We love to see pregnancy as a blissful period, but trying to conceive and the following risks can bring unwanted struggles into the lives of parents-to-be. Those with an ongoing medical condition related to reproductive health are quite right to ask if there will be conception and pregnancy issues. PCOS is one of the such conditions. So, today, we discuss the the best age and time to get pregnant with PCOS and the patient’s options for fertility improvements.
PCOS: definition, prevalence, and causes
The abbreviation PCOS stands for polycystic ovary syndrome—an endocrine disorder that affects reproductive-aged AFAB patients. Different reviews suggest different prevalence rates of PCOS in female populations:
- estimated 8 to 13%, according to WHO;
- from 5 to 18%, suggested by The Lancet Regional Health–Europe (October 2022 issue);
- 6.8% (prevalence rate in girls belonging to South India of age 13-25; the study published in the Cureus journal, August 2022);
- the mean prevalence of 21.27%, according to the review published in the Journal of Human Reproductive Sciences, in December 2020.
So yes, the condition is not rare. Moreover, statistics say that 70-78% of patients live undiagnosed.
What occurs in the ovary to make it polycystic, and what does it even mean? With this condition, ovaries create higher-than-normal amounts levels of androgens, or male sex hormones. “Polycystic” refers to the presence of several cysts. Those cysts in PCOS are really follicles, which are tiny, fluid-filled sacs. When ovulation takes place in healthy ovaries, eggs develop in the follicles and are released for sperm fertilization. However, in most cases, PCOS prevents the egg from maturing, which results in reduced ovulation.
It is not fully clear what causes PCOS. The issue could originate from many factors (often combined) that can affect hormone levels. For instance, many patients with PCOS are diagnosed with insulin resistance—an occurrence when the body cannot use insulin properly. This causes endocrine disturbances and high blood glucose. Additionally, PCOS can worsen insulin resistance in the form of a pathologic cycle.
PCOS: signs of the syndrome
By interfering with ovulation and hormone balance, PCOS can cause the symptoms listed below:
- menstrual disorders: heavy bleedings; irregular, unpredictable, or absent periods due to abnormal hormone levels;
- inhibited ovulation and the following fertility problems, because eggs do not mature in the follicles;
- hirsutism: increased hair growth on the face, chest, abdomen, and thighs; occurs because of high androgen levels;
- acne lacking response to standard treatment;
- oily skin;
- acanthosis nigricans: skin hyperpigmentation that creates darkened, thickened, velvety skin patches;
- increased body mass up to obesity;
- cysts in the ovaries.
PCOS can be diagnosed as a result of:
- pelvic exam showing abnormal growth in the ovaries;
- blood tests showing abnormal androgen levels;
- ultrasound showing cysts in the ovaries.
How age affects fertility and PCOS
If ovarian cysts contain eggs, does this mean that PCOS fertility increases with age? Unfortunately, no. As we mentioned before, due to hormone disbalance, eggs do not mature and ovulation is suppressed. Both fertility in otherwise healthy women and PCOS fertility rates decline with age.
Every woman is born with a fixed ovarian reserve: the number and quality of eggs that determine her reproductive potential. The number decreases with age; the remaining eggs have a higher possibility of chromosomal abnormalities, including one that causes Down syndrome.
Untreated PCOS tends to lead to many complications, such as depression, diabetes (due to insulin resistance), cardiovascular diseases, and endometrial cancer.
Under age 25
In the late teen years and early 20s, the signs of PCOS may not be apparent. Irregular periods is the most common one, and it can be easily dismissed by a person, especially if their menstruation began not long ago.
According to the American Society of Reproductive Medicine (ASRM), the chances of getting pregnant in one year at the age of 20-24 are 86%.
Ages 25-30
At this age, ovulation rates start to decline but they do it rather slowly. ASRM estimates that chances of getting naturally pregnant within a year at the age of 25-29 are still pretty high: about 78%.
The article published in 2022 in the Scientific Reports journal states that most cases of PCOS are diagnosed between the ages of 20 and 30 years old. This means that the woman has a better chance to mitigate the condition and successfully conceive.
Ages 30-35
Getting pregnant with PCOS after age 30 is possible, but it can be difficult. ACOG warns that fertility declines faster once you reach age 30. The chance of a natural pregnancy within 12 months of trying is estimated by the ASRM to be 63%.
Over age 35
At the age of 35, only 15 healthy women out of 100 are able to conceive naturally in one menstrual cycle. Within a year of trying, the chances are 52%. By this age, it is more likely to develop conditions that affect fertility, such as endometriosis.
This period is referred to by doctors as advanced maternal age. It carries an increased risk of miscarriages, birth abnormalities, and other problems during pregnancy and delivery.
Some clinical data suggests that getting pregnant after 35 with PCOS can be easier because suppressed ovulation preserves ovarian reserve. Once age-related improvement in endocrine disbalance restarts ovulation, 35+ old patients with PCOS have an advantage over non-PCOS patients. However, this 2019 study considered IVF conception which is itself a treatment method for infertility.
Best Age to Get Pregnant with PCOS
Based on the information above, trying for a child with PCOS is best done between the ages of 25 and 30. The fertility rate is still high and the patient is probably well-informed about their health at this age. The finest possible pregnancy outcomes are made possible by this.
The average time to conceive with PCOS does not differ much if the patient addresses the issue properly. In the next section, we are talking about the option to get PCOS and fertility under control.
Controlling PCOS in Pregnancy
People who wish to get pregnant fast with PCOS should give their health a little more thought. Acknowledging and diagnosing the problem is the first step. The second step is to talk to your healthcare practitioner (OB-GYN or primary care physician) and heed their advice.
Lifestyle
An unhealthy lifestyle hits your health on multiple levels. Sedentary living, poor diet, bad habits, such as smoking, alcohol and drug abuse, and no stress management take a toll on your hormone levels, cardiovascular health, mental state, energy levels, etc. With PCOS, the risk of additional health challenges increases, and you do not need that.
Exercise and a balanced nutrition plan, proper sleep hygiene, management of stress levels, and ditching bad habits are essential for successful conception and trouble-free pregnancy.
Medications
PCOS cannot be fully treated but it can be efficiently mitigated by proper pharmaceutical options:
- anti-diabetic drugs, such as metformin, to increase insulin sensitivity;
- birth control pills help rebalance your hormone levels;
- Clomid (clomiphene citrate) stimulates ovulation.
Summary
PCOS can make it difficult to conceive, especially without a proper diagnosis, but the right medical attention can solve the issue. If PCOS patients adjust their lifestyle and use medicine to normalize their hormone levels, they can successfully become pregnant naturally. Other therapeutic alternatives, such as Clomid to induce ovulation, could also be beneficial.
FAQ
Does fertility improve with age if you have PCOS?
Fertility is more likely to decline with age. In some cases, patients with PCOS in the advanced maternal age have an advantage because their eggs can be of better quality. However, this phenomenon needs further research.
Can I get pregnant in my 30s with PCOS?
Absolutely! If you have doubts, address your worry during a consult with an OB-GYN or a family doctor to discuss your options.
What is the childbearing age for PCOS?
Patients with PCOS have the best chances to conceive at the age of between 25 and 30 before fertility starts to decline.
Can I get pregnant at 25 with PCOS?
Yes, the age between 25 and 30 is considered optimal for conception with PCOS because you are likely diagnosed and can maintain proper care.