When a patient with polycystic ovary syndrome is actively preparing for pregnancy I am a patient with polycystic ovary syndrome and I want to come for advice on how to get pregnant, why am I prescribed contraceptives instead? Birth control pills do not only work as a contraceptive, but also to regulate menstrual cycles and counteract hyperandrogenism. Although the pill has a contraceptive effect, it is more of a therapeutic effect for patients with polycystic ovary syndrome who suffer from scanty menstruation and hyperandrogenism. Only when the internal environmental disorder is corrected, it is possible to have a good ovulation treatment effect and to create a suitable condition for the baby to be laid, otherwise, direct ovulation may fail and conception may be easily aborted. Does a patient with polycystic ovary syndrome need to have regular menstruation in order to get pregnant? Most patients with polycystic ovary syndrome need to rely on medication to maintain regular menstruation. Once the medication is discontinued, irregular periods soon appear as the patient does not ovulate on her own. It is usually a waste of time and a misconception to keep waiting to regulate your periods before getting pregnant. Patients with polycystic ovary syndrome who are ready to get pregnant can use ovulation-promoting drugs to promote ovulation and pregnancy after a period of treatment to adjust their own endocrine and metabolic conditions, such as effective weight loss, decreased insulin glucose levels, and improved lipid biochemical inflammatory indicators. How long do I have to take medication to get pregnant with polycystic ovary syndrome? Can I get pregnant immediately after stopping the medication? Will there be any adverse effects on the baby? Patients with polycystic ovary syndrome cannot get pregnant easily because their ovulation is abnormal, mostly anovulatory, and their metabolic disorders such as hyperandrogenism, insulin resistance and abnormal glucose tolerance are not suitable for embryo implantation. Therefore, it depends on whether the endocrine and metabolic disorders have been corrected or not, and it needs to be confirmed after the review. If the drug is short-acting estrogen and progestin, ovulation can be promoted after menstruation without affecting conception or having adverse effects on the baby, while other drugs require individual assessment by clinicians. My doctor said I have polycystic ovary syndrome, why does it affect pregnancy? Can I still get pregnant naturally? A normal woman of childbearing age has one follicle that matures and ovulates every month. In polycystic ovary syndrome, there is hyperandrogenism and hyperinsulinemia, and the hormonal and metabolic abnormalities lead to the accumulation of dozens and dozens of small follicles in the ovaries, which do not mature and prevent ovulation, thus making the patient infertile. However, patients with polycystic ovary syndrome are not absolutely infertile. The chance of natural conception is related to the severity of insulin resistance, obesity and other symptoms, and some obese polycystic patients may experience natural ovulation and conception after weight loss or medication such as metformin. Some patients with polycystic ovary syndrome have difficulty conceiving naturally. In patients with polycystic ovary syndrome combined with infertility, it is recommended to check the husband for semen abnormalities and the woman for tubal obstruction. After excluding the above causes of infertility, the preferred treatment for the woman is to take oral ovulation-promoting drugs to induce ovulation, the most used drug is clomiphene, followed by letrozole, which can allow some patients to successfully conceive after 3-6 months of ovulation. If polycystic ovary syndrome is combined with hyperinsulinemia, the addition of metformin increases the sensitivity of ovulation promotion. In patients with hyperandrogenism and LH, adjustment with oral short-acting contraceptives is needed before ovulation promotion. In some patients who are resistant to clomiphene and still do not ovulate after the drug, gonadotropin injections can be given, and nearly half of the patients can get pregnant after six months to a year of the drug. However, the chances of ovarian hyperstimulation syndrome are higher when this drug is used. Those who do not do well with ovulatory drugs need to be considered by the attending physician at his discretion to analyze the cause and whether further adjustments should be made to the treatment of hyperandrogenemia and metabolic abnormalities; laparoscopic ovarian perforation is the second-line treatment option, which uses electric needles to destroy some ovarian tissue, thus reducing androgens and normalizing ovarian function, with the prospect of a short-term return to ovulation after surgery. However, it needs to be chosen carefully because it is an invasive tool plus the efficacy does not last long. If both medication and surgery have failed or if surgery is not accepted, then one cannot delay any longer and can consider assisted reproduction techniques to help conception, such as doing in vitro fertilization-embryo transfer. I am a patient with polycystic ovary syndrome. I have had several intermittent ovulation treatments over the past 2 years, and I have dominant follicles, but why can’t I have intercourse? The causes of infertility are complex. For polycystic ovary syndrome, ovulation disorder is the most common cause, however, other factors cannot be excluded from causing infertility. For example, obstruction of the fallopian tubes, immune factors, fertilization disorders, embryo implantation disorders, and poor quality of the male partner’s semen. Therefore, if other factors of infertility are combined, it is possible that conception may not be successful even if there are dominant follicles with multiple ovulation inductions. In this case, it is recommended to re-evaluate the cause of infertility in order to solve the problem with the right medicine. In addition, the wrong timing of intercourse can also make it difficult to conceive. It is necessary to have intercourse at the right time and live an effective life under the guidance of a doctor. Effective intercourse is when couples have intercourse one or two days before and on the day of ovulation, when they are most likely to get pregnant. During this period, the timing of intercourse can be adjusted according to ultrasound monitoring and hormone levels. If you have intercourse after this effective time, it is not helpful for pregnancy.