Is pregnancy possible?

In polycystic ovarian syndrome, although the regulated circulation of the menstrual cycle is disturbed, the function of the ovary is not necessarily impaired. Therefore, a pregnancy is possible in principle despite PCO, and even spontaneous pregnancies have been described, although rarely. Multiple cysts contain functional follicles, which are synchronized and stimulated with drug support and thus ovulation can take place.

It is important to discontinue oral contraceptives, which are regularly used in the treatment of polycystic ovarian syndrome. The patient can then undergo follicle-stimulating therapy, which is usually carried out with the active substance clomiphene. This triggers ovulation in up to 80% of cases.

The probability of pregnancy through hormone stimulating measures varies between 25-40%. The probability of a multiple pregnancy is increased. Other possibilities for pregnancy in polycystic ovarian syndrome include switching to an LH/FSH preparation or in vitro fertilization (IVF).

In general, in the case of blood sugar irregularities caused by PCO, the chances of pregnancy can be increased by correct drug adjustment of the sugar levels. Two goals are pursued in the treatment of PCO syndrome (PCOS, polycystic ovarian syndrome): 1. to attempt to alleviate the existing symptoms through treatment 2. to normalize the metabolism and thus prevent late effects (e.g. diabetes mellitus, cardiovascular diseases). If a polycystic ovarian syndrome is diagnosed, the primary goal is to reduce the existing overweight.

For this purpose, it is recommended to change one’s diet and to take more exercise.This alone is usually enough to achieve a regular cycle and ovulation in PCO syndrome. The measures used in the further therapy depend on the wishes of the patient, especially whether she wishes to have children or not. Without desire to have children: The PCO syndrome (PCOS, polycystic ovarian syndrome) causes typical hormonal disorders, against which a hormonal therapy helps, which is usually carried out with the contraceptive pill.

However, this treatment for PCO syndrome (PCOS, polycystic ovarian syndrome) is only suitable for women who do not wish to have children, as the contraceptive effect of the hormones would otherwise stand in the way of conception. The hormone preparation works against male hormones and thus helps to break the cycle of hormonal dysregulation. In addition, the therapy with the contraceptive pill is also effective against undesirable consequences such as altered hair growth (hair loss on the head and heavy body hair), as well as skin problems.

With a desire to have children: For women who suffer from the PCO syndrome (PCOS, polycystic ovarian syndrome), but would like to become pregnant, a therapy with hormones that also have a contraceptive effect is not suitable. For this reason, these women are given low doses of cortisone preparations to reduce the production of male hormones in the adrenal gland. If the prolactin level (milk-forming hormone) is also too high, it can be lowered with medication.

If, in addition to the PCO syndrome (PCOS, polycystic ovarian syndrome), there is also hypothyroidism, this must also be treated, since an unfulfilled desire for a child can also be due to hypothyroidism. If no regular cycle sets in despite this treatment of the PCO syndrome (PCOS, polycystic ovarian syndrome), it is possible to induce ovulation by means of antiestrogens (e.g. clomiphene). If clomifen is used unsuccessfully, the treating physician may also inject the follicle stimulating hormone (FSH), but in a low dose.

This treatment increases the risk of sudden, increased follicle formation and thus the risk of higher-grade multiple pregnancies. Therapy for PCO syndrome (PCOS, polycystic ovarian syndrome) must be carried out under regular check-ups, which must be carried out at short intervals (sometimes daily). Sometimes surgery can be a useful treatment option for women with PCO syndrome (PCOS, polycystic ovarian syndrome).

In a laparoscopy (laparoscopic), the excess cysts are destroyed with heat or laser… If the blood sugar level is elevated (often the case with PCO syndrome (PCOS, polycystic ovarian syndrome), the drug metformin is suitable for lowering blood pressure because it also stimulates ovulation and follicle formation. We have published a completely separate topic on this topic under Metformin and PCO.