You may have heard that women with PCOS have difficulty getting pregnant and may require fertility treatment. Whilst it’s true that PCOS is a common cause of anovulatory (lack or absence of ovulation) infertility, it’s also true that many women with PCOS don’t struggle getting pregnant at all. So please don’t think that you’re destined for a long journey of infertility.
Can I get naturally pregnant with PCOS?
If you are concerned or have been trying to get pregnant for a while there is so much that you can do to increase your chances of getting pregnant naturally before having to explore fertility treatment options.
Knowing how PCOS impacts fertility can clarify why making lifestyle changes can be so beneficial, let’s take a look at what goes on.
PCOS is associated with an imbalance of different hormones – many of which are involved in the development of a mature egg (ovulation) and maintaining a healthy pregnancy. Every month, one follicle in your ovaries develops into a mature egg which is then released ready to be fertilized by a healthy sperm.
In PCOS, the hormonal imbalances often result in this follicle not maturing, which means it cannot be released and ovulation does not occur. Insulin resistance is one of the drivers of these hormonal imbalances; when insulin resistance is present (which it is in about 70% of women with PCOS) it stimulates the ovaries to produce more testosterone and these elevated levels of testosterone have a negative impact on ovulation.
How can I increase my fertility with PCOS?
Here are some evidence-based ways to help you improve fertility and prepare your body for a healthy pregnancy.
Eat more plants
In the Nurses Health Study, women with the highest intake of animal proteins (chicken and red meat) experienced more ovulatory infertility than those with a lower intake of animal protein, and those who consumed a diet higher in plant-based proteins had the lowest amounts of infertility. Beans, lentils, chickpeas, nuts, soy and other plant-based proteins are good sources of folate and iron, both important nutrients for ovulation and egg quality.
Exercise improves ovulation
Doing 30 minutes of exercise three times a week has been linked with more regular periods and ovulation. Exercise helps improve insulin sensitivity which helps lower testosterone levels and improve ovulation. Find exercise you enjoy doing to help you stick with it and if 30 minutes feels intimidating, start with three lots of 10 minutes and work your way up to 30 minutes. Here are some more exercise tips for PCOS.
Have sex every 2-3 days
Although tracking and trying to be more aware of when your fertile window is can help improve your chances of getting pregnant, it can also become stressful and overwhelming, especially if your cycle is irregular. Did you know that sperm can survive for up to six days in healthy cervical mucus, which is why there isn’t just one “best day” to have sex? By having sex every 2-3 days throughout your cycle you are likely to have intercourse twice during your fertile window, increasing the likelihood of getting pregnant.
Choose full fat dairy products
Swapping your low fat or fat free dairy for full fat and sticking to 1-2 portions a day can help improve ovulation. In the Nurses’ Health Study women who consumed 1-2 portions of full fat dairy ovulated more regularly than those consuming fat free dairy products. One portion of dairy is equivalent to 30grams cheese, 240ml milk or 150ml yoghurt.
Make sure you’re eating enough
So much of the advice for women with PCOS is around losing weight. This often results in years of diets, calorie restrictions and excessive exercise. When we’re not consuming enough our body can’t function at its best and non-essential functions (such as reproduction) are down regulated by the body to save energy for the more important functions, such as breathing and digestion. So, ditch the diets, focus on foods that nourish your body and give your body a chance to rest between exercise sessions.
Manage your stress levels
When we’re stressed our bodies release a hormone called cortisol, if we’re constantly in a stressed state these elevated cortisol levels can result in a rise in insulin levels. Although stress is a normal part of life, and we can’t completely avoid it, it’s important to find ways to try and reduce cortisol levels. Things like meditation or breathing exercises, restorative forms of exercise, such as yoga and Pilates and writing a journal at the end or beginning of every day, are all great ways to de-stress. You may need to try a few of these to find what works for you. Read more here for our 5 top tips for managing stress when you have PCOS.
Enhance your diet with supplements
No supplement can substitute having a healthy diet and lifestyle, however certain supplements and vitamins can play a vital role in maintaining our health and improving fertility.
Inositol has been proven to improve insulin sensitivity, regulate ovulation and improve egg quality.
Omega 3, specifically EPA and DHA, have been proven to decrease insulin and testosterone levels in PCOS.
Vitamin D plays a role in the maturation and development of egg follicles and studies have shown that women with PCOS are often deficient in Vitamin D.
If reading these tips has left you feeling a little overwhelmed then why not break it down. Choose one or two of these changes to begin with and once you’ve implemented these changes you can add one or two more. Unfortunately, there is no quick fix to improving fertility, so patience and trying a mix of these tips to discover what works for you is a good approach.
And if you're interested in taking natural myo-inositol combination supplements, then MyOva's range might suit you.
Jodie Relf is a registered dietitian and qualified Pilates instructor who is passionate about empowering women to take control of their PCOS symptoms naturally.
Having personally experienced the challenges of being diagnosed with PCOS in her early twenties and feeling frustrated with the lack of evidence-based advice and treatment available, Jodie made it her mission to specialise in this area.