If you’re wondering how to get pregnant with PCOS, then you’ve come to the right place.
In 2016, I overcame what I’d come to believe was incurable PCOS infertility, and I’ve since then had the pleasure of seeing thousands of other women take control of their reproductive health and fall pregnant too.
As someone that’s been through the full list of fertility treatments before finally falling pregnant naturally, this article provides a comprehensive overview of both the lifestyle changes and the medical interventions that can help you achieve a healthy happy pregnancy.
With the information you’ll find here in these 11 “must know” principles, you’ll be able to make the best fertility choices for your particular circumstances.
Can You Get Pregnant With PCOS?
While PCOS can cause infertility due to ovulation and egg quality issues, PCOS is also one of the most treatable causes of infertility. Given the number of options available, both natural and medical, your chances of getting pregnant despite a PCOS diagnosis are very good.
1. Getting Pregnant With PCOS Requires First Understanding How PCOS Affects Fertility
When I first started having trouble falling pregnant, I had no idea what I was dealing with and this made the problem a hundred times scarier. It now seems obvious that the first place I should’ve started is understanding the cause of my problem better.
For women under 38 years of age, more than 9% of IVF cycles conducted in the US are primarily undertaken because of PCOS (SART online1). This is more than twice as common as endometriosis and it’s widely understood that ovulatory disorders in general, and PCOS more specifically, is the number one cause of infertility.
Like the majority of women with this disorder, I was put on birth control as a teen because I only had a period about once or twice a year. While this got rid of the symptom, it did nothing to actually address the underlying problem which is why I often refer to birth control as a band-aid solution for women with PCOS.
Irregular periods are a rite of passage for most women with PCOS because of the way this disorder affects our hormones. At the heart of the matter is our unusually high levels of androgenic hormones like testosterone, and chronic low grade inflammation. These two mechanism are the primary cause of ovarian dysfunction and give us two ways we can improve our fertility through lifestyle interventions.
By eating pro-inflammatory foods like vegetable oils and sugar, we’re essentially adding further fuel to an existing fire so it makes sense that eliminating these foods is a simple way to boost your chances of getting pregnant.
Since insulin is one of many important hormones that controls our cellular processes, when insulin is unbalanced, many other hormones go out of synch too. Most significantly for our periods is the fact that excess insulin causes our ovaries to overproduce androgens which ultimately cause our eggs to stop maturing before they get a chance to ovulate.
It’s a bit of a circular loop: PCOS means high androgens and chronic inflammation which in turn leads to insulin issues. When our insulin functioning gets bad enough, it then returns the favor by promoting more androgens and further inflammation.
But PCOS infertility runs much deeper than just affecting ovulation.
In order to get pregnant with PCOS not only do you need to ovulate, but you also need to ovulate good quality eggs. This is one of the key reasons why ovulation induction drugs or injectable hormone products are not a complete solution to PCOS infertility.
As a further kick in the guts to anyone who manages to ovulate a healthy egg while trying to conceive, having a PCOS diagnosis means you’re also more likely to miscarry. This has been shown to be true even when the other major variables like age, body weight, and embryo genetics are controlled for (Luo et al. 20173).
As anyone who’s experienced miscarriage before can tell you, the results can be devastating. With the two I experienced, it took me months to get over the shock and distress I went through.
And while not specifically a barrier to having a baby, the reality of getting pregnant with PCOS means you also have elevated risks for pregnancy complications like pre-eclampsia, and you’ll need to be especially vigilant about gestational diabetes given our three-fold risk of this disorder (Yao et al. 20174).
2. Don’t Underestimate Diet And Lifestyle Changes
Many fertility doctors and OBGYN’s will tell you that a PCOS diagnosis means you’ll only ever be able to get pregnant with the help of fertility treatments. This could not be farther from the truth.
I’m a classic example of this after having fallen pregnant naturally despite years of previous unsuccessful fertility treatments. I was able to restore my period by changing my diet and lifestyle which then eventually helped me fulfill my dreams of motherhood without another trip to the fertility clinic.
Modifying the way you eat, exercise, and manage stress has been shown to have a profound effect on PCOS related infertility. This is true regardless of whether you’re trying naturally or you need a little extra help with fertility treatments.
Besides the link to a list of scientific studies above let me back this up with some specific examples:
If you’re trying to conceive, you have PCOS, and you also happen to be overweight, it’s likely that you would’ve been advised that losing weight before conceiving is a good idea right? While this advice can often be poorly delivered by an insensitive health care professional (often with little support on how to achieve this), there’s good consensus with this view amongst experts (Tarlatzis et al. 20085).
Excess weight has been shown to adversely affect the reproductive outcomes of a PCOS diagnosis (Baghdadi et al. 20126; Joham et al. 20147) so getting to a healthy preconception body weight can really boost your fertility.
To give you a feel for the results that can be achieved, in this one particular study, ovulation rates improved by around 50%, while live births more than doubled as a result of lifestyle modifications prior to fertility treatment.
This is why I say it doesn’t matter if you’re planning on undertaking medical fertility treatments or not. By being intentional about what you eat, the exercise you do, and how you cope with stress, you’re setting yourself up for success irrespective of whatever else you are doing – which many women from my free 30 Day PCOS Diet Challenge can attest to.
The benefits of a PCOS friendly lifestyle goes well beyond just getting pregnant. Eating in a way that supports your PCOS reduces the risk of miscarriage and pregnancy complications, improves breastfeeding, and provides lifelong health benefits to both you and your baby. As long as you’re sustaining this healthy way of living, you’ve effectively solved the underlying cause of your infertility.
The downside of using lifestyle interventions to treat PCOS infertility however, is that it can take longer. It takes time for your body to heal and for the effort to convert into real results so plenty of patience is clearly a key factor for success here (definitely not my strong suit).
I can clearly remember that gut-wrenching desperation I felt once I’d decided I was ready to be a mom, so I completely understand the desire to “just get on with it” and the justifications for heading straight to the fertility clinic.
This is largely why I sought fertility treatments for my PCOS in the first place as the dietary changes I had begun to make only a few months earlier still didn’t seem to be working. My lack of understanding meant I completely underestimated just how powerful lifestyle changes could be.
While it took me two years before I started having a regular period, once I got there, I was able to fall pregnant naturally very quickly.
Not to mention a lot of bruised and collapsed veins!
3. Know When Fertility Treatments Are Needed For PCOS
To be fair and balanced here, there’s no doubt that fertility treatments certainly have their place and we’re lucky to have this option. The key is knowing when they’re necessary and when they’re not.
If there’s a male factor fertility issue or another complication beyond PCOS, medical intervention may be well warranted.
Fertility treatments may also be a good option if you’re in your late 30’s and are concerned about the time that may be needed to heal your PCOS through diet and lifestyle changes alone. As a 1981 baby that still feels like a spring chicken, I absolutely hate saying that your late 30’s are “old” but unfortunately our biology takes no prisoners.
The effect of age on egg quality can be seen in studies that look at the percentage of embryos produced via IVF that have the correct number of chromosomes. Embryos with the wrong number of chromosomes almost always either fail to implant in your uterus or they result in early miscarriage so chromosome count is an excellent indicator of egg quality.
As the figure below shows, egg quality peaks in your late twenties, and then begins a speedier decline after your mid-thirties. Unfortunately the reality is that this has a direct effect on your chance of getting pregnant with PCOS.
Figure 1. Percentage of embryos produced by women that have the correct number of chromosomes i.e. “good quality” eggs. (Franasiak et al. 20149).
What this means for our “natural” fertility is that for the average woman, things start to get pretty difficult once you hit 40 as can be seen in the next figure. These results used the genealogical data from women and their husbands born between 1840 and 1859 which is useful for seeing how fertile we’d be if it weren’t for all the advances in the medical technology that we benefit from today.
Figure 2. Changes in relative “natural” fertility rates with age from historical population data (Menken et al. 198610)
The ability to extend the age at which we can start or grow our families is one of the greatest gifts of advanced reproductive technology, but even with the best clinics, age can be a major barrier. While the media loves to cover celebrities having children in their 50’s, the reality for women wanting to use their own eggs is that even with IVF, once you pass 45 years of age, your cumulative success rates are likely to be less than 20% after three attempted cycles.
While I hate being so blunt, the take home message here is that if you’ve hit your forties, it’d be prudent to pursue IVF regardless of how PCOS friendly you’re living.
4. Understand What Fertility Treatments Can’t Do For PCOS
The downside of fertility treatments is that they do nothing to address your underlying PCOS diagnosis – they’re more of a clever way to get around the problem for the purposes of having children. Just like how taking the pill “solves” irregular periods, fertility treatments are another band-aid solution that may help you get pregnant in the short-term but do not benefit your pregnancy or your health beyond that.
The risk of your PCOS getting worse after pregnancy is also a major concern that I see regularly through my PCOS support group.
This is why I get so many mom’s taking part in my free 30 Day PCOS Diet Challenge. Because it’s also not uncommon for unwanted hair, and acne to get worse, and many women will struggle with their weight even more following childbirth.
Women that don’t get the help and support they need to adopt a PCOS friendly lifestyle, will also often find themselves back to square one when they’re ready to have another baby.
5. Be An Informed Fertility Patient If You Need Treatment
Thankfully for the families in need, reproductive technology has advanced a long way beyond telling people to “just relax and it will happen”. This was always a pet peeve of mine during my four and a half years of trying to conceive.
When I first went to get fertility treatments I really didn’t understand what my options were. I was at the mercy of the doctors I would see, and looking back now, I don’t necessarily think they were as up to speed with the science as I would’ve preferred. I don’t want to be disparaging towards doctors, but the reality is that the man or woman who came last in their class at medical school is still called a doctor so I firmly believe in the principle of being your own health advocate. The best weapon that an informed patient can wield is good information obtained through self-education.
Here’s the basics of the standard PCOS fertility treatment options:
The first cabs off the rank for most fertility specialists that treat women with PCOS are metformin and clomide.
Metformin helps reduce the high insulin levels I mentioned earlier which hopefully in turn will enable ovulation to be restored. Clomide on the other hand takes a more direct approach by forcing your ovaries to ovulate. The downside of Clomide is that it can have some nasty side effects and it doesn’t restore ovulation in more than one in four women. Only 29% of women that take this drug actually have a baby (Homburg 200511).
If like me, you fail to fall pregnant after 4-6 months with these drugs, it’s likely you’ll advance to one of the more modern ovulation inducing drugs which will be either an aromatase inhibitor known as letrozole (sold under the brand name Femara) or an injectable hormone product.
It’s worth noting here that many experts now believe that doctors should skip the first step and head straight for letrozole as this drug has been shown to result in better outcomes for women with PCOS (Legro et al. 201412; Klement et al. 201513).
One of the most important things to keep in mind when undergoing ANY kind of ovulation induction is that you need to receive regular ultrasound monitoring leading up to the day you ovulate. I appreciate that depending on your health plan, this can add costs to the process but these drugs all greatly increase your chances of having twins and triplets as they can make you ovulate more than one egg at a time.
While this might sound good in theory if you’re in a rush to have lots of kids like I was, falling pregnant with twins or triplets presents serious health risks to both you and your babies and is definitely not an outcome that suits women like us given our already compromised reproductive health.
In my case, I tried six times with clomide before moving on to injectable hormones. I miscarried twice during this process due to chromosomal issues which is what led me down the road to IVF with ICSI and embryonic genetic testing – the most advanced weapon in the fertility specialist’s arsenal.
IVF starts with ovulation induction, but unlike when you’re trying naturally or doing an IUI cycle, IVF involves taking a lot more hormones. The goal is to intentionally mature 12 – 20 eggs so the specialist can “harvest” these for fertilizing in the lab.
Once your eggs have been collected, they are then fertilized either by introducing your partner’s sperm and letting the little swimmers do their thing, or by injecting a single lucky sperm directly into the egg – a process known as ICSI. This last step is an optional technology which greatly increases fertilization rates and essentially overcomes any shortcomings in your partner’s fertility. This is something my husband and I opted for the second time around after so few of my eggs fertilized during my first cycle.
Once the eggs are fertilized they are then grown for a few days under carefully controlled lab conditions before either being placed back into your uterus as a “fresh embryo transfer”, or being cryogenically preserved for a later date in what’s known as a “frozen embryo transfer”.
But just to be clear on this technology, women with PCOS have been shown to have a normal risk for chromosomal abnormalities (Luo et al. 20173) so a decision to undergo PGS should be made for other reasons.
In my case, PGS took my IVF success rate probability from 35% per transfer to 70% which essentially halved the chances of an early miscarriage. PGS is super expensive though, so it’s not for the faint hearted and as my successive failed cycle’s show it’s still no guarantee of success.
6. Don’t Make This Preconception Treatment Mistake With Clomide
Putting the principles of Step #5 into practice, here’s some essential knowledge for anyone that’s advised to go on birth control before starting a clomide cycle:
A recent survey revealed many obstetricians and even reproductive endocrinologists have major knowledge gaps when it comes to PCOS (Dokras et al. 201714).
The problem with this approach is that it’s based on outdated science.
Recent research has shown that taking birth control for four months in preparation for fertility treatment may in fact do more harm than good. Preconception birth control not only has no benefit to your chances of ovulation, but it also worsens metabolic health and may potentially be detrimental to your fertility (Legro et al. 201515; Legro et al. 20168).
As I mentioned earlier, rather than mess around with birth control ahead of taking clomide, it’s been clearly shown that taking a four month break to improve your diet and lifestyle makes it far more likely that you’ll successfully fall pregnant if and when you eventually proceed with your fertility treatments (Legro et al. 20168).
During every free 30 Day PCOS Diet Challenge that I run I continue to see many women struggling with the idea that an answer as simple as dietary changes can lead to such powerful results. My hope is that this will diminish as more great research like this comes out.
7. Consider Taking Myo-Inositol
After having been through IVF twice, with a nearly disastrous outcome the first time (see my journey to overcome PCOS and infertility) one of the things I wish I had known before starting IVF, was how useful the supplement myo-inositol is. This is another nugget of information, the most well informed PCOS fertility patients should know about.
Myo-inositol has also been shown to be more effective than birth control at regulating our ovarian function (Ozay et al. 201618), and appears to be better than metformin for boosting pregnancy rates in women with PCOS (Raffone et al. 201019).
One of the most popular inositol supplements for women with PCOS is the product Ovasitol by Theralogix. This supplement contains a combination of two types of inositol, with myo-inositol being the main ingredient. Ovasitol is widely promoted for helping you to get pregnant with PCOS, and this certainly seems to be well supported by science.
Here’s where I differ from other people about this product though. While Ovasitol is clearly a good supplement, even after allowing for the smaller recommended dosage, it’s three times more expensive than a regular myo-inositol supplement.
For women with PCOS that are only interested in boosting their fertility, this well-marketed product does not appear to be significantly better than it’s cheaper alternative. This is actually spelled out in the results of the most commonly cited study, it is just that it is conveniently omitted by promoters of the product (Nordio and Proietti 201220).
While I’m not a fan of self-prescribing anything besides food and exercise, if you were to take myo-inositol, doses of 4000 mg per day are commonly prescribed for the treatment of PCOS infertility. This dose appears to be safe throughout pregnancy (Regidor et al. 201621; Corrado et al. 201122; D’Anna et al. 201223).
8. Implement Dietary Changes No Matter Which Path You Choose
While diet changes are listed as #8 on this list, they are actually the MOST important step you can take towards a successful PCOS pregnancy.
At the top of this article I explained the mechanisms by which our hormone imbalances mess-up our ovulatory cycle and that it all begins with high androgens, inflammation, and how our cells respond to glucose. With this in mind, it makes perfects sense that we can reverse these negative effects by being more selective about the foods we eat.
First, as I’ve mentioned, we can eliminate pro-inflammatory foods like vegetable oils and sugar. Other foods that trigger our immune system can also make a big difference to our fertility as I describe more here.
Rather than eat foods that spike your blood sugar levels, it’s better to nourish yourself with foods that sustain you across the day.
By directly addressing your insulin response in this way you’re treating your infertility at a basic level rather than applying another band-aid solution. Instead of taking a drug to alter your hormones, you’re eating in a way that let’s your body do so naturally providing a long term solution with benefits that go well beyond just getting you pregnant.
By treating your PCOS with food you lower your chances of miscarriage, and the likelihood of developing gestational diabetes, or preeclampsia. You’ll breastfeed better, your baby will be healthier long-term, and if you’re blessed with a girl, you’ll lower the chances of passing on your PCOS diagnosis to her (Tata et al. 201824).
From a general health perspective, the right PCOS diet helps you achieve and maintain a healthy body weight, improves both your cardiovascular and metabolic health, and lowers the risk of liver disease, and cancer which are generally elevated in women with PCOS.
PCOS friendly food really has a lot going for it…
If I’ve managed to convince you that dietary change really is a kick-ass solution and you’re ready for action, make sure to read my comprehensive PCOS diet blog. In this ultimate beginner’s guide, I provide a thorough description of how to put these good ideas into practice, in 13 simple steps.
One of the important things to keep in mind with this approach is that you don’t need to count calories or restrict your energy intake in anyway, even if losing some weight is included in your fertility plan. With the right changes to what you eat, excess body fat can be naturally eliminated without the need to worry about how much you’re eating.
9. Make Exercise Part Of Your Weekly Routine
Like the right PCOS diet, exercise is another powerful way we can directly improve our reproductive potential (and neuro chemistry too) without taking drugs (Hakimi et al. 201725).
From what I understand, the way this works is that when we workout, we’re actually increasing the density of mitochondria, the cellular organs that power our muscles. More mitochondria in our muscle cells make them more sensitive to insulin, and the more sensitive they are to insulin, the better our hormone balance.
Aerobic exercise is also known to have a powerful effect at improving insulin sensitivity, but what’s even more interesting is its effect on inflammation – another root cause of many PCOS symptoms and health risks. This too has been well documented by science (Covington et al. 201629).
All of this should be of great interest to women with lean type PCOS as much as it is to women with more classical PCOS symptoms looking to lose weight. By reducing androgen levels, ovarian function is directly improved and this means better baby-making potential, whether or not you are wanting to lose weight.
This is saying nothing for the fact that exercise is indisputably the cheapest, safest and most effective way to help with stress management – the third key pillar to a PCOS friendly lifestyle.
10. Implement Stress Management Techniques
Many people mistakenly ignore the psychological impact of infertility on reproductive function. This is fairly understandable given the research is fairly anecdotal still, and most people have become accustomed to stressful lifestyles where we’re pushed to our limits all the time.
But if you’ve ever felt anxious after a strong cup of coffee, or depressed after a boozey night, then you’ll have an appreciation for the link between our emotional state and our hormones. Our physiology affects our mental state, and our mental state affects our physiology. With the link of course, being our hormones.
While coping with stress is important for anyone’s good health, it’s particularly important that women with PCOS take care of their emotional wellbeing. Especially if you are trying to get pregnant.
Studies have shown that women with PCOS have elevated levels of the hormone cortisol when subjected to stressful situations (Benson and Arck 200930). Not only does this reduce our capacity to cope with stress well, but it also causes fat to accumulate on our stomachs and thighs, promotes insulin resistance, and markedly increases our probability of suffering from heart disease (Black 200331; Pasquali 200632; Koertge 200233).
Women with PCOS are also known to suffer from anxiety and depression at much higher rates than their PCOS-free sisters (Setji et al. 201434; Cinar et al. 201135) which is the last thing you need given the stresses of infertility.
The interventions that I have always found most useful when trying to conceive (which I generally like to group as “self-care” therapies) include cognitive behavioral therapy, mindfulness meditation, and the practice of self-compassion. Relaxation exercises are also fantastic for acute stress and insomnia, and certain essential oils can be a great help too (see my free 5 Day Essential Oils for PCOS course for more information).
By practicing self-care in a methodical, disciplined way, we can actually attenuate our hyper-sensitive cortisol levels and have a small but real effect on our chances of falling pregnant.
Self-care really is one of the best things you can do for yourself if you’re trying to get pregnant with PCOS.
11. Don’t Lose Hope – PCOS Pregnancy Success Stories
Motivation is the secret sauce that makes all of these powerful lifestyle changes work. So let me give you a taste of what’s possible with a couple of inspiring examples of women that have taken this approach seriously and fallen pregnant as a result:
She started doing short workouts that included a progressive resistance training program designed specifically with PCOS in mind. As I mentioned above, this type of exercise has been shown to be highly effective at restoring hormone balance in women with PCOS. But perhaps more importantly, Hanna also made the dietary changes she learned during my free 30 Day PCOS Diet Challenge. While this sounds almost too good to be true, her periods returned astonishingly quickly and within a few months she was happily pregnant.
She was cycling between binge eating and starving herself as a result of her depression.
Fast forward a few months after taking the bold decision to implement a truly PCOS friendly diet and Katrina had not only fallen pregnant, but she was also experiencing a wonderful pregnancy that was so much healthier than the first time around. She even managed to not get gestational diabetes like she had in her first pregnancy. This short summary hardly does justice to the transformation Katrina undertook so for anyone interested, you can read more of her story here.
While Hanna and Katrina may sound like extreme cases, the fact of the matter is that I’ve now lost count of the number of women with PCOS that I’ve seen fall pregnant after taking part in my free 30 Day PCOS Diet Challenge so this isn’t a rare event.
Even for me personally, despite all the medical treatment I went through, in the end, it was a low carb, nutrient dense, anti-inflammatory diet that restored my period for the first time since puberty and finally led to me falling pregnant naturally.
Whether you pursue assisted reproduction, or you stick to doing it the old fashioned way, by sticking to a PCOS friendly diet, by doing the right kind of exercise, and by proactively managing your stress, you are going to greatly increase your chances of getting pregnant with PCOS.
So if you’re ready for action, then come and join me for my next free 30 Day PCOS Diet Challenge.
And if you are pumped after reading this and don’t want to wait for the next live Challenge then I also have a free 3 Day PCOS Meal Plan to get you started.
Having kids really is all it’s cracked up to be and you totally deserve every ounce of joy that they bring.
Wishing you the best of luck in your journey to that BFP!
2Palomba, Stefano; Daolio, Jessica; La Sala, Giovanni Battista. Oocyte Competence in Women with Polycystic Ovary Syndrome. TRENDS IN ENDOCRINOLOGY AND METABOLISM, 2017.
3Luo, Lu; Gu, Fang; Jie, Huying; et al. Early miscarriage rate in lean polycystic ovary syndrome women after euploid embryo transfer – a matched-pair study. REPRODUCTIVE BIOMEDICINE ONLINE, 2017.
4Yao, Kui; Bian, Ce; Zhao, Xia. Association of polycystic ovary syndrome with metabolic syndrome and gestational diabetes: Aggravated complication of pregnancy (Review). EXPERIMENTAL AND THERAPEUTIC MEDICINE, 2017.
5Tarlatzis, B. C.; Fauser, B. C. J. M.; Legro, R. S.; et al. Consensus on infertility treatment related to polycystic ovary syndrome. HUMAN REPRODUCTION, 2008.
6Baghdadi, Leena R.; Abu Hashim, Hatem; Amer, Saad A. K.; et al. Impact of obesity on reproductive outcomes after ovarian ablative therapy in PCOS: a collaborative meta-analysis, REPRODUCTIVE BIOMEDICINE ONLINE, 2012.
7Joham, A. E.; Ranasinha, S.; Zoungas, S.; et al. Gestational Diabetes and Type 2 Diabetes in Reproductive-Aged Women With Polycystic Ovary Syndrome. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2014.
8Legro, Richard S.; Dodson, William C.; Kunselman, Allen R.; et al. Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2016.
9Franasiak J.M, Forman E.J, Hong K.H, Werner M.D, Upham K.M, Treff N.R, Scott R.T. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening, Fertility and Sterility, 2014.
10Menken J, Trussell J, and Larsen U. Age and Infertility. AMERICAN ASSOCIATE FOR THE ADVANCEMENT OF SCIENCE, 1986.
11Homburg. Clomide citrate—end of an era? a mini-review. R.HUMAN REPRODUCTION, 2005.
12Legro R.S, Brzyski R.G, Diamond M.P, Coutifaris C, Schlaff W.D, Casson P, Christman G.M, Huang H, Yan Q.S, Alvero R, Haisenleder D.J, Barnhart K.T, Bates G.W, Usadi R, Lucidi S, Baker V, Trussell J.C, Krawetz S.A, Snyder P, Ohl D, Santoro N, Eisenberg E, Zhang H.P. Letrozole versus clomide for infertility in the polycystic ovary syndrome. NEW ENGLAND JOURNAL OF MEDICINE, 2014.
13Klement A.H, Casper R.F. The use of aromatase inhibitors for ovulation induction. CURRENT OPINION IN OBSTETRICS AND GYNECOLOGY, 2015.
14Dokras, Anuja; Saini, Shailly; Gibson-Helm, Melanie; et al. Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome. FERTILITY AND STERILITY, 2017.
15Legro, Richard S.; Dodson, William C.; Kris-Etherton, Penny M.; et al. Randomized Controlled Trial of Preconception Interventions in Infertile Women With Polycystic Ovary Syndrome. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2015.
16Papaleo, Enrico; Unfer, Vittorio; Baillargeon, Jean-Patrice; et al. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. FERTILITY AND STERILITY, 2009.
17Ciotta, L.; Stracquadanio, M.; Pagano, I.; et al. Effects of Myo-Inositol supplementation on oocyte’s quality in PCOS patients: a double blind trial. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, 2011.
18Ozay, Ali Cenk; Ozay, Ozlen Emekci; Okyay, Recep Emre; et al. Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY, 2016.
19Raffone, Emanuela; Rizzo, Pietro; Benedetto, Vincenzo. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. GYNECOLOGICAL ENDOCRINOLOGY, 2010.
20Nordio M; Proietti, E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, 2012.
21Regidor, Pedro-Antonio; Schindler, Adolf Eduard. Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY, 2016.
22Corrado, F.; D’Anna, R.; Di Vieste, G.; et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes, DIABETIC MEDICINE, 2011.
23D’Anna, R.; Di Benedetto, V.; Rizzo, P.; et al. Myo-inositol may prevent gestational diabetes in PCOS women. GYNECOLOGICAL ENDOCRINOLOGY, 2012.
24B Tata, NEH Mimouni, AL Barbotin, SA Malone et al. Elevated prenatal anti-Müllerian hormone reprograms the fetus and induces polycystic ovary syndrome in adulthood. NATURE MEDICINE, 2018.
25Hakimi, Osnat; Cameron, Luiz-Claudio. Effect of Exercise on Ovulation: A Systematic Review, SPORTS MEDICINE, 2017.
26Cheema, Birinder S.; Vizza, Lisa; Swaraj, Soji. Progressive Resistance Training in Polycystic Ovary Syndrome: Can Pumping Iron Improve Clinical Outcomes? SPORTS MEDICINE, 2014.
27Thomson, Rebecca L.; Buckley, Jonathan D.; Noakes, Manny; et al. The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2008.
28Miranda-Furtado, Cristiana Libardi; Picchi Ramos, Fabiene K.; Kogure, Gislaine Satyko; et al. A Nonrandomized Trial of Progressive Resistance Training Intervention in Women With Polycystic Ovary Syndrome and Its Implications in Telomere Content. REPRODUCTIVE SCIENCES, 2016.
29Higher circulating leukocytes in women with PCOS is reversed by aerobic exercise. Covington, Jeffrey D.; Tam, Charmaine S.; Pasarica, Magdalena; et al. BIOCHIMIE, 2016.
30Benson, S.; Arck, P. C.; Tan, S.; et al.Disturbed stress responses in women with polycystic ovary syndrome. PSYCHONEUROENDOCRINOLOGY, 2009.
31Black, PH. The inflammatory response is an integral part of the stress response: Implications for atherosclerosis, insulin resistance, type II diabetes and metabolic syndrome X. BRAIN BEHAVIOR AND IMMUNITY, 2003.
32Pasquali, Renato; Vicennati, Valentina; Cacciari, Mauro; et al. The hypothalamic-pituitary-adrenal axis activity in obesity and the metabolic syndrome. ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 2006.
33Koertge, J; Al-Khalili, F; Ahnve, S; et al. Cortisol and vital exhaustion in relation to significant coronary artery stenosis in middle aged women with acute coronary syndrome. PSYCHONEUROENDOCRINOLOGY, 2002.
34Setji, Tracy L.; Brown, Ann J.Polycystic Ovary Syndrome: Update on Diagnosis and Treatment. AMERICAN JOURNAL OF MEDICINE, 2014.
35Cinar, Nese; Kizilarslanoglu, Muhammed Cemal; Harmanci, Ayla; et al. Depression, anxiety and cardiometabolic risk in polycystic ovary syndrome. HUMAN REPRODUCTION, 2011.