Getting pregnant with PCOS

Olivia’s infertility had a ‘perfect storm’ of possible causes, but a major contributory factor was polycystic ovary syndrome (PCOS).

Olivia and Liam's story

Childhood sweethearts Olivia and Liam, now 32 and 33, married in 2017 and started trying for a baby soon afterwards.  

Nothing happened for several months and Olivia had a gut feeling that something wasn’t right. 

She’d been on the pill for 10 years as it helped keep her skin clear. Perhaps her body was finding it hard to adjust to an unmedicated menstrual cycle? 

Or perhaps it was her weight training? Olivia and Liam worked out at a gym up to four nights a week. They both loved lifting weights and, due to all this targeted exercise, Olivia’s body fat had dropped to just 13% (25-31% is considered a healthy range). 

A visit to the doctor confirmed that she needed to put on weight to give her reproductive system the best chance of working properly. Aside from that, and Olivia’s irregular periods, nothing was found wrong with either Olivia or Liam. 

“This appointment was helpful but just a tick in the box really,” remembers Olivia. “We couldn’t get a referral to a specialist until we’d been trying for a full 18 months.” 

Finally, they were referred to a West Berkshire NHS fertility specialist. 

“The years were ticking by."

Olivia was prescribed Metformin. This drug lowers insulin and blood sugar levels, which can help regulate periods and improve ovulation. 

Next, she was put on Clomid, to stimulate her ovaries to release eggs.  

“Clomid was a very strong drug and I was on it for many months – yet each month was another negative pregnancy test. I wondered if this was ever going to happen for us,” says Olivia.  

After a year, Olivia had a HyCoSy test (Hysterosalpingo Contrast Sonography) to see if there were any blockages in her fallopian tubes.  

Olivia says that after each new medication or procedure, she was told to ‘wait and see if this works’ for three or six months. Yet nothing worked.  

After they’d been trying for two years, the couple became eligible for one round of NHS-funded IVF, courtesy of their local health authority.   

The couple had chosen TFP Oxford Fertility for the treatment. 

“The staff were just the most natural and caring and it wasn’t a huge sales pitch,” recalls Olivia. “Also, we looked online at their success rates and they were strong.” 

On New Year’s Day in 2021 they walked through the snow to their village Post Office. 

“We had both signed a consent form for IVF and we took a photograph as we posted it,” she remembers. 

Things happened quickly from there. 

The TFP Fertility consultant examined Olivia and told her that she had polycystic ovaries and PCOS (polycystic ovary syndrome). It was a revelation – suddenly everything started to make sense.  

Olivia explains, “What this condition means for me is that the timing of my ovulation and menstruation is out of sync. My egg is released late so my period comes along and washes it away before there’s an opportunity for it to be fertilised.” 

An egg can normally live for between 12 - 24 hours after ovulation. For pregnancy to occur, it must be fertilised in this time frame.   

"I didn't think an embryo could survive this."

By this time, the couple admit that although they were hopeful, they were also worn out.   

Olivia says, “Knowing how long we’d been trying for a baby, a lot of people would tell us to just relax, have a glass of wine or go on holiday. Imagine having to explain that we’d been trying for years. It was exhausting.” 

The treatment began: Olivia had standard IVF and handled the injections well. Then, after a successful egg collection, which produced 14 eggs and ultimately six embryos, she had a fresh transfer.  

Women with PCOS have a higher likelihood of ovarian hyperstimulation syndrome (OHSS), where their body has an exaggerated response to the medication that stimulates egg production. Yet Olivia’s body had responded so well to all the treatment that what happened next was totally unexpected. 

“After the transfer, my stomach swelled and swelled with excess fluid and I couldn’t stop being sick. I was advised to go to A&E straight away and was diagnosed with OHSS,” says Olivia. 

“I was in hospital for a week being monitored. There’s not much that can be done and I feared that, even if the transfer had been successful, my chances of staying pregnant were virtually nil.” 

Nurses took Olivia’s bloods daily and noted that her hCG (human chorionic gonadotropin) levels were increasing, indicating that she was probably pregnant.  

Two weeks later, with her stomach having gradually reduced in size and with much of the discomfort now over, Olivia was back at home and ready to take a pregnancy test.  

“Although the hospital nurses never really confirmed the pregnancy, we knew it was likely to be good news, given the levels. Even so, we were so excited to get this final confirmation. 

“Our little embryo that we had named Topsy, because it was the top quality one, became our baby boy Arthur.” 

"Next time it was easier."

Eighteen months later, Olivia and Liam were ready to try again.  

And this time they called their embryo Flashy because of the bright flash on screen when it was put into Olivia’s uterus. 

“It was so straightforward,” says Olivia. “Just five days of injections to prepare the lining of my uterus and then a frozen transfer. Plus, tablets and pessaries pre and post the transfer.” 

Once again, Olivia was pregnant. This time, with George.  

Thinking back on their experience of IVF, Olivia feels that it was great to have had a plan.  

“We’d had years of doctors saying try this, try that,” she says. “But now we knew what was going to happen. All the steps were laid out for us and we knew what would happen next if the outcome wasn’t what we wanted.” 

Aside from the unexpected OHSS, Olivia found one of the hardest aspects of the treatment was staying away from weightlifting.  

“I had stopped on the advice of the NHS consultant, so that I would put on weight, and was too terrified to start again once I was pregnant, for fear something could go wrong,” she says.  

“When you are fit and healthy, it is a shock to have to stop an exercise you love. My friends who weight lifted were able to carry on through their pregnancies, but this wasn’t for us. 

“I love lifting weights and plan to go back to it, now we have the children.” 

Despite their challenging route to parenthood, Olivia and Liam have no regrets.  

“I’d do it all again to get my boys,” she says.