Fertility Issues for Women with Polycystic Ovaries Syndrome (POS)

I was diagnosed with PCOS about 6 years ago and included diabetes (extreme result of insulin resistance). Myself and mother had read research that said pregnancy actually sometimes benefits those with PCOS. I consider myself one of those people. Yes, I have gotten pregnant twice. First time I was given something to kickstart my period after going off the pill, but I think that was because I had been on the pill for so long and had originally gone on it (pre-PCOS) for irregular periods. I actually never got my period and found out I was pregnant. Prepping for pregnancy planning, I went to a Reproductive Endocronologist who specializes in PCOS. He analyzed the meds I was on, changed them to prep for pregnancy. I was put on Metformin and continued it for the first trimester to control my blood sugar / diabetes. I never got gestational diabetes. Post the first pregnancy I had no symptoms of diabetes or PCOS issues (regular periods, blood sugar issues, etc). Second time I got pregnant the first try. I would recommend she goes to a specialist for evaluation and planning. Dr. Rogerio Lobo was excellent (specialist in PCOS and reproductive endocronology).

I was diagnosed with PCO in college and too was told that I may have difficulty getting pregnant. NOT THE CASE! It only took ONE try each time, I have 3 healthy children and this last time around I had my tubes tied b/c apparently I am very fertile!

When I was first diagnosed I was so depressed by the thought of possibly not having children, I had to move out of my apartment and back in with my family for emotional support. I especially had trouble getting over the fact that I had sufferred for years from symptoms such as cystic acne and hair growth on my chin and PCO was never suspected b/c my body type was not "typical". Finally an ob/gyn did a simple blood test and then treated me simply with a birth control pill.

I have POS and I have two great, healthy kids. I went to a fertility doctor at Yale who was great. the best thing to do is stay slim and in shape if you can. There are also some meds (oral) they use that work without having to get stuck every day. I did use those, in conjunction with egg monitoring at the doctor during my cycle. The second time I just did it on my own. HOwever, I will say both times took a while, it took me 2 1/2 years the first time and my kids are 3 years apart and we did not prevent in between. It is possible, so tell her not to give up.

Hi G.,

PCOS can be overcome ... I know this because I have it along with a beautiful 7 month old girl! I was in infertility treatment for a year and a half, but I was lucky enough to get pregnant with IUI (artificial insemination). Here's a link to a book called Fertility Foods, which I found to be REALLY useful during my struggles. http://tinyurl.com/32e2yp

Your niece is young (I had my baby at 39!) so that can only be helpful. I was on a variety of drugs (one of which was metformin, the same drug that my dad, who has type 2 diabetes was taking!) It was no surprise that when I became pregnant I developed gestational diabetes, which was no fun. Sticking to GD diet was amazingly helpful - I only gained 10 pounds while pregnant! I know that keeping fit helps - I probably need to go back on that diet! They say breastfeeding keeps you skinny, but not if you eat too much chocolate!

If your niece has any questions, she can email me. I am no expert, but I did go through it myself.

Take care,

R.

I have PCOS with only one ovary functioning. I tried for 7 years and refused to use fertility drugs. As a last resort at age 33, my dr. ordered a sonohistogram (so long ago, now sure if this is correct term!) to see if my tubes were open. Apparantly they weren't. Here's what happened: April 7th, took test, April 9 got period and got okay from dr to try getting pregnant, May 7th positive pregnanct test! my daughter is now 4 years old and although her dad left me when I was 5 months pregnant, i never looked back or had regrets! On my annual visit January 2007, to our extreme surprise, my functioning ovary had mature eggs and is apparantly working just fine! Explore non-medicated ways as a first option.

Has your niece had any luck?

I myself have been a diabetic since I was 8. I also have pos. I have 2 wonderful children 8 and 3. I used birth control to regulate ( a low dose ) then quit the pill to get pregnant. It worked each time. My Ob/gyn claims that right off of the pill your body will give you a couple cycles that are enough to get pregnant. I worked closely with my endo. To keep the a1c below 6. My kids were both healthy and are doing great. No learning problems or health issues.

G.,
I was told I also had cystic ovaries. I would miss a period for months and months. I had surgery when I was 21 where the surgeon put a "wedge" in my ovaries. I began ovulating almost immediately and I went on to have 3 children including a set of twins. I'm not sure if this is your neices condition but it does sound similiar. I remember the day I told my husband to be that I might not be able to have children. Ha! Anyway before she begins costly, painful and sometimes unproductive invitro suggest she see if a surgical procedure might help. Also the word "difficult" does not mean impossible! Hope this helps.

Highly recommend the book "The Garden of Fertility" by Katie Singer.

I have PCOS and I have a 2i/2 year old daughter. Yes, I did have trouble getting pregnant. I took about 2 years. My ob/gyn but me on Clomid days 5-7 of my period but it wasn't working. I then went for a hystrosalpingogram which is a test to see if your tubes are open. They were so I then had a chromotubation which just clears out the tubes. After all these procedures the doctor but me on both CloMmid a Glugophage(it's a diabetes medicine) I don't have diabetes but because of the PCOS your sugare can be a little out of wack. I got prgnant the next month.

hi G.,

have her see an acupuncturist/ herbalist. back when i was training in chinese medicine in clinic i treated a woman with POS. she hadn't had her period in over a year and was trying desperately to conceive. after 2 treatments she got her period. in the 11 treatments we had together (that's all that was allotted) although she didn't get pregnant, she did get her period twice... a great sign for someone who is trying to conceive. good luck!

K.

I have PCOS (and am insulin resistant) and was able to get pregnant naturally. I used accupuncture to get my hormones in balance. Endocrinologist wanted me to go on metformin to regulate insulin but I refused. I started accupuncture in Apr/May and by Sept of the same year, I was pregnant. I gave birth naturally (no drugs) in July of the following year to a healthy baby girl.

I too was diagnosed with PCOS a few years ago when I was considering starting a family. I have spend most of my life with problems with my period. I would go months without having my period sometimes I would get it only once or twice a year. When my husband and I decided that we wanted to start having children I went to my OBGYN because I knew that only ovulating once a year and never knowing when that time would come was going to be a problem. Sure enough they ran some tests and found my testosterone levels were high and they could see the cysts on my ovaries. I was devastaded when they told me I was infertile and would need fertility drugs to get pregnant. Fertility drugs just scared us. We heard some beautiful success stories but also heard a few nightmares and after some research found that these drugs can have some long term side affects for me in the future and the future of my baby. After many discussions and alot of tears we decided that fertility drugs were not for us and we would just trust God to decide what was meant to happen. I now have a beautiful son who is 20 months old and I am 6 months pregnant with my second. I understand my story is not like most with my condition but I also believe that like myself most women panic at the thought of having PCOS and as we all know that stress alone can prevent pregnancy. Maybe just accepting my diagnosis and not torturing myself relaxed me enough that nature was able to take it's course I'm not sure but please tell your niece to do the research on the drugs that she will need to take so that she can make an educated decision.

I am a 32 year old registered nurse and a woman with pos. And i am proud to say that i am also a mom. My son is five years old and We actually got pregnant on the first try. I know this is not the case for eveyone. Fertility issues with pos come when the woman does not ovulate. if your niece has regular menstrual periods she may be ovulating and she may not have trouble. If they are irregular or she doesn't get them at all that's more difficult. There are treatments to try before fertility drugs. But she should not wait longer than six months of trying to get pregnant before she seeks out the gyn. for her best options.

I have PCOS, and via no fertility drugs except Metforfmin/Glucophage (for about a year to regulate my periods) I gave birth to a healthy, wonderful baby boy, and then, when he was 4 months old, I got pregnant and gave birth to a beautiful, wonderful baby girl (they're 11 months apart - two words: BIRTH CONTROL!! We thought we were invincible). It's possible and highly probable to get pregnant. I had my first at 29 and my second at 30... Best of luck to your niece.

My friend has POS and was also told that it might be difficult to conceive, but ended up getting pregnant on her honey moon. There is a great book out there called
"Fertility, Cycles & Nutrition" by Marilyn Shannon. It has great info on POS. I hope your niece is sucessful.

I am a married mother of a beatiful 3 year old son. I was diagnosed with polycystic ovary syndrome. We tried to conceive on our own for about a year and then we saw a fertility specialist. Once that doctor prescribed Clomid, I conceived immediately, only a month and a half or so after starting with the fertility specialist. I don't know about the other medical conditions you mentioned, as I don't have personal experience with those.
All the best to your niece, the fertility process takes different periods of time for each person, tell her to hang in there!!

I too had PCOS. I was put on Metformin, clomid and had an IUI with my first son. The second time around (not trying to get pregnant), I wasn't getting my periods. So I went on metformin to regulate myself. Apparently it worked really well, b/c I got pregnant with my second son.
PCOS presents itself in many different ways. Therefore I would seek out a fertility specialist to see what her next step would be. She may have an easy solution or she may have to undergo many more procedures.
Tell her to keep a positive attitude and hopefully a specialist can help her.
Good luck!

I did, and I did not get pregnant, but I'm much older than your niece. When I was there the nurse advised me to check into accupuncture. She said that with a good certified accupunturist, many women get pregnant. Also I would check into alternative therapy. There is a good book that can give you some guidance, it is called "The Woman's Guide to Natural Health." I can't remember the name of the author. I found it to be an excellent resource. It may be worth it to try alternative therapy even if you have to pay out of pocket, because in vitro can cost 15,000 to 30,000 if you are not insured.

Hi G.,

I have PCOS. I am 25 and was diagnosed when I was 21 because my OB/GYN noticed I have an irregular uterus during a routine exam, so he did a sonogram. I could see the screen and my ovaries looked like baby swiss cheese- tiny little cysts all over the place. I never noticed any symptoms because I always had a regular period (exactly 28 days- ugh!)

He put me on birth control to prevent my body from creating cysts (your body creates one every period cycle when you ovulate- being pregnant & breastfeeding also prevent ovulation) and sent me for blood work to see if I needed glucophage. He told me if I wanted to conceive I would need to wait 4-6 months after coming off birth control before I tried, and I would most likley have a difficult time getting pregnant.

People with blood sugar issues are more apt to develop PCOS than people who do not. Diabetes runs in my family, but I have not developed it, and hope not to. When he mentioned glucophage, I told him that I am already careful with my diet and exercise regularly to prevent the onset of diabetes. He said that a good diet and exercise are better than any drug, and if that was working would be able to tell from the blood work. To my relief, I was doing well without another drug (I HATE DRUGS, ESPECIALLY BIRTH CONTROL).

I was on Ortho Evra and got blood clots from it (which destroyed veins in my legs), so I was taken off all birth control nov 2005. Blood work showed that I have a predisposition for heart attack & stroke due to clotting, and excessive hormones compounded the problem, so no more birth control, ever, and no option for infertility drugs if I had trouble getting pregnant.

He did another sono and saw that most of the little cysts had ruptured or joined together into one of 5 larger cysts. He said he wanted to do another one in about a year to see if more had ruptured and healed by themselves. I never got that far...

My husband and I had not talked about trying to get pregnant, and we were using condoms up until we went out to Montauk for a weekend in June 2006. We had no condoms with us, and I thought he would pull out, but he smiled at me and kissed me and did exactly the opposite. Only took once, and it was 8 months after coming off birth control.

My best advice is 2 things-

1) to have her take a serious look at her diet and exercise. I did this when I was 18 and 35 lbs overweight (a lot for someone 5' tall) and having a lot of trouble with hypoglycemia. I changed the way I eat and exercise and never looked back. I did this because I have seen my grandmother suffer with diabetes and prescription after prescription, and I was headed down that path. It actually helped out in so many ways I can not name them all.

2) try to do this without drugs via natural, wholistic, and alternative therapies before jumping into infertility drugs & in vitro. It doesn't work for everyone, but it is far healthier for her & the baby if it does. IMHO- if you can do it without medical interventions, you are better off. Every drug you put into your body has side effects, and everyone reacts differently. This is especially true for unborn children. The effects of infertility drugs on children and adults later on in life has not been widely studied.

Changes in lifestyle are often the best remedies, and often "cure" more than the one problem you are focusing on. Good luck, and best of health to all of you!!

Dear G.,
In my profession, I have worked with numerous women with PCOS who were able to become pregnant. Your niece should speak with her OB-Gyn about possible referrals to a reproductive endocrinologist.
Best,
J.

Hi, I have a 26 year old daughter with POS and she is overweight. You didn't say if your niece is overweight but from what I have read in a lot of cases if women with POS will lose weight they tend to be able to conceive. My daughter is in the process of dieting now and has already lost about 20 lbs. Her periods are becoming more regular since the weight loss so maybe that is a good sign. She is not at this point trying to conceive but her and her husband do nothing to prevent it so we will see what happens down the road. If weight is an issue with your niece maybe this will help. J.

Hi G.,

My suggestion for your niece, and I know this is very different then other people would recommend, is to try natural hormone therapy and other natural therapies. I wish I had had someone to steer me in that direction at her age and she should start now. I did not have POS, I had fibroids and other problems, but most reproductive issues have to do with hormonal imbalances. They just manifest themselves differently in different people. Nutrition and hormone worked wonders for me. Please take a look at my doctor’s web site www.drwald.com. It gets an idea of what I’m talking about and he has a free initial consultation. Doctors (Reproductive endocrinologists) told me that it would be highly unlikely (really never) give birth. After 2 years of working with Dr Wald I gave birth (using IVF) to my daughter at the age of 41!

I would also recommend my RE for IVF at http://www.ccivf.com/ if she decides to go in that direction. All IVF centers are not the same, they are excellent. Email me directly if you like.

Good luck and God bless,
G.

Hi G.-
I have POS. It's pretty common. As far as becoming pregnant, it can be difficult. She should give herself a time limit as to how long she will try to get pregnant on her own before seeing a fertility specialist. He/She will probably prescribe Metformin, which is a medication diabetics take.
I have had invitro three times. The first time worked and I have a beautiful 27 month old son. Unfortunately, the other two procedures did not work. Your niece can also try artifical insemination, which some insurance companies actually cover.
Good Luck to your Niece.

Hi G.,
Please reassure your niece that PCOS does not equal infertility. I had a very hard time conceiving my first - after a year and a half, my OB/GYN put me on Clomid (which I DO NOT recommend) and I did end up preg. with my dd after 6 more months of trying. When we tried to conceive #2, I was nearly two years older. After trying for a while, my dh and I went to a fertility specialist who diagnosed me with PCOS right away. She pointed out, by the way, that Clomid doesn't work for everyone and often doesn't work for women with PCOS, as it can cause further cysts on the ovaries and those cysts can fill with blood. After a month "off" of Clomid, I went through a month of injections with my new doctor. I will not lie - the process was at times painful (shots) and was certainly not romantic. :-) My hubby and I opted to go with intrauterine Injection (IUI) instead of in vitro fertilization on our first attempt to get preg. under her care. I was lucky, and became pregnant with my son on the first attempt. Oh, and I was 37 at the time. My doctor monitored my hormone levels and blood sugar/blood pressure weekly (sometimes twice a week) until the end of my first trimester.
In terms of health risks, there is indeed a much higher chance of contracting diabetes if you have been diagnosed with PCOS. Friends I know who have PCOS did contract gestational diabetes while pregnant, but that is not a given either. In terms of monitoring the diabetes threat, your niece should always remind her GP that she has PCOS so that they can do the best blood sugar level checks on her over time. There is a blood test called an A1C test which is a more thorough check of blood sugar than the usual short term fast test. Also if she ends up seeming to have insulin resistance (often a precursor to diabetes), she may want to talk to her GP about treatments that help. One friend I have is aon a low dose of Metformin, a diabetes medication, and it is meant to help her NOT fully contract diabetes and also help with her fertility issues.
I hope all of this helps.
Good luck!

I have PCOS and I have 3 beautiful children. I didn't have problems getting pregnant with my first (8yo). But it did get worse. I tried for 2 years for my second with no success, until I went on clomid for 6months then I had my second (5yo). Then I miscarried with a 3rd and tried naturally for another 2 1/2 yrs. I went back on Clomid and got pregnant in 3 months (9mo old) I didn't have any complications with the pregnancies due to PCOS. Be aware that my insurance didn't cover the Clomid because it is considered a fertility drug. I think it cost @ $150 a month. Good luck to your niece!

I'm 38 yo with PCOS, diagnosed in 2004/5. I also have 1 blocked fallopian tube. It took about a year to regulate my period using BC pills, and was also dealing with severe anemia. My ob referred me to a wonderful fert doc, who tried diff drugs and dosages. I got pregnant w/ our son in Dec 2006, after 6 monthly cycles. My ins didn't cover in vitro, so we did drugs with intra uterine insemination (IUI). The one blocked tube had also decreased my chances ea month. I had a healthy preg and delivery. We decided to go through the process again when my son was 10 mos old. Pregnancy has a way of "curbing"" PCOS and the month we were to start treatments, I became pregnant w/o assistance (well, my hubby helped!)We now also have a healthy 2-wk old baby girl. Your niece needs to find a good fert doc, one who is more concerned w/her as a pt and not how many birth outcomes he/she can rack up. My MD is in Syosset, w/another ofc. In Brooklyn if you need a referral.

I was diagnosed with PCOS years ago and was always told that it may be difficult for me to become pregnant. Last April my husband and I decided to try and I went on WebMD (website) to find out when I was ovulating. I got pregnant in May on the first "try". I did get gestational diabetes but that was not related to the PCOS. Tell your niece to make sure she knows for sure when she is ovulating (try WebMD) and try that way first. How long has she ben trying? I know women without PCOS that try for a while with no luck. Tell her not to give up. I wouldn't start taking any infertility drugs yet.

Hi G.,
I am a physical therapist working with Clear Passage Therapy based in Florida. We work with women with fertility issues and I have worked with women with POS(Polycystic Ovarian Syndrome). I would suggest you check out the website www.clearpassagetherapy.com and call them in Florida to get some more information. Yes, she needs to start doing more aggressive work--there are different approaches and I think the holistic way might be better first. There are no side effects to holistic therapies and POS is a lot about hormone imbalance. You should also check out acupuncturists who specialize in fertility issues.
You are a very special, caring Auntie!

My daughter was conceived in vitro, but I didn't have POS. I have a friend with POS, but she was diagnosed with diabetes and lost her health insurance in the same month, so she adopted instead. I know it's often complicated by diabetes and weight problems, and if you can get the weight under control the prognosis improves, but I don't know a lot beyond that.

If your niece decides to go into treatment, it's important to go to a really good clinic. The drugs are okay if you get the dosages right -- they're the same hormones your body produces already -- but each cycle has to be monitored so the doses can be tailored just so, and there can be some nasty complications if it's even a little bit off. Even at the best clinics things sometimes fall through the cracks, so you have to pay attention (they gave me the wrong instructions once, and thank goodness I caught it and was persistent about getting re-tested!) I went to the Reproductive Science Center in Boston, they're one of the best and they have several branches across the US.

In vitro fertilization was not nearly as big a deal as I thought it would be -- it's just a whole lot of shots and a simple surgery. And you get to see ultrasound pictures of the little one when s/he's barely old enough to have a heartbeat! I was a total emotional basket case from the high doses of progesterone, weeping all over the nurses when I went in for my blood tests, and I was completely exhausted for my entire first trimester, but that was the worst of it. The rest of the pregnancy & birth were completely normal, and my daughter is fine and wonderful (she's 7 now.)
- M.

I do not have POS. But, 2 of my close friends do. One of them tried naturally for about year with no luck. Then she moved no to clomid and IUI and became pregnant after 3 cycles. The other one became pregnant after 2 cycles of clomid and IUI. The second time around for the first friend, she conceived naturally right away. My other friend had to go to clomid again, with no luck. Then on to injectables with no luck. They took a break from it all and got pregnant that month.

What a wonderful aunt you are to your niece!

When I was in my twenties it took several years for my condition PCOS to be diagnosed. Finally at 28 we concieved our daughter. She is now twenty and has PCOS - at least I was aware of the symptons. So she could get the treatment she needs. My husband and I did use fertility drugs with both my pregnancies. I believe it was Clomid - a medication that induces ovulation. After four years of trying we were blessed with a daughter and four years later, after only two months of trying we were blessed with a son.

If you watch Jon & Kate + 8 on TLC you will find out that she too has PCOS.

Good luck!

I have PCOS also and had no problem getting pregnant. My advice is to tell your neice to try first before she assumes she can't do it.

Also, I was on a load of medications (metformin, spironolactone, etc.)for the PCOS but stopped about 2 months before I got pregnant. I don't know if stopping the meds made a difference, but I do feel a lot better off of them, especially because it's tough to take any drugs while pregnant and feel like they're really safe.

FYI, I think the best doctor in NYC for PCOS and fertility is Dr. Michelle Warren. Her office is on the Upper East Side. I was seing another dr (who had me on, like, 5 different meds a day for the PCOS) but switched to her and am glad I did. No insurance taken though, so expect to pay a bundle up front.

Last note - I got pregnant (PCOS and all) almost immediately upon trying. My sister, who does not have PCOS and is generally healthier than I am, took 4 years. There are lots of things your niece can try to facilitate pregnancy, but it's also good to remember that it's just harder/easier for some women sometimes, regardless.

Good luck.

Hi G.,

I am 28 and have POS and was told it would be difficult to get pregnant but it was not at all. I stopped taking my pill about 2 months before trying. I monitored my ovulation and temperature and we were successful. I highly suggest your niece tries to get pregnant naturally first. POS does not mean she is infertile. I had a healthy son of 7 lbs and 19.5 inches long. I had no complications during pregnancey. My POS pain actually went away during pregnancy. Now my son is almost 6 months old and I am menstruating again. My ovaries are always tender and sore now but the doctor said once I go back on the pill that will get better again. Good Luck to your niece!

I was having a very hard time getting pregnant the second time. We had no problems with my first son, then lost one baby after trying for a year. My first doctor couldn't figure out why so I looked for another doctor we were so blessed to find my current doctor. He diagnosed me and within a year we were pregnant after trying for over 3 years. Our son is going to be 1 year in April. I had to have a DNC, we used the tmperature tracker to know when fertile, and we used Clomid (sp) a fertility drug for 3 months. We never had to do invitro. Feel free to have her contact me I would be glad to offer any help I can. I know how emotional it can be!

My baby boy is 3 months old and was conceived through IVF at Cornell/NY Presbyterian in the city (otherwise known as the Center for Reproductive Medicine (www.ivf.org).
Although my fertility issue was not 'female related', I highly recommend this clinic if your niece does in fact have to go this route. It is one of the top places in the nation and people from all over, with all types of issues, go there for assistance. (Mine happily worked on the first try too!)
If you require additional information or have any questions, please feel free to contact me personally. I hope everything works out for her- best of luck! :)

Hi G.,
I am 29 years old and have PCOS, hypoglycemia, cronic anovulation and a pituitary tumor. BUT, I also have 8 month old twins!!!!! I was diagnosed at 18 and after years of lots of medical problems and being told I would have trouble getting pregnant I finally found a wonderful endocronologist who listened to me. He worked very closely with my ob/gyn but after about 1 1/2 years we decided to go ahead with invitro. I couldn't wait any more. After 3 IUI's we went to IVF and our first time was successful. I was also going for acupuncture at the time. It is a personal decision whether or not to use drugs to concieve but you rniece should know there are options and there are success stories!!! Tell her to be positive and believe it will happen. Best wishes to you both!!!!!!

Hi I did in vitro for other reasons however I met so many women with the same issue as your niece. With the help of in vitro these women became pregnant. Everyone is different and it is difficult to project how long it will take b/c they will need to moniter her and help her body ovulate. Although there are never any guarentees Cornell/NY Presbyterian Center for Reproductive Medicine Infertility is one of the best places to go. Good Luck I will say a prayer!!!

I found out that I had PCOS at 34 when I tried to get pregnant. I got pregnant at 36 without any help. We had tried artificial insemination and I took Clomid for 6 months. No luck. After we decided to adopt because invitro was too much of a gamble and for the cost of two invitro tries we could adopt and start a family, I got pregnant. My symptoms from PCOS actually abated during pregnancy and nursing. I guess it was the extra hormones. Also- excercise helps- my periods are regular when I excercise. I have a healthy 5 year old now and I currently am overweight and have high blood pressure. Since it is a syndrome there is a wide range of symptoms and severity but tell your niece not to give up. Good luck!