News & Information

What You Need To Know About PCOS


September is PCOS Awareness Month, and a good opportunity to revisit one of the issues many women face when trying to get pregnant and have a family.

It’s well known that advanced maternal age is the biggest challenge to getting or staying pregnant but polycystic ovarian syndrome or PCOS affects more than 20% of women during their family-building years. Dr. Maureen Schulte, Dr. Molina Dayal, and Melanie Miranda, WHNP from STL Fertility, the only female-owned, all-female fertility center based here in Saint Louis talked about PCOS and getting pregnant.

“Unfortunately, PCOS is very common, but many patients can find success thanks to the different treatment options that we have today,” offered Dr. Schulte. “PCOS is basically a buildup of androgen levels in the body which creates small cysts in the ovaries and leads to irregular periods or none at all. If we can restore proper hormone balance, we often can get patients to egg retrieval,” added Dr. Schulte who along with Dr. Dayal and WHNP Melanie Miranda, provide a comprehensive work-up process to properly diagnose PCOS.

PCOS often presents with some tell-tale physical characteristics like excess hair on the face and arms but not always, Dr. Dayal shared how they can “see” PCOS, “On an ultrasound, we can see PCOS clearly as these little white cysts. Some patients come to us with physical clues to a PCOS diagnosis such as hirsutism, acne, insulin resistance, and or have a high BMI. But in some cases, we have patients who are lean and exercise a lot – perhaps too much and not a typical PCOS patient at first glance. For them and all patients, a comprehensive infertility work is critical to success.”

Whether trying to get pregnant or not, maintaining a healthy diet and moderate exercise is one of the best ways to restore hormone balance and have more regular menstrual cycles. “We get it, it’s hard to keep a balanced diet in a foodie town like Saint Louis. Rather than just cutting things out consider bringing more things into your diet especially whole grains, fruits, and veggies. But if you were to cut things out look at your carbs and saturated fats – big no-no’s for PCOS patients,” commented Dr. Schulte.

PCOS patients across Saint Louis have several treatment options to help restore normal ovulation including medications like Clomid or Letrozole, intrauterine insemination (IUI), and of course in vitro fertilization (IVF). Fertility care isn’t one size fits all for PCOS patients, Dr. Schulte explained, “I’ve talked with PCOS patients who had reservations about doing IVF, but there are other options including oral medications like Letrozole that can help put the body back into balance.”

Often PCOS patients are at increased risk for type 2 diabetes, high blood pressure, and other cardiovascular issues. Routine exams with your OB/GYN or primary care doctor is the best way to catch these and other potential issues early. “PCOS can show up in your early 20’s when you may not be thinking about getting pregnant and having children. It’s not just an infertility issue, PCOS is a total women’s health issue that needs proper diagnosis and care,” added Dr. Dayal.

The emotional and psychological needs of the PCOS patient are unique and often overlooked. According to PCOS, depression, body image, and sexual dysfunction can make the PCOS infertility experience worse, WHNP Melanie Miranda explained, “I see patients all the time who have been struggling to lose weight to help with ovulation. They hate it when someone just tells them. They need the support and emotional coaching that our entire team provides at STL Fertility to break through these issues. Sometimes, you can’t do it alone, and you’re never alone with us.”

If you or someone you know might be struggling with PCOS and trying to get pregnant there are a few resources that can help steer them to the right providers and solutions including and

To learn more about STL Fertility or Dr. Molina Dayal, Dr. Maureen Schulte, and WHNP Melanie Miranda visit today!