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The journey to pregnancy can be a tough one. You’re certainly not alone. Many women are in your shoes.
It’s true that research shows fertility does tend to decrease with age. Science says getting pregnant before 35 is easier. But what if you have PCOS? Does that change your pregnancy timeline?
The answer to this is more than just a number. That’s why we are here to deliver information that shows that pregnancy is possible at all ages, despite the odds feeling out of favor. So let’s take a look at fertility, age, and PCOS and give you information that fills you with hope, rather than stress.
How does age affect natural fertility?
The journey to parenthood is full of questions. One of the most common ones is about age. Yes, it’s true that fertility can naturally decrease as we get older.
Here’s a quick look at the relationship between age and fertility, according to a study.
Age | Chances of getting pregnant (%) | |
After 6 cycles | After 12 cycles | |
21-24 | 56.8 | 70.8 |
25-27 | 59 | 79.3 |
28-30 | 62 | 77.9 |
31-33 | 60.7 | 76.6 |
34-36 | 55.9 | 74.8 |
37-39 | 46.3 | 67.4 |
40-45 | 27.6 | 55.5 |
As you can see from the table, peak pregnancy success rates happen in your mid-twenties. After this point, natural fertility starts to decline. But don’t let that scare you!
This study also shows that even at age 36, your fertility rates are still looking pretty great. As you reach your late 30s and early 40s, however, you can see those numbers start to drop more rapidly.
Why?
Because as you age, your reproductive system ages as well. Your egg quantity and egg quality naturally declines. You may experience ovulation irregularities due to hormonal changes. And unfortunately, there’s also an increased risk of pregnancy complications beyond 35 years.
Learn more: What Are My Chances of Getting Pregnant by Age? Check Out Our Chart
Polycystic ovary syndrome brings to the table its own list of complications. But there’s more than age to consider when it comes to PCOS. Let’s look at why PCOS can make it harder to get pregnant in the first place.
Is it harder to get pregnant with PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal condition that can affect fertility. It throws your body’s delicate hormonal balance off kilter. This leads to ovulation abnormalities, irregular periods, metabolic disturbances, and fertility issues.
If you have PCOS, you’re not alone. This condition affects 8-13% of women worldwide. Studies show that even more women are likely undiagnosed PCOS patients.
We understand this condition can be frustrating, and age can add another layer of complexity.
But getting pregnant with PCOS is possible! It will take some additional considerations, however.
We are here to help you navigate those challenges and increase your chances of a healthy pregnancy.
Let’s start by taking a deeper look at the key hormones involved in PCOS. This will help you better understand the condition and how it may affect you when TTC.
These hormonal imbalances can lead to complications.
Anovulation or oligo-ovulation
Ovulation is that key time of the month when your body releases an egg where hopefully a sperm is waiting for it.
With PCOS patients, ovulation can get a little off-track. Studies show that 33% of women with polycystic ovaries don’t ovulate regularly. Here’s a look at what may be going on.
- Anovulation
Sometimes with PCOS, the ovaries don’t release an egg every month. This can result in irregular ovulation or even skipping ovulation altogether, which is called anovulation. This is due to the higher levels of androgens (male hormones) that are present with PCOS.
Due to high androgen levels, the follicles in your ovaries stay small and immature. We’re talking tiny – 5-10 mm, according to studies. This means they can’t properly prep for ovulation. And as a result, your body will skip right over that crucial ovulation step.
- Oligo-ovulation
This is an inconsistency in ovulation that can happen in women with PCOS. You may not miss ovulation every month, but it’s not happening every month, either.
If your body doesn’t ovulate regularly or skips it entirely, the egg doesn’t get released according to plan. Then the meet-cute between your sperm and egg doesn’t happen the way it should. Which means no fertilization either.
Menstrual abnormalities
Like ovulation issues, hormonal imbalances can also cause irregular periods.
This could look like shorter periods, longer periods; heavier periods, lighter periods, or even skipped periods for women with PCOS.
Irregular ovulation and periods are not foreign to polycystic ovary syndrome. These issues make it harder to know your fertile window, which is key to pregnancy.
But there’s something that can help women with PCOS: the Inito Fertility Monitor.
Inito tracks four key fertility hormones – LH, estrogen, PdG (a urine metabolite of progesterone), and FSH to track and confirm ovulation – on a single test strip. It takes away the guesswork by measuring actual hormone values rather than thresholds and maps them out on easy-to-read charts.
Since LH values are consistently high in PCOS, it can be hard to track your “true” LH surge with other ovulation tracking methods. Inito looks for a rise in LH from your baseline and gives you your true Peak Fertility day. And, by tracking the rise in PdG after your LH peak, Inito can actually confirm ovulation.
Insulin resistance
Scientists are unsure of whether insulin resistance is the cause of polycystic ovaries or an effect. Either way, it’s a problem that you may have to face if you’re a woman with PCOS.
Studies show insulin resistance can cause issues with how your liver makes a specific protein, SHGB (sex hormone-binding globulin).
Why is SHGB important? Because it keeps your androgen levels in check. If you’ve got PCOS, this complicates things.
When SHGB levels drop in women with PCOS, free testosterone levels increase. This causes a further increase in your androgen levels, making the hormonal imbalance worse.
Chronic inflammation
Inflammation gets a bad rap, but it isn’t all bad. It serves as your body’s alarm system to tell you something’s wrong.
The problem with inflammation and PCOS patients? The alarm system never fully turns off. It’s always running in the background (chronic), which can wreak havoc on your hormones.
PCOS’ chronic inflammation can cause the insulin resistance and ovulation struggles we talked about earlier.
Increased chances of miscarriage
For PCOS patients trying to conceive, it’s important to know that you have a higher risk of miscarriage.
Studies show that PCOS patients who undergo IVF have a 40-60% higher miscarriage rate.
Lower oocyte quality
Inside the ovaries, a process called folliculogenesis preps immature follicles to release a healthy egg. If this process doesn’t go as planned, the egg may not mature properly. This abnormal egg paired with elevated androgens from PCOS means lower egg quality.
Endometrial dysfunction
Irregular ovulation, high insulin and androgen levels, and obesity can all lead to what’s called endometrial dysfunction.
This basically means that the lining of your uterus (endometrium) isn’t properly prepped for implantation and pregnancy.
Now it’s time to look at the best time to get pregnant with PCOS. Plus, some ways to increase your chances of a successful pregnancy.
What age should I try for a baby with PCOS?
After all the above, you’re probably thinking the sooner you start trying to get pregnant, the better.
There is some truth there.
But age isn’t everything when it comes to pregnancy and polycystic ovary syndrome. Other factors are even more important than age.
We’re talking about your cycle regularity and metabolic health.
Cycle regularity
The regularity of your menstrual cycle goes hand-in-hand with ovulation. Without ovulation, you can’t get pregnant. And since 33% of PCOS patients don’t ovulate regularly, it’s going to take effort to get ovulation going again.
You may think you can hack the system and take drugs like Clomid® to induce ovulation. But for women with PCOS, it’s not that simple.
These medications that induce ovulation are great when it comes to ovulation. But they won’t help with your egg quality and implantation issues, which are a big part of a PCOS patient’s life. (And, in some cases, they can lead to ovarian hyperstimulation syndrome.)
Plus, meds that induce ovulation don’t address the real source of your hormone imbalance: insulin resistance and inflammation.
You’ve got to turn to lifestyle shifts and medical treatment to get your cycle and ovulation back on track.
Spend the next 6-12 months getting your polycystic ovarian syndrome under control. Doing so may speed up your chances of getting pregnant.
Metabolic health
At this point, you know that polycystic ovary syndrome creates issues with ovulation, egg quality, and implantation. And studies show that being overweight makes this even worse.
The good news? Losing 2-5% of your body weight may make a big difference in your PCOS struggles. It can help regulate your periods and get you one (giant!) step closer to achieving pregnancy. It can also help you lower your insulin resistance and risk of gestational diabetes.
So how do you do this? By exercising and eating a healthy diet that’s rich in whole, unprocessed foods. And manage your stress so you can live a healthy life overall, too.
TLDR? Stop focusing all your attention on age. Focus instead on getting your ovulation running smoothly, your periods regular again, and your insulin resistance in check.
Learn more: PCOS and Pregnancy: All You Need To Know
But what happens if you’re over the age of 35, though? You need to focus some attention there, right? What options exist for women with PCOS over 35? Let’s take a look …
Should I do IVF if I have PCOS?
Even though PCOS makes it harder to get pregnant, PCOS patients may be able to use IVF to have babies at a later age than women without PCOS. Yes, you read that right!
One study suggests that polycystic ovarian syndrome women may have an advantage when it comes to IVF fertility treatment. Their chances of a successful pregnancy using IVF stayed stable for a wider age range (22-41). This is when compared to women without PCOS who saw a decrease in success rate with age.
On top of that, women with polycystic ovary syndrome tend to have more eggs compared to others undergoing fertility treatment. This may mean more embryos and more embryo transfer cycles. These two things combined increase the chances of pregnancy.
We talked about the importance of weight loss for polycystic ovary syndrome earlier. But it’s important to note that studies suggest a different focus for older age PCOS patients. Research shows this group may benefit more from getting right into IVF treatments rather than focusing on weight loss first.
So if you’re over 40 with PCOS and thinking about doing in vitro fertilization treatment, know this: You may have a higher chance of getting pregnant than women your age who don’t have PCOS.
The moral of the story? Every woman is unique. But it’s great to hear about encouraging and promising research for women with PCOS. There is a lot of hope for pregnancy, regardless of age.
Always talk to your doctor about your individual situation and needs. They can guide you in managing your polycystic ovary syndrome to increase your chances of a healthy pregnancy.
In Review
- Polycystic ovary syndrome (PCOS) is a hormonal condition that can affect fertility.
- PCOS makes it harder to get pregnant due to irregular ovulation, cysts, insulin resistance, and inflammation.
- Age can affect fertility, but it is not the most important consideration for PCOS patients.
- Focus on regulating your hormones and cycles so ovulation can occur. Lifestyle changes can help with this.
- Your metabolic health plays a role in getting pregnant with PCOS as well. Losing even just a bit of way and managing your insulin resistance can boost your chances.
- Place your attention on managing your PCOS rather than your age.
- Studies show that PCOS patients may have greater success with IVF in a wider age range than non-PCOS patients.
- Consult your doctor to see if IVF might be the best course of action for you.
- Over 35 with PCOS and don’t want to do fertility treatment due to concerns about ovarian hyperstimulation syndrome or other issues? Continue to focus on managing your PCOS and talk to your doctor about how to boost your fertility.
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- Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy | ACOG
- Age and fecundability in a North American preconception cohort study | AJOG
- Age-Related Fertility Decline | NIH
- What Are My Chances of Getting Pregnant by Age? Check Out Our Chart | Inito
- Hormonal changes in PCOS | NIH
- Effect of lifestyle intervention on the reproductive endocrine profile in women with polycystic ovarian syndrome: a systematic review and meta-analysis | NIH
- PCOS and infertility | NIH
- Etiology of Anovulation in Polycystic Ovary Syndrome | ScienceDirect
- Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome | NIH
- Common variants in the sex hormone-binding globulin gene (SHBG) and polycystic ovary syndrome (PCOS) in Mediterranean women | NIH
- Chronic low-grade inflammation in polycystic ovary syndrome: is there a (patho)-physiological role for interleukin-1? | Springer Link
- Polycystic ovarian syndrome and miscarriage in IVF: systematic revision of the literature and meta-analysis | Springer Link
- Oocyte quality in adult polycystic ovary syndrome | NIH
- Endometrium in PCOS: Implantation and predisposition to endocrine CA | NIH
- How many days after Clomid® do you ovulate? | Inito
- Obesity and female infertility: potential mediators of obesity’s impact | NIH
- Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over | NIH
- A meta-analysis of pregnancy-related outcomes and complications in women with polycystic ovary syndrome undergoing IVF | NIH
- No impact of gestational diabetes mellitus on pregnancy complications in women with PCOS, regardless of GDM criteria used | NIH
- PCOS And Pregnancy: All You Need To Know | Inito
- Sustained fertility from 22 to 41 years of age in women with polycystic ovarian syndrome | NIH
- A Slower Age-Related Decline in Treatment Outcomes After the First Ovarian Stimulation for in vitro Fertilization in Women With Polycystic Ovary Syndrome | Frontiers
