Often one of the first things that women hear when they are given the diagnosis of PCOS is that they will be infertile or at least have a challenging time getting pregnant. Such news can be devastating. What I prefer to tell women is that we know there is a problem, BUT we also know how to treat it! Sometimes there is a journey to health and fertility, but not always. Many women with PCOS can have successful pregnancies with only simple interventions.
When couples go for infertility testing, about half the time all the tests come back with normal results. Patients often find this reassuring, but as their doctor if there is nothing wrong, I don’t have anything to fix. I love to see infertility patients with PCOS because at least I know what the issue is that I need to correct: they are not ovulating regularly due to insulin resistance.
Metformin
As I mentioned in my last post, diet and exercise are key to treating PCOS. Women with PCOS who loose just 10% of their body weight will often see a return to ovulation. Weight loss and Metformin will lead to ovulation 60% of the time. Metformin is safe to take at the time of conception. Continuing it during pregnancy has been the basis of debate and is provider dependent.
Pregnitude
Pregnitude is a dietary supplement recently available in the US that has been shown to help women improve their fertility, especially women with PCOS. It contains folic acid and myo-inosol, which is derived from a B vitamin complex. Myo-inosol is a natural insulin sensitizer made by the human body. The product was the focus of an article in the August edition of The Female Patient that listed 2 small but significant scientific studies which found improved menstrual regularity and ovulation in those taking the supplement versus folic acid alone. 82% of women on the supplement ovulated within 3 months, while only 63% on folic acid alone ovulated. The supplement allowed women to ovulate much quicker as well, 24 days versus 40 days. Women undergoing IVF who took the supplement had significantly more eggs retrieved (12) on the supplement than those on placebo (8). The supplement is taken as a powder mixed in water twice a day and is available over the counter. The cost is ~$30 a month if ordered from their website or bought from Walgreens.
Almost daily, I get requests for a ‘more natural’ option for fertility and Pregnitude appears to be the perfect answer. It also appears ideal for women who don’t meet the definition of infertility (one year of trying without conceiving) but are frustrated that conception seems to be taking longer than they think it should.
Clomid
When diet, exercise and Metformin have not resulted in pregnancy, then it may be time to discuss Clomid. Mention the words ‘fertility drugs’ and people see visions of women getting shots in the butt, seven babies and a reality show. Clomid is the mildest of the fertility medications. It has a risk of twins of 10% but triplets or higher is extremely rare. Clomid is taken for 5 days during the cycle and has an ovulation rate of 70%. Clomid is inexpensive at less than $50 a month. So if you can’t afford Clomid, you likely can’t afford a baby.
To monitor if Clomid is working, your doctor will either perform ultrasounds or check progesterone levels at different points of your cycle. Once you have found a dose of Clomid that produces ovulation, you will usually conceive within 3-6 months. If you haven’t conceived in 6 months, the likelihood that you will is extremely low, so additional therapies should be considered. This is the point where I will refer my patients to a reproductive endocrinologist (infertility specialist).
Clomid is an estrogen receptor modulator. It acts to starve your body of estrogen for 5 days, tricking your ovaries into ovulating. A lot of women report significant hot flushes and mood swings during the 5 days they are on the medication. Like estrogen itself, it can increase your risk of blood clots, so it should not be taken if you have a history of DVT or stroke.
PCOS does not have to be synonymous with infertility. PCOS can present challenges for those wishing to conceive, but these challenges can often be overcome with minimal interventions. For more on the diagnosis of PCOS, see the first post in this series.
Sources for this series of posts include: Clinical Gynecologic Endocrinology and Infertility, Seventh Edition pages 465-498; Summary from Up to Date; ACOG technical bulletin #109, in addition to the article from The Female Patient that was linked to within the post.
What fertility interventions have you taken in order to become pregnant with PCOS?
I know this is super old but I just bumped into this because I was diagnosed with PCOS and am really trying to have a baby with my husband. Im also taking vitex ( since April). I got off BC in April and ovulated (obgyn did a sonogram) and that cycle was 55 days. Well now this 2nd cycle is on day 51 and according to my BBT there has been no ovulation. I had kinda positive looking OPKS ( I know, no such thing but they were getting almost just as dark). I’ve been taking pregnitude for 4 days now and all of a suden my OPK was VERY DARK. It was a 100% positive, usually I 2nd guess myself and never really know for sure. I’m assuming this has all to do to pregnitude! I will find out soon enough if I really did ovulate I guess 🙂
I have been trying to conceive since my miscarriage almost two years ago periods wwere regular and then about 6 monthsand nothing again i have diabetes and pcos so it this product gping to be a waste of my time or will this help me in my goal pf becoming a mommy soon
Hi Jessica. I have PCOS and insulin resistance and I just started Pregnitude a week or so ago. I’ve already noticed some changes taking place in my body. I’m actually planning on asking my dr about going on Metformin with Pregnitude as they both have great effects on women with PCOS and diabetes or insulin resistance.
Just wondering how safe is Pregnitude to take when pregnant…praying to conceive this month!
I take 1500,g of Metformin plus TJ’s Pre-Natal and am on Day 2 of Clomid. My doctor said it is fine to start on Pregnitude as well. Here is my success story: EAT a PALEO-FRIENDLY DIET! My weight is low (I have lean PCOS but after I stopped YAZ I had put on 5 lbs and this helped me lose it fast) and keeps the androgen levels low too. My main reason for wanting to take Pegnitude is to keep any pimples from forming!
Can I take provera along with pregnitude. My doctor told me to take provera and clomid after taking for three months no positive results than doctor said she wants me to see the fertility doctor but my does not cover. I recently found pregnitude and started a week ago, no results. So please advise if i can take Provera along with pregnitue. Thanks
Iv tried femara and clomid and both make me ovulate but still not pregnant after 8 months of meds. Had an HSG and tubes are clear…what else can I do?
i want to say to all women that ,, i had one tube and also had hormone inbalance so the doctor said i cant get pregnant,, i did everything possible but to no avail, on my 40th bday i cried alone instead on celebrating and it was there i saw online how dr alladdin has helped many women with my situation, i contacted dr alladdin and he sent me a healing water and a spiritual poweder to use as instructed i did it ,and two months later i got pregnant i delivered my baby and now again i just found out am 4weeks pregnant thanks dr alladin for your pregnancy spiritual water and powder you can contact dr alladdin on email :whiterabbitspell@yahoo.com and u too will get your babies
Is it safe to take premature while breastfeeding? My 1 year old hasn’t weaned yet, but I would like to start trying for another, hopefully without clomid.
Is it safe to take this along with natural progesterone?
ive been trying to conceive for 2 years. Its my first time trying pregnitude but i was wondering if i could drink the 2 packages at the same time. Instead of drinking one in the morning and one in the afternoon.
My doctor has me on 2000mg of Metformin daily. I really want to try something more natural. I know I can take pregnitude with metformin but I have also read about low blod sugar levels with to much metformin and pregnitude. Should I lower my metformin intake?
I have PCOS and have been bleeding for 6 months. Its been very heavy bleeding with clots. I would go for long periods without a period and then as of recently i got a period but it would not stop. I have been taking Pregnitude for about a month and apple cider vinegar twice a day. The bleeding ahs just finally stopped and my question is, Will taking Pregnitude make me start bleeding again?? I read that it induces menses and i am trying to make it stop since like I said its been 6 long months of constant bleeding. Should I stop taking the Pregnitude??
I believe the “period” I was having was just the lining of my uterus shedding.
Hello,
Thanks for all the helpful info. I am an atypical PCOS’er- thinner, not IR, high testosterone causing hair loss, do not typically ovulate on my own. I conceived in 2007 with Clomid. I am currently on the progestin-only pill due to occasional high blood pressure. I want to start Pregnitude soon. I would like to be pregnant as early as May, so I’d stop my birth control pill probably in April.
Do you see much success with Pregnitude in ladies that are not IR? I am certainly willing to go the Clomid route again but would be thrilled if Pregnitude helps me to ovulate and not require Clomid and it’s side effects 🙂
I’ve been taking Pregnitude for 7 months. I just found out that I am pregnant. Should I continue taking Pregnitude or stop immediately??
Can I mix the pregnitude in more than 8oz? Like in a 16 oz water bottle?
Yes.
Is it safe to drink pregnitude with metformin & provera (I’ve been taking provera for years to start my cycle)?
Yes.
Hi all i am 24 i was diagnosed with PCOS/insulin resistance last year, me and my husband decided that we wanted to start trying so we went to the obgyn and he put me on metformin 500mg 1x a day progesterone, Clomid 50 mg first month no ovulation 2nd month he uped the dosage on clomid to 100 that didnt make me ovulate either i am not on my last day of progesterone and will be taking clomid 150mg i am also taking dexamethasone and pregnitude to help me ovulate. Any success stories with these meds ?? Please help i am very frustrated and am giving up, my next step would be injections and looking into them they are very costy and i would not be able to afford them. Good luck to everyone out there in my shoes.. 🙂
Yes, I have seen lots of success with these drugs! Up to 75% of women will ovulate with the help of clomid. Femara is another option to consider before you proceed to injectables.
Is it OK to dissolve the Pregnitude in juice or hot tea instead of water? Much easier to drink that way, I find.
Any beverage is fine
PCOS is regarded as one of the major causes of infertility in women. It is reassuring to hear that effective treatments are available to treat it. Thanks for sharing the information.
Is it necessary to mix the pregnitude in 8oz water or could it be just a cup of water? Does it affect anything? Sometimes I just cant finish the 8oz water
As long as you drink enough fluid to dissolve it , it should be fine.
Is it okay to take Pregnitude with Femara? Femara doesn’t increase the risk of blood clots like clomid does it??
Yes it is safe to take pregnitude with femara. I do believe that femara also has the estrogenic effect of an increased risk of clots.
I was put on the birth control pill as a teenager because I wasn’t having a regular period. Once I was married and got off the pill, I realized that I was not ovulating and was diagnosed with PCOS. I was prescribed many different dosages of metformin & clomid, but never ovulated. I then tried femara and finally a double dose of this drug made me ovulate. I conceived the first month I ovulated with baby #1. Because we knew the dosage that worked, it only took a few months to conceive baby #2. My sister-in-law has PCOS, but she has different symptoms and problems. With my experience PCOS is different for everyone … I’m sure it is sometimes hard to help ‘fix’ because of this.
Absolutely Ashlee. So different for everyone and different things work. That’s why it’s so important to partner with your provider to find a solution that works for you. So glad you did. Hoping the same for your sister!
Is it safe to take both metformin and pregnitude?
Yes.
Since pregnitude contains folic acid would this combined with a prenatal vitamin be too much folic acid? Is there such a thing as too much folic acid?
It is safe to take up to 4 mg of folic acid a day, so you can take pregnitude in addition to PNV.
I was diagnosed with PCOS a few years back, but only recently started trying to conceive. I just finished my first round of Clomid and learned it did not help me ovulate. I was on a dose of 50 mg, I’m curious how high a does is typically prescribed before it’s detirmined Clomid won’t work.
Typically the highest dose is 150mg.