After a recent podcast, someone messaged me saying they had been diagnosed with PCOS and thought it meant they would never be able to fall pregnant. They were relieved to learn that this isn’t necessarily the case!
When you search for information about PCOS, one of the first things you might see is that it’s the “most common cause of anovulatory (not ovulating) infertility.” It’s understandable why this diagnosis can be so worrying.
Let’s Get Some Facts Straight
1️⃣ PCOS Doesn’t Have to Be Permanent: While genetic predisposition plays a role, PCOS in many people is caused by insulin resistance, which interferes with the communication between the hypothalamic-pituitary-ovary axis (high LH vs. FSH). This means that with lifestyle changes and/or medications, people can improve their insulin resistance and high insulin levels, potentially reversing PCOS.
2️⃣ Egg Quality is Not Affected by PCOS: If lifestyle changes or medications like metformin don’t restore ovulation, there are treatments available to induce ovulation. The main ones used are Clomifene or Letrozole, which work by decreasing oestrogen levels or stimulating oestrogen receptors. This prompts the hypothalamus and pituitary to secrete hormones that stimulate the ovaries, leading to oestrogen production and ovulation.
From my clinical practice, it’s rare to see someone need IVF purely for PCOS. Remember, it takes two people to make a baby, and 50% of fertility problems are at least partly related to the male partner.
Take-Home Message
PCOS can make it difficult to fall pregnant, but it doesn’t mean it’s impossible. There is nothing wrong with egg quality in PCOS, and ovulation and pregnancy can definitely occur with a combination of lifestyle changes and medications if needed. Furthermore, PCOS can be a transient diagnosis that many people can reverse or manage completely. Finally, a diagnosis of PCOS is not a form of contraception, so make sure you’re still covered if you’re not trying for pregnancy. 😎