PCOS Fertility Meds
Some women with PCOS have very mild symptoms and don't need much, or even any, medical assistance in getting pregnant. Others are not so fortunate. Even so, many PCOS patients who do have irregular menstrual cycles, or even cease ovulating altogether, can bring their reproductive systems "back to life," so to speak, by losing weight, exercising, and eating well.
Why Lose Weight First?
If you have PCOS and you're struggling to conceive, you doctor will almost certainly make you try all these methods before even considering treating you with fertility drugs. In fact, given that PCOS is often associated with being overweight, your doctor may insist that you lose some weight before he can ethically put you forward for fertility treatment, because being overweight can lead to a risky pregnancy. Furthermore, it has been proven that PCOS symptoms, such as irregular or absent periods, often improve in patients who slim down.
The Medical Route
If you've done all of the above to no avail, your doctor may offer you ovulation-inducing medications. These medications take "control" of the natural pattern of your reproductive system and force it to produce and release mature eggs at a certain point in your now "artificial" cycle - enabling you to have intercourse at the time when chances of conception are highest.
Clomid (generic name: clomiphene citrate) - clomid is a very popular fertility drug, usually the first one tried by women who are failing to conceive. It's taken as a pill for 5 days of your cycle. Some doctors tell women to start on day 3 of their cycle, other doctors prefer that women begin taking it on day 5. Clomid suppresses the natural effects of your own estrogen production - therefore the drug, not your body, decides when and if you are going to ovulate. Ovulation usually occurs soon after the 5th day AFTER you've finished taking your 5 pills. On this day you should begin having sex at least every other day for a week.
Your doctor will probably start you on a low dose of clomid and increase this dose if you don't ovulate on your first clomid cycle. In PCOS patients, a fertility doctor may decide to combine clomid treatment with a drug called metformin. This drug is used to treat people who suffer from type 2 diabetes. Metformin is effective in PCOS patients because many women with PCOS suffer, in varying degrees, from insulin resistance, just as diabetes patients do.
Tamoxifen - tamoxifen is another anti-estrogen drug, also taken in pill form, which has a very similar effect to that of clomid, but acts in a slightly different way on the body. Whereas clomid controls the behavior of the ovaries via messages from the brain, tamoxifen works directly on the ovaries themselves.
Gonadotropins - these fertility drugs are administered as injections. Just like clomid and tamoxifen, they help to "schedule" ovulation and allow you to make sure you're having sex at the right time. Synthetic FSH (follicle stimulating hormone) is a gonadotropin that encourages the follicles on your ovaries to grow and nurture your eggs until maturity. Synthetic LH (luteinizing hormone) is a gonadotropin that forces your ovaries to release eggs into the fallopian tubes, where they will hopefully encounter a healthy sperm cell.
All these fertility drugs stimulate your ovaries more highly than your naturally produced hormones do. Therefore, there is a risk that more than one healthy egg will be released and fertilized by your partner's sperm. This means there is a chance that you will conceive a riskier-than-average multiple pregnancy, or that you may suffer from OHSS (Ovarian Hyper Stimulation Syndrome).