Getting Pregnant With PMOS: What Helps

If you’ve been diagnosed with polyendocrine metabolic ovarian syndrome (PMOS) — formerly known as polycystic ovary syndrome (PCOS) — you may worry about what that means for your fertility.

It’s true that PMOS is a leading cause of female infertility. The good news is that it’s also treatable.

“Even with PMOS, you can still get pregnant with the right treatment and support,” says reproductive endocrinologist Panayota Zarmakoupis, MD.

Dr. Zarmakoupis explains why PMOS affects fertility and what can help improve your chances of getting pregnant.

How PMOS impacts fertility

PMOS is a hormonal condition. Among other things, it affects ovulation — the process where your body releases an egg from your ovary.

Your hormones are supposed to work together to help an egg mature and be released each month. But when you have PMOS, high levels of hormones like insulin and androgens can interfere with that process.

“In PMOS, ovulation is often irregular or absent, a condition known as anovulation,” Dr. Zarmakoupis explains.

These hormonal imbalances can make it harder to get pregnant. While difficulty conceiving can be troubling, there’s hope.

“PMOS can make the path to pregnancy more complex, but not impossible,” she adds. “It may take longer, but interventions can help a lot.”

How to increase your chances of getting pregnant

If you have PMOS and hope to get pregnant, there are ways to make that happen. Dr. Zarmakoupis shares common treatment approaches.

Weight management

Weight doesn’t cause PMOS, and lifestyle changes won’t cure the condition. But they can help improve insulin sensitivity, support hormone regulation and encourage more regular ovulation.

If you have PMOS and overweight or obesity, a modest weight loss — 5% to 10% of your body weight — may help improve hormone balance and restore ovulation, Dr. Zarmakoupis notes.

Strategies that may help include:

• Eating a nutritious, balanced diet that’s high in fruits, vegetables, lean proteins and whole grains
• Limiting highly processed foods and added sugars
• Getting regular physical activity
• Considering bariatric surgery or anti-obesity medications (including GLP-1s, like Ozempic® and Wegovy®) if you haven’t gotten the results you expected with lifestyle changes

Managing other conditions

PMOS is closely linked to insulin resistance and other metabolic conditions. Addressing those concerns may also improve your fertility.

Your healthcare providers can help you keep tabs on conditions like:

• Prediabetes
• Type 2 diabetes
• High blood pressure

Managing these conditions can improve your chances of getting pregnant and support your long-term health.

Medication

Certain medications can help stimulate ovulation, increasing your chances of conception. Your provider may recommend:

• Metformin: This medication is commonly used to treat Type 2 diabetes. If you have insulin resistance, it can help improve your body’s response to insulin, which can help to balance your hormones and support ovulation.
• Letrozole (Femara®): This medication is typically used for breast cancer treatment but is now considered a first-line therapy for inducing ovulation. “Letrozole appears to be as effective as clomiphene citrate, but with fewer side effects and a lower risk of conceiving twins and higher-order multiples,” Dr. Zarmakoupis explains.
• Clomiphene citrate (Clomid®): This medication is U.S. Food and Drug Administration (FDA)-approved for treating ovulation issues. It’s a pill you take for five days, beginning between the second and fifth day of your period.

Assisted reproductive technologies

If medication isn’t doing the trick, your provider may recommend other fertility treatments.

Trouble ovulating doesn’t necessarily mean there’s a problem with your eggs. In fact, many women with PMOS have a large number of eggs in their ovaries. The challenge lies in getting those eggs to mature and be released regularly.

In vitro fertilization (IVF) helps bypass that obstacle because it doesn’t require you to ovulate on your own. When you have IVF, your eggs are fertilized outside your body. The resulting embryo is then transferred to your uterus.

When to talk to your provider

If you’ve been trying to conceive without success, it’s worth discussing your concerns with a healthcare provider.

You should also talk to your provider if you have symptoms that may suggest PMOS, including:

• Irregular or missed periods
• Excess facial or body hair
• Persistent acne
• Difficulty managing your weight
• Thinning hair

Your provider can evaluate your symptoms, assess whether you’re ovulating regularly and recommend treatment options based on your goals.

Pregnancy is possible with PMOS

A PMOS diagnosis may make your fertility journey less predictable, but pregnancy can still be within reach. In fact, PMOS is considered one of the most treatable causes of infertility, and you have options to build the family you want.

“With appropriate monitoring and care, you can often go on to have a healthy pregnancy and a healthy baby,” Dr. Zarmakoupis says.