing insulin resistance and suppressing pro-inflammatory cytokines. Inositol lowers insulin resistance, improves reproductive function, improves oocyte quality and restores ovulation in patients with PCOS.
Late 30s and Thereafter: The fall in fertility is more rapid as women advance into their late 30s. It gets difficult for those with PCOS to conceive naturally as well. Hence, they must seek fertility assistance if they desire pregnancy past this age.
DISCUSSION. In this study, letrozole was found effective and better choice of treatment for subfertility than clomiphene in PCOS women. Regarding primary outcome, letrozole treatment resulted in the higher live birth rate compared to CC (25.4%vs 10.9% p= 0.005).
however, it is possible for GPs to continue to prescribe clomifene after the appropriate dose has been established; this should be done as part of a formal shared-care agreement between hospital and primary care.
Medications to restore fertility
Foods to Avoid with PCOS
Lifestyle Changes: A balanced diet, regular exercise, and stress reduction can help manage PCOS symptoms and reduce miscarriage risk. Medications: Ovulation-inducing medications, insulin-sensitising agents like Metformin, and progesterone supplements can improve pregnancy outcomes.
If your hormone levels continue to be high or your excess hair growth doesn't improve, your health care provider may re–check your hormone levels, or may suggest that you take the Pill continuously. This means that you would take just the “active pills” for 3–4 months or longer.
Having PCOS does not mean you can't get pregnant. PCOS is one of the most common, but treatable, causes of infertility in women. In women with PCOS, the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation). If you don't ovulate, you can't get pregnant.
Here are some of the ways our doctors test for ovulation.
12 tips for getting pregnant faster with PCOS: A step-by-step...
Therefore, you should not take Yasmin if you have kidney, liver, or adrenal disease because this could cause serious heart and health problems. Tell your doctor if you are on daily long-term treatment for a chronic condition such as cardiovascular disease or chronic inflammatory disease.
Unwanted-21 Days Tablet is used to prevent pregnancy by inhibiting ovulation, regulate menstrual cycles, and manage PCOS symptoms. This medication is taken once daily for 21 days, followed by a 7-day break before starting a new pack.
“Oral birth control remains a safe and effective first-line option for managing PCOS symptoms, and our research showed providers can prescribe it alone with greater peace of mind knowing that it's safe and effective for these higher risk patients.