You’ve had irregular periods for years. Maybe you’ve experienced acne, weight gain and excess facial hair. Now you can’t get pregnant. But until you started trying to conceive, doctors never put two and two together to confirm you had polycystic ovary syndrome, also known as PCOS.

PCOS is the most common form of female infertility. PCOS prevents ovulation by stopping the ovaries from making the hormones needed for an egg to mature. The follicles, however, continue to grow and fill with fluid, eventually becoming cysts, which we confirm by ultrasound. In addition, the ovaries produce male androgens, like testosterone, instead of progesterone, the female hormone necessary for having a period.

A PCOS diagnosis, however, does not mean you cannot get pregnant. In fact, there are several effective treatment strategies, ranging from relatively simple remedies, such as dietary and lifestyle changes, to medication regimens to undergoing more advanced treatments like in vitro fertilization.

Diet and exercise
Starting a diet and an exercise program may not seem simple or easy, but it is a cost-effective way to keep PCOS symptoms at bay and restart ovulation. Many women with PCOS have insulin resistance, meaning their bodies have trouble breaking down the insulin produced from the food they eat. This effect is exacerbated when eating certain types of carbohydrates, such as sugary snacks, white bread, white rice and similar foods.

Consuming low-sugar carbohydrates with fiber, like whole grains, fruits and vegetables, is best for decreasing insulin levels. Combining them with proteins and/or fats will help slow the absorption of carbohydrates to keep insulin levels low.

Exercise is the second part of the formula for lowering insulin levels and shedding weight. Try going for a walk after a meal, which should help metabolize insulin. If you have not exercised regularly, start off slowly and work towards partaking in at least 60 minutes of physical activity five days a week.

Even a loss of five percent of body weight can make a difference in your PCOS symptoms. Plus, eating evenly throughout the day can help lower blood glucose levels more uniformly.

As reproductive endocrinologists, we can prescribe a variety of medications as part of a PCOS treatment protocol. The goal is to help control reproductive hormones and/or insulin levels.

For women trying to conceive, the most common medications are:

  • Metformin: Also known as Glucophage, which is used to control insulin and androgen levels.
  • Clomid: Also known as Clomiphene and Serophene and prescribed to jumpstart the regular ovulation necessary for achieving pregnancy.
  • Gonadotropin injections: These consist of luteinizing hormone (LH) and follicle stimulating hormone (FSH) and are prescribed with the goal of both starting ovulation and producing multiple follicles and eggs to be used in IVF treatment.

In vitro fertilization and frozen embryo transfer
Recent studies have demonstrated that IVF is an even more effective treatment for PCOS sufferers when frozen embryo transfer is used.

The Yale School of Public Health collaborated with Penn State College of Medicine and 13 universities in China to study the differences in outcome between fresh and frozen IVF cycles. Not only did a frozen embryo transfer (FET) improve the live birth rate for women with PCOS, but it also lowered the risk of ovarian hyperstimulation, a rare side effect of treatment. Scientists believe this is because a FET gives a woman’s ovaries the chance to recover from over stimulation during IVF and for the endometrial lining to shed. The downside is that a higher incidence of preeclampsia (high blood pressure) was seen in women who underwent FET.

PCOS is a common, but treatable infertility diagnosis. One of the first steps in helping women with PCOS have children is to spread awareness of its symptoms as well as how women can become proactive in controlling it.