Making a baby isn’t always easy, but trying to conceive when you have Polycystic Ovarian Syndrome (PCOS) can feel like the hurdles you have to overcome are especially high.

Polycystic Ovarian Syndrome is a common condition that affects around 10% of people with cycles. With PCOS, small cysts form on the ovaries and produce an abnormal amount of the hormone androgen. Excess androgen can disturb the menstrual cycle, ovulation process, and even the quality of eggs being produced.

Everyone’s experience with PCOS is unique. You may have missed or irregular periods, acne, or excess body hair. Some people have cysts on their ovaries, while others do not. PCOS can also cause a lack of ovulation, which is the most common cause of fertility challenges.

The good news is that although PCOS may make it harder for some folks to get pregnant — it’s not impossible. Research shows that people with PCOS have a similar number of pregnancies and children over their lifetime to people without the condition. It’s just that people with PCOS may need more fertility assistance to get there.

One of the most powerful ways you can help yourself on your journey to make a baby is to learn more about your body by tracking your cycle. Cycle tracking can give you important information to find the right time to try to conceive. It may also help you learn that you’re not ovulating so you can start discussing alternative options earlier.

How does PCOS affect your fertility?

In a typical menstrual cycle, the brain, ovaries, and uterus follow a sequence that prepares the body for pregnancy. During the first half of the cycle, small increases in follicular stimulating hormone (FSH) tell the ovary to develop a follicle that contains an egg. That follicle produces the hormone estrogen, which triggers the pituitary gland to release a large amount of luteinizing hormone (LH). The surge of LH triggers the release of a mature egg from the ovary.

In people with PCOS, however, many small follicles accumulate in the ovary. These follicles often will not mature enough to trigger ovulation. When ovulation doesn’t occur, getting pregnant isn’t possible because there’s no egg available to be fertilized by sperm. The immature follicles also cause estrogen, progesterone, LH, and FSH levels to become imbalanced. This imbalance in hormones further impacts your menstrual cycle.

What challenges do people with PCOS have tracking ovulation?

Irregular cycles

People with PCOS often have cycles that vary in length from month to month or are longer than the average cycle. Many people with PCOS will have just 6-8 cycles per year, lasting 35 days or more. This makes it difficult to predict when the fertile window is because it doesn’t fall in the “typical window” of ovulation. Not to mention, the longer the cycle, the fewer opportunities there are to get pregnant every year.

Confusing hormone levels

The hormone imbalances associated with PCOS can make it harder to get accurate results using hormone-based ovulation predictor kits (OPKs) or fertility monitors.

People with PCOS often have a higher baseline level of LH. That level may already be above the level an OPK tests for, potentially causing a false positive result. On the other hand, there may not be a sufficient change in LH for the test to detect a surge, giving you a false negative result. 

Making things more complicated, people with PCOS can have multiple peaks of LH during their cycle, but not every spike in LH will result in ovulation. While OPKs predict ovulation, they can’t confirm it actually happened. There are kits available that test the Pregnanediol Glucuronide (PdG) level in your urine to confirm whether you’ve successfully ovulated and have enough of that hormone to sustain implantation.

Tracking ovulation is important for anyone trying to conceive, but because of these challenges, it’s essential for people with PCOS. And, to get the most detailed information about your body, you’ll want to use as many methods as possible, all at the same time.

Different ways to track ovulation with PCOS

There are many ways to track your cycle. Some of these methods involve monitoring your body for the subtle signs of ovulation and tracking the data over time. Other methods use home-based technology to test your hormone levels. If you have PCOS, the amount of data you need to collect can get a little overwhelming. Luckily, there are many different cycle-tracking apps and connected devices that can help with this.

Basal body temperature (BBT) tracking

Basal body temperature (BBT) tracking involves monitoring your body's resting temperature daily to detect the slight rise around ovulation. The challenge with this method is that many variables can throw your temperature off. Additionally, this method will only tell you when you’ve already ovulated, so while it’s very effective at helping you track your fertility cycle over time, it won’t help you predict ovulation before it happens (which is essential when you’re trying to conceive).

Cervical mucus monitoring

Cervical mucus monitoring involves observing changes in the consistency and quantity of cervical mucus throughout your menstrual cycle. As ovulation approaches, the consistency of your mucus will typically become clearer, stretchier, and more slippery, like egg whites. Cervical mucus is a great way to monitor your fertility if you have PCOS, especially if you also use an ovulation predictor kit.

Learning how to “read” your cervical mucus can take a little bit of time, so if you want to take the guesswork out of this method, theKegg fertility tracker is a device that uses sensing technology to track your cycle and tell you when you’re most fertile.

Cervical position checks

The position and feel of your cervix changes throughout your menstrual cycle. As you approach ovulation, the cervix becomes softer, higher, and more open. Learning how to feel these changes is yet another way to tell if you’re approaching ovulation.

Ovulation Predictor Kits (OPKs)

Ovulation Predictor Kits (OPKs) are tools used to detect a surge in luteinizing hormone (LH), which typically comes around 36 hours before ovulation. By identifying the surge in LH, OPKs can help pinpoint more days of your fertile window, enhancing your chances of conception.

Fertility Monitors

Fertility monitors are advanced devices that track and analyze multiple fertility indicators, such as hormone levels and basal body temperature, to predict ovulation. By offering a more comprehensive view of what’s happening in your body, these monitors can provide a more precise understanding of the best times to conceive within your menstrual cycle.

The best ovulation predictor kit for people with PCOS 

If you have PCOS and irregular periods, using an OPK that tests your LH level can give you misleading results. As we discussed before, your LH level may be above the baseline the kit tests for, the test may not be sensitive enough for your surge, or you may have multiple surges per month. However, OPKs do offer a more affordable option when compared to fertility monitors to track ovulation. 

So, if you’d like to use an OPK, we recommend using a kit that includes a test to confirm whether or not you’ve ovulated.The Proov Predict & Confirm™ Kit can help you find your fertile window and confirm ovulation by measuring LH first and PdG after. 

Though a bit pricier, we recommend using a fertility monitor if you want detailed information throughout your cycle. TheMira Fertility Monitor tracks four key fertility hormones, including LH, E3G, PdG, and FSH, and makes recommendations about your fertile window based on your personalized levels.

If you have PCOS and a regular cycle, theMosie Baby Ovulation Predictor Kit is one of the most affordable options to predict when you’re ovulating. The kit, which can be delivered straight to your door, comes with seven tests and is 99% accurate. 

Other tips for trying to conceive with PCOS

While trying to conceive with PCOS does have its challenges, remember, it’s not impossible. Here are some additional tips to consider along your journey:

Consult with a specialist: We absolutely recommend seeing a healthcare provider with expertise in PCOS if you have irregular or lengthy cycles. PCOS can increase your risk of developing other conditions, so it’s important to get diagnosed and work with your doctor to support your fertility and overall health.

Maintain a healthy weight that feels right for your body: We know it can be triggering to talk about weight loss when trying to conceive—and we understand that weight is not a reliable indicator on its own of overall health. We do see in the research that excess weight can make the hormone imbalances commonly associated with PCOS more extreme. Doing what you can to work toward maintaining a weight that’s right for your body can help regulate those hormonal imbalances and enhance ovulatory function.

Eat a balanced diet: Shifting your diet to include more whole foods, including whole grains, lean proteins, and healthy fats, can help reduce some of the symptoms of PCOS. Some people with PCOS benefit from a low-glycemic index (GI) diet, which can help manage insulin levels. We recommend focusing on eating plenty of protein and decreasing foods that are highly processed or high in sugar.

Get regular exercise: Physical activity can help improve insulin sensitivity, support mental and physical well-being, and promote regular menstrual cycles.

Manage blood sugar: Insulin resistance is common in people with PCOS. By managing blood sugar levels through diet, exercise, and possibly medication, you may be able to improve your ovulatory cycles.

Avoid stress: We know it can be stressful when you’re trying to conceive and haven’t seen a positive result yet. And being told to reduce your stress doesn’t exactly make things better. But, chronic stress can exacerbate hormonal imbalances. You might want to consider adding stress-relief techniques like yoga, meditation, deep-breathing exercises, and counseling to your life as you go through this journey.

Consider taking supplements: Most people with PCOS have deficiencies in fiber, omega-3, calcium, magnesium, zinc, folate, vitamin C, B12, and D. Taking supplements may help with the symptoms of PCOS, but we always recommend consulting with a healthcare provider before starting any supplement.

Try herbal therapy:Certain herbal therapies can help manage the symptoms of PCOS and its underlying causes. Just like any other treatment, we recommend working with a knowledgeable practitioner who can guide your therapy and monitor for side effects and interactions.

Moving forward in your journey with PCOS

Having PCOS can sometimes feel like there’s an unexpected challenge at every turn. But remember, you’re not in this alone. There are many ways you can take control of your journey, whether that’s finally figuring out when your unique fertile window is using the right OPK, making some lifestyle changes that benefit your fertility, or helping your provider get the data they need about your unique body so you can start fertility treatments sooner. We’re rooting for you every step of the way and hope you see a positive result soon!

References

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