Falling Pregnant with PCOS: Our Fertility Journey

Every woman’s and couple’s fertility journey is different. Our decisions to have, or not have children are different. And I believe this entire journey is a physical, mental, emotional and spiritual one. Regardless of these differing journey’s, know that we are all connected and you are never alone, even if you feel your story is different or imperfect (all of our stories are perfectly imperfect), or has included heartbreak and challenges.

Throughout my pregnancy so far I’ve read and listened to many women’s pregnancy/birth stories and found it really helpful. I wanted to share my journey honestly and openly as it may resonate with you, help to provide education and insight in some way, or you may find it encouraging no matter what stage of your journey you are on.

It wasn’t easy to write and share this. I was scared there would be parts of my story that could be misunderstood or judged. You may feel parts of my story are triggering for you, or you may feel my story has been far more easy than your own. Just know you are not alone, seek guidance and support where needed, and be gentle with yourself on your journey.

(12 weeks pregnant here, with my barely there bump that looked more like I'd just eaten too much! Sharing the news with family at Christmas time)

DECIDING ON STARTING A FAMILY

This decision was something we never took lightly. It’s one big (scary/exciting/every emotion possible) life changing journey. To be honest I was never someone who felt a strong maternal urge to have babies and was never really clucky. I think part of me always had this little fear in the back of my mind that I may never conceive naturally or at all, due to having been diagnosed with PCOS (polycystic ovarian syndrome) at 22 years old. The comment the Doctor gave me at diagnosis “you won’t be able to have kids, you’ll need to try IVF”, stuck with me and played a role in me never really feeling in touch with my feminine power. After years of my own research, seeking natural treatments, healing/reversing my PCOS and studying Nutritional Medicine, I knew it was possible to conceive with PCOS, I believed it was possible for me. Yet a little part of me still held onto that fear.

My husband and I talked a lot about having kids before we made the decision. What life could be like with or without them, how we would raise our children. It wasn’t until I was nearly 35 that I started to feel a strong pull towards motherhood. I didn’t feel the time was right (is it ever?). I was still studying my degree at the time and had huge hopes and dreams for what my future business would look like. But still, I did feel like I was meant to be a mother one day (plus seeing my husband around kids makes my heart absolutely melt!).

In the end we decided to kind of leave it up to the universe…

PCOS & FERTILITY

PCOS is the most common endocrine, metabolic and reproductive disorder in women of reproductive age, affecting approximately 12-22% of women worldwide. Of these women, approximately two-thirds don’t ovulate regularly. PCOS is associated with difficulties conceiving, known as sub-fertility (defined as the inability to conceive after 12 months of regular unprotected sex, and affects 1 in 7 couples).

In PCOS, high lutenizing hormone (LH) as well as insulin in some cases, causes the ovaries to produce higher levels of androgens, impacting ovulation and progesterone production. This can cause the excess ovarian follicles (basically our eggs that have been blocked from ovulating and build up in the ovaries), irregular menstrual cycles or anovulatory cycles (periods without ovulation), making it difficult to conceive. Furthermore, PCOS is associated with potentially higher risks of miscarriage, as well as pregnancy-induced gestational diabetes, hypertension and pre-eclampsia.

PCOS research has developed significantly over the last decade, and it is now understood there are several PCOS ‘phenotypes’. This means PCOS women may have differing underlying causes and may benefit from different treatments such as supplementation, dietary and lifestyle changes to improve hormonal balance, regulate menstrual cycles and improve fertility and pregnancy outcomes. This newer research was so helpful in my own journey and helping me heal and reverse my own PCOS.

MY PCOS JOURNEY

When I was first diagnosed with PCOS (nearly 15 years ago now) I was prescribed the oral contraceptive pill (OCP) to “regulate” my menstrual cycle and clear my acne. I was told to come back when I was ready to have kids so I could be prescribed Clomid (a drug that stimulates ovulation) and if that didn’t work, IVF. I was also given the option of Metformin (a diabetes drug to improve insulin sensitivity), even though my blood sugar control was normal, so I declined. Not once was diet and lifestyle discussed. What I didn’t know at the time is the OCP doesn’t regulate your cycle at all. In fact, it acts like a bandaid; halts natural hormonal production and stops ovulation, which means your body doesn’t produce progesterone - a vital hormone for regular menstrual cycles, pregnancy and many other health benefits. OCPs contain “progestins” - synthetic progesterone that does not have the same health benefits.

After a year of being on the OCP I stopped and decided to follow a more natural approach to treating PCOS after doing my own research and discovering there were other options than pharmaceutical drugs. I ended up with post-pill amenorrhea for 2 years! It took time and work to get my periods back, including dietary and lifestyle changes, supplementation, as well as trying natural therapies approaches (Naturopathy, Nutrition and Acupuncture). What I didn’t learn until later was stress was the biggest missing link for me, and one of my key drivers for PCOS as I have adrenal dominant PCOS. It wasn’t until I addressed this more fully that I was able to reverse my PCOS and have more regular cycles.

If you have been diagnosed with PCOS and want to learn how to reverse your PCOS, my signature program Heal Your PCOS is for you! I also love working with women 1:1 in guiding them with dietary, lifestyle and supplement changes to improve and reverse their PCOS and improve fertility outcomes. I'm also a Fertility Awareness Method educator, to help you track and pinpoint ovulation and your fertile window to increase your chances of falling pregnant - more about consultations with me here.

(15 weeks pregnant)

MY FERTILITY JOURNEY

Not long after we got married we decided to start preconception care to get our bodies in the best possible health (and making healthy sperm and eggs!) about 6 months prior to trying to conceive (TTC). We made the decision together that we wouldn’t go down the path of IVF and would TTC naturally - please know this was just our personal decision. We are so very blessed to live in a world today where medical science has enabled so many couples to fall pregnant and have a family, and that makes me so incredibly happy. If you choose to use IVF or other assisted reproductive techniques, there is still so much you can do dietary and lifestyle wise to prepare your body for the best possible outcomes. That’s what I love about nutrition and natural therapies - it can be used as stand-alone treatment or alongside medical treatment.

Preconception care

We implemented the preconception care program I use for my clients (which differs slightly for each couple depending on where they are at in their fertility journey and what their health status and health concerns are). Preconception care is individualised care that may improve conception and pregnancy outcomes, reduce risks and complications, as well as plays a key role in the health of the next generation, in a process known as foetal programming. The health of the parents prior to conception, during pregnancy and breastfeeding impacts their baby’s genes being switched on or off, affecting health and disease outcomes for their lifetime and the next generation. So we have the power to improve the health of at least 2 generations after us! Pretty incredible.

We started off by having a range of tests done so I could get an insight into our overall health and anything that needed support. This included nutrients important for conception, healthy sperm and eggs, and pregnancy; thyroid function which impacts metabolic rate and hormone production; blood glucose, lipids and liver function; and for me some additional checks (hormones and ultrasound) to see where my PCOS/hormonal balance was at.

I tracked my menstrual cycle using an app - I charted my basal body temperature every morning, took notice of changes to cervical mucous and recorded any symptoms throughout my menstrual cycles. This helped me determine whether I was ovulating each month, my fertile window, how long my cycles were and how long the phases of each cycle were (a “normal” cycle for me is approx. 35 days but any extra stress can easily lengthen this for me, and I ovulate later than “average”, around day 21 of my cycle). This is known as a “Fertility Awareness Method” (FAM); a method of contraception based on identifying the fertile window to avoid pregnancy or conceive. We used this method to avoid pregnancy prior to TTC. FAM is said to be 76-88% effective as a contraceptive method when used correctly.

Nutrition and lifestyle wise we were both very healthy, but I had some little extra tweaks that would take our health to the next level. We started off with a detoxification phase for a few months (this should always be done prior to trying to conceive, not whilst trying to conceive). This included specific supplementation and diet that increases detoxification and elimination pathways, reducing alcohol and caffeine, and reducing/removing as many environmental toxins as possible (think things like plastics, cosmetics and personal care, food that burdens the liver/detoxification pathways).

Following the detoxification phase we began a nourishment phase for a few months and continued this whilst TTC. The nourishment phase is all about restoring and building nutrient stores, nourishing the nervous system as it plays a role in hormonal production, maintaining healthy menstrual cycles, and improving egg and sperm quality, using supplementation, dietary and lifestyle modifications. I prescribed us both practitioner quality supplements as they typically have far higher levels of nutrients and forms of nutrients that are highly bioavailable compared to over-the-counter supplements, which is why a qualified practitioner is required to prescribe them.

(26 weeks pregnant on our babymoon holiday in Byron Bay)

Falling pregnant

We decided to start TTC towards the end of my final uni trimester. Rather than using any methods such as timed intercourse (which can be helpful if you’re having difficulty conceiving), we decided not to plan or think about it, but simply stop avoiding falling pregnant. We honestly both figured it may take quite some time to fall pregnant naturally, assuming we could at all due to my health history. It’s my nature to be a bit of a planner so to me this seemed perfect as I could finish uni, begin and establish my business all before falling pregnant. I thought I had it all worked out (haha). To our shock and of course huge excitement, I fell pregnant very quickly on my second menstrual cycle whilst in my final trimester of uni! I love that life works like this – never quite what we plan but perhaps just the way it was meant to be, or in mysterious ways we can learn from.

I did also fall pregnant on my first cycle but experienced a very early miscarriage approx. 6 days after my period was due (close to 5 weeks pregnant). Whilst it was early on and we hadn’t even confirmed I was pregnant until it happened, I did feel a sense of loss and disappointment. That fear I held onto that maybe my body couldn’t do this, maybe this wasn’t going to be possible for us kicked in. Sometimes the realisation that we aren’t in full control over everything that happens can be scary, as much as it can be a lesson.

And if you’re curious as to how I found out I was pregnant… leading up to my period being due I had all my usual mild symptoms – increased hunger, mild cramps, and tender breasts. And then the symptoms subsided but my period never came. I waited. And waited. Days later I started wondering if I could be pregnant, maybe I even intuitively knew. But I second guessed myself especially after experiencing miscarriage. I just wasn’t quite ready for that disappointment again. A week later I decided it was time to take a home pregnancy test, by this stage the waiting game was testing my patience! One very early morning whilst my husband was in our backyard training before work (we were still in lockdown at the time), I took a test. That little positive line seriously started appearing immediately and my heart began racing while I waited the 4 minutes for the test to be ready. Hello positive line. Oh my gosh, I’m pregnant! My heart was still racing as I waited for my husband to finish training. I’m not sure which one of us was more surprised as I showed him that little pregnancy stick after he sat down to eat breakfast.

When it comes to fertility and pregnancy, I’m learning how important it is to surrender to the process and to what comes up. We can’t plan and we don’t have control over everything in life. We unfortunately can’t control every part of our journey or story. But what we can do is educate and empower ourselves to do the best we can for the best possible outcomes, and we can work on the areas we can control.

REFERENCES:

Cooney, L. G., & Dokras, A. (2018). Beyond fertility: polycystic ovary syndrome and long-term health. Fertility and sterility, 110(5), 794–809. https://doi.org/10.1016/j.fertnstert.2018.08.021

Thurston, L., Abbara, A., & Dhillo, W. S. (2019). Investigation and management of subfertility. Journal of clinical pathology, 72(9), 579–587. https://doi.org/10.1136/jclinpath-2018-205579