Dr Chantal Simonis is a gynaecologist and obstetrician at TFP Fertility UK and has a doctorate for her specialist research in PCOS.
“Polycystic ovaries and polycystic ovary syndrome are often confused as the same condition but, in fact, that’s not the case.
Women can have polycystic ovaries (PCO) without the full polycystic ovary syndrome (PCOS),” says Dr Simonis.
She explains that PCOS is a hormonal condition that usually stops regular ovulation, which is when you release an egg during your menstrual cycle.
Some women have PCO that shows up on a scan, but if their menstrual cycles are regular and they have no other symptoms, then it shouldn’t be a problem getting pregnant.
This is why it’s important to correctly diagnose whether you have PCO or PCOS.
Women PCOS may find it takes longer to fall pregnant. If general advice about diet, lifestyle and healthy body weight haven’t led to ovulation, they might need fertility treatment.
Gemma and Daniel met as teenagers and, as they grew up, they began to dream about starting a family together.
“I so wanted to give Daniel a child,” says Gemma. “Later, when I found out I couldn’t conceive naturally, I was really upset.”
Aged 13, Gemma had experienced one heavy period. And that was it. The following year, doctors had suggested the pill to help with her cycle.
In her late teens, Gemma came off the pill, but no periods arrived. Two years later, following an internal scan and blood tests, she was diagnosed with polycystic ovaries and polycystic ovary syndrome (PCOS).
“Doctors said I had time on my side to start a family. I was only 20, so maybe, now I was off the pill, my body would adjust and I wouldn’t need IVF. They gave me medication to regulate my cycles and then three rounds of clomid, to stimulate ovulation. Each round, the dose was stronger. But nothing worked,” says Gemma.
The couple knew they were young but they felt ready to fulfil their dream of being parents. They had a house, stable jobs and family support.
They approached TFP Wessex Fertility and felt immediately that they’d found the right place for their IVF treatment. Gemma says: “The reviews about Wessex were great and I read the stories on their website. I thought, if I am getting one chance at this, I want it to work.”
When Gemma and Daniel came to Wessex Fertility, the first step was to have a fertility assessment.
Even though they already knew she had PCOS, a full fertility health check looks at hormone levels and does a scan to explore what’s going on physically in the womb (uterus) and ovaries.
Tests by the Wessex team revealed that Gemma’s uterus was healthy and she had plenty of follicles, although they weren’t producing eggs. Daniel’s sperm count was healthy, too.
“Bless the guys at Wessex,” she says, “They did the first injection for me. Then Daniel did some but he had to go back to work, so I learned how to do it on my own. It got easier.”
When Gemma administered her trigger shot, which was to stimulate release of her eggs, she rang the Wessex out of hours line to check she’d got her dosage right.
“I was very emotional and hormonal throughout all this,” she admits. “But I was also making sure my diet was healthy. I was eating veggies and fruit, nothing unhealthy, plus drinking loads of water. I was completely focussed on making sure my eggs were good quality.”
At the egg collection, we were able to retrieve 19 eggs from Gemma – and her healthy diet may have helped, as they were all good quality.
“The procedure was quick!” Gemma says. “All I remember is waking up afterwards to tea and biscuits.”
The eggs were fertilised in the lab using Daniel’s sperm. Then came the wait, to see how many of Gemma’s eggs would be fertilised and become healthy embryos.
“The Wessex guys called every couple of days to tell me how the embryos were progressing. That was very nerve wracking."
After five days, Gemma had 12 embryos. The healthiest one is carefully chosen and placed back in the womb. The next step is waiting to see whether the pregnancy is successful.
“The problem was that me and my mum were so impatient. We couldn’t wait for the two weeks to see if I was pregnant!”
After Archer’s birth in August, midwives advised Gemma to use contraception. Gemma felt confident she didn’t need to, as she didn’t ovulate and never had periods.
However, later that year, Gemma began being sick in the mornings so her mum suggested she do a pregnancy test, just to make sure.
“I said, it won’t happen for me. It can’t. But then we did the test, and I was pregnant,” says Gemma. “I called TFP, panicking, in case I needed some sort of medication. But they said my body had conceived naturally so I didn’t need medical help - and they congratulated me.”
“So now I have both Archer and my new baby girl, Autumn. Her arrival was the biggest shock of my life.
“These babies are both miracles,” she says.
Research has found that the chance of conceiving naturally after IVF is as high as one in five. With PCOS, the spontaneous conception rates after IVF may be assisted by “needling”.
Needling can be done when we collect eggs during IVF, where a needle enters the ovarian tissue.
This is similar to a process called ovarian drilling which has been used as a treatment in PCOS to try and cause normal ovulation.
It’s possible that some women with PCOS would have normal ovulation after IVF and could fall pregnant naturally.
Gemma describes her experience with TFP Fertility Wessex as amazing. “I couldn’t fault them,” she says. “It was quite nerve-wracking being so young but I didn’t feel judged by anyone.
“A couple of times, I felt overwhelmed, like when I had my medication delivered. I had an online chat with Wessex and that made me feel better.
“Being told you can’t conceive is heart breaking. So, when you find a good fertility clinic you need to stick with it. I was lucky, but I know if it doesn’t work it can get depressing and upsetting. Pick a good clinic that will support you,” she says.
Gemma and Daniel’s remaining embryos are in storage just in case they can’t conceive naturally again. “But we won’t be trying again for a good few years,” laughs Gemma.
Contact us if you’re having difficulty getting pregnant with PCOS and want to explore your fertility treatment options.
Dr Chantal Simonis is a gynaecologist and obstetrician who has worked with TFP Fertility since 2000.
Dr Simonis has developed the Rapid Fertility Assessment clinic at TFP Wessex Fertility, which allows for prompt diagnosis and treatment of fertility problems. She was awarded her Doctorate in Medicine for research into polycystic ovary syndrome in 2011.