One of the main questions that women pose after the diagnosis of polycystic ovaries is: “can I get pregnant?”
The first thing worth mentioning is that, fortunately, the great majority of women with polycystic ovaries can become mothers spontaneously. Just a small group of women will need some assisted reproduction technique. In any case, what does having polycystic ovaries mean, and what are the consequences of this in a woman’s life?
Dr. Lucas Minig and his team will explain it all in detail in this article along with some tips to increase the probability of becoming a mother with polycystic ovaries.

What are polycystic ovaries?

The name «polycystic» comes from the Greek word «poly», meaning “many” and «cyst», meaning “closed sac”. In other words, ovaries with multiple cysts. And the only way to see this is by performing an ultrasound.
While patients have ovary cysts, these are of a few millimeters each. Thus, the final size of the ovary is usually greater than the one of a normal ovary. This has nothing to do with women diagnosed with an ovarian cyst. Here, there is usually a big dominant cyst of around 4 centimeters or more.

Polycystic ovary image

Ovarian cyst image

Is polycystic ovary syndrome the same?

A different thing is polycystic ovary syndrome (PCOS) which refers to the consequences (signs and symptoms) of the same disease.

PCOS usually affects women in early adulthood (20-30 years old) and is the consequence of an imbalance in female sex hormones (estrogen and progestin). This imbalance is responsible for the clinical manifestations of the disease.

The most common of them are menstrual cycle disorders. But also, women with polycystic ovary syndrome can develop skin conditions such as acne and hair excess (hirsutism), difficulties getting pregnant, and on rare occasions, other health problems.

The hormonal disturbances caused by polycystic ovaries are characterized by increased production of androgens in the ovary. This is what alters the female hormones (estrogen and progestin) and what causes the menstrual cycle disorders, and the skin conditions (acne and excess hair). In essence, the main issue is the failure of the ovary to make a follicle grow each month and produce ovulation. Thus, the menstrual cycle is altered and women usually have menses more than 29-35 days apart (which is the normal range).

Women with polycystic ovaries, aside from having the menstrual disorders described, can also suffer from metabolic syndrome associated with a greater risk of developing cardiovascular disease or diabetes in the future.

How do I know if I have polycystic ovaries? How is the diagnosis of polycystic ovaries made?

The main warning sign regarding this disease is knowing if women have menstrual cycle disorders, often periods more than 45 days apart. All of these, either associated or not with acne and excess body hair known as hirsutism.

After talking about these signs and symptoms with the gynecologist, they will perform an ultrasound to observe the polycystic aspect of the ovaries. Afterward, a complete blood analysis must be drawn to rule out the causes of the symptoms and achieve.

What are the main symptoms of polycystic ovary syndrome?

The severity of symptoms of polycystic ovary syndrome is variable among women. Thus, it is possible to find women with only mild menstrual cycle disorders; also, they can present with difficulties in conception, skin conditions, etc.

Irregular menstrual cycles

It is the main symptom in women with polycystic ovary syndrome. This is usually explained by the impaired ovulation, and thus, the patient has periods at intervals longer than normal (28-30 days)

These cycles, on occasion, can come every 90 days or more. In this case, the patient must visit her Gynecologist to prevent uterine cancer in the long run.

Irregular genital bleeding

It refers to uterine bleeding outside of the normal menstrual period that can be intermittent and of variable quantities.

Acne

It is a very frequent symptom that usually develops on the face, chest, or back.

The explanation for this is the hormonal disturbance with an increase in male hormones.

Body hair increase or hirsutism

It is common to see an increase in body hair on the chest, abdomen, and face areas, as well as around the nipples.

The explanation, same as for acne, is the hormonal imbalance with an increase in male hormones.

Increase in body weight and/or obesity

Some women with polycystic ovary syndrome can have a gradual increase in body weight and, more rarely, develop obesity.

This problem, although rare, is something that must be treated correctly to reduce the risk of cardiovascular problems and cancer in the future, and increase the probability of conception in women trying to get pregnant.

Difficulty getting pregnant

Having trouble getting pregnant in women with polycystic ovary syndrome responds to the hormonal disorder that impairs ovulation, and thus, reduces the pregnancy rate. However, it is worth noting that most women with polycystic ovary syndrome, do not usually have any trouble achieving a spontaneous pregnancy.

What is the best treatment for women with polycystic ovary syndrome?

The main question when establishing the best treatment is whether the woman with polycystic ovary syndrome wants to become a mother or not.

Polycystic ovary syndrome treatment in women with no desire for pregnancy

The treatment of choice in these patients is combined oral contraceptives with estrogen and progestin. This will help, not only by controlling menstrual cycles, but with the reduction of acne and body hair with some last-generation contraceptives. This is evidently not the only solution if the patient wants to become a mother.

Anyway, an early diagnosis and treatment of polycystic ovary syndrome is key to reducing the risk of developing issues in the long run and it is also very important if a future pregnancy is wanted.

How to get pregnant with polycystic ovaries

As mentioned, women with polycystic ovary syndrome can experience trouble becoming mothers. 

The main problem is the impaired ovulation that women with this condition have. While ovulation normally takes place on the 14th day of each menstrual cycle, women with polycystic ovary syndrome can ovulate every 50 days or more. However, given that women might eventually ovulate and menstruate, they can get pregnant spontaneously; although with a little more trouble.

Only in those women with a complete absence of menstruation, pregnancy is virtually impossible to achieve spontaneously.

Some tips to increase the probability of getting pregnant with polycystic ovaries are:

Holding frequent sexual intercourse

Given that ovulation is essential in women with polycystic ovaries and irregular cycles, the best strategy is to have sexual intercourse very often, especially 10 days after the menstrual period.

Keep in mind that the sperm cell can survive up to 72 hours and the ovum lives between 24 to 48 hours after ovulation. This is important to increase the pregnancy probability of each couple.

Have a healthy lifestyle

This translate into a balanced diet, smoking cessation, and regular physical activity maintaining an appropriate body weight for the woman’s height.

These are very important factors that will help achieve the goal of being a mother for women with polycystic ovary syndrome.

Visit a specialized Gynecologist

If after 6-12 months of having regular sexual intercourse pregnancy has not been achieved, you must visit a specialized Gynecologist. The specialist will evaluate your partner to identify any infertility risk factors, study the polycystic ovary syndrome in detail to understand to what level is the woman’s fertility compromised, and will assess the partner’s health status to rule out possible risk factors for male infertility.

The Gynecologist might prescribe some specific medication to regulate and predict ovulation, and that way increase the probability of spontaneous pregnancy in women with polycystic ovary syndrome.

These are some general guidelines to increase the odds of pregnancy in women with polycystic ovary syndrome. Nevertheless, keep in mind that the disease along with the menstrual cycle disorders often improves spontaneously with time or after pregnancy.