PCOS Part 3: Getting Pregnant {Featuring Pregnitude: A New Natural Supplement}

getting pregnant

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?

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Comments

  1. 1

    Gabby says

    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.

  2. 3

    Sarah says

    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?

  3. 7

    says

    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.

    • 8

      Jessica says

      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!

  4. 9

    Charissep says

    Is it okay to take Pregnitude with Femara? Femara doesn’t increase the risk of blood clots like clomid does it??

  5. 11

    laura says

    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

  6. 14

    Carolyn says

    Is it OK to dissolve the Pregnitude in juice or hot tea instead of water? Much easier to drink that way, I find.

  7. 16

    Denise says

    Is it safe to drink pregnitude with metformin & provera (I’ve been taking provera for years to start my cycle)?

      • 18

        says

        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.. :)

        • 19

          says

          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.

  8. 22

    Denise says

    I’ve been taking Pregnitude for 7 months. I just found out that I am pregnant. Should I continue taking Pregnitude or stop immediately??

  9. 23

    Kim says

    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 :)

  10. 24

    Andrea says

    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??

  11. 26

    Angela says

    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?

  12. 27

    Cynthia says

    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.

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