Content

• To step
• Part 1 of 2: Before you get pregnant
• Part 2 of 2: If you have become pregnant
• Warnings

Polycystic ovary syndrome (PCOS), also called Stein-Leventhal syndrome, is a condition affecting 5 to 10% of women of childbearing age. It is a hormonal disorder that can cause obesity, acne and hair growth and is one of the most common causes of infertility. Hormonal imbalance caused by PCOS can cause irregular ovulation and poor egg quality. Your midwife and reproductive endocrinologist will give you suggestions to help you conceive with PCOS if you are struggling with it yourself.

To step

Part 1 of 2: Before you get pregnant

1. Notify the midwife if you are ready to try to conceive. Many women with PCOS need help to make ovulation more regular and to protect themselves from miscarriages. This requires the supervision of a doctor. Your doctor will help you with this and will monitor you closely in early pregnancy.
   • Medications you take to control PCOS may not be safe to use during pregnancy. You may therefore have to choose other medications or stop using them altogether. This is also a good reason to see your doctor right away.
2. Determine how often you have your period. PCOS can cause irregular periods in many women. Irregular periods can mean that you don't ovulate often, reducing the chance that sperm will fertilize an egg. Map your period, using an over-the-counter ovulation test or a thermometer to measure your basal body temperature - this will help you determine when you are ovulating.
   • If you ovulate regularly, try to schedule intercourse for your most fertile days.
   • If you are not ovulating, your ovulation is irregular, the basal body temperature and the ovulation kit do not provide an unambiguous answer, or you have not become pregnant after six months of regular ovulation, visit the midwife. Explain your concerns and request a referral to a reproductive endocrinologist.
3. Ask your endocrinologist about how to regulate your period. The biggest problem women with PCOS face is irregular ovulation. If you are not ovulating when you think you are ovulating, or if you are not ovulating at all, trying to conceive is like fighting a losing battle. Fortunately, doctors - and the magical powers of science - can serve you.
   • Many doctors prescribe drugs such as metformin and clomiphene to help promote regular periods and ovulation, respectively.
     • Metformin is mainly used in the treatment of diabetes, but it is also used in women with PCOS who have difficulty absorbing insulin. High insulin levels produce high levels of androgens, which makes menstruation more difficult.
     • Clomiphene is a drug that is prescribed for reduced fertility to stimulate the production of ovulation-causing hormones.
   • If you are having trouble getting your period at all, your doctor can prescribe a medicine like medroxyprogesterone.
4. Ask your doctor about in vitro fertilization (IVF) if non-invasive drug prescriptions do not lead to pregnancy. Some PCOS patients choose in vitro fertilization when other methods fail. In rare cases, PCOS affects the quality of the eggs, which means that donor eggs must be used.
5. If none of the other treatments work, explore other options. Laparoscopic ovarian drilling, a surgical procedure, can help some women with PCOS get pregnant. In laparoscopic ovarian drilling, a surgeon inserts a camera through a small incision in the abdomen. He / she then looks for ovarian follicles and tries to burn holes in them. This adjusts your hormone levels, so you may be able to get pregnant naturally.

Part 2 of 2: If you have become pregnant

1. Talk to your doctor about the risk of miscarriage. Future mothers with PCOS have a three times higher risk of miscarriage than future mothers without PCOS. Many doctors will therefore recommend that you continue to use metformin during pregnancy to reduce the risk of miscarriage.
2. Ask your midwife about regular exercise. Many doctors will stress the importance of regular mild exercise in moms-to-be with PCOS. Exercise improves the way the body absorbs insulin, normalizes hormone levels, and maintains weight. Regular exercise is often also recommended for women trying to conceive - exercise increases the chance of regular ovulation.
   • Ask your doctor what types of exercise are allowed and which ones you should avoid. Walking and light weight training are often ideal for mothers-to-be.
3. Follow a balanced diet that is high in protein and green vegetables, and low in simple carbohydrates. Because PCOS hampers the way the body regulates insulin, you, like a diabetic, need to be very careful about what you eat. A diet that is high in protein and fiber can help lower insulin levels, thereby mitigating the impact PCOS has on your body. Avoid engineered foods and added sugars.
4. Pay special attention, especially during pregnancy. Unfortunately, there are several risks associated with PCOS, even if you have already become pregnant. Ask your doctor how to protect yourself against pregnancy-induced high blood pressure, gestational diabetes, and pre-eclampsia (preeclampsia) - these conditions are common in women with PCOS.
   • Know that women with PCOS often give birth by caesarean section. That's because future mothers with PCOS are more likely to have complications.

Warnings

• Many herbal supplements are marketed as natural remedies for PCOS. Always consult your doctor before use to make sure the supplements are safe to use.