I was told I could never get pregnant on my own with PCOS, but surprise, we did

By Cathy Peshek as told to Maressa Brown

Right after my husband Adam and I eloped in 2017, I stopped taking the birth control pill, which I’d been on since I was 15. I wouldn't say we were trying to get pregnant, but we always said that we were not, not trying. After a year, I wasn’t getting pregnant and my periods were all out of whack – one month I'd have one and another month, I wouldn't. At this point, I was 33 years old and ready to be pregnant so I went straight to my ob-gyn who referred us to a fertility clinic here in Atlanta. 

After a lot of blood work and ultrasounds, my fertility doctor diagnosed me with polycystic ovarian syndrome (PCOS), a condition that can cause hormone imbalances and irregular periods. PCOS essentially prevents the small follicles in the ovaries from developing into mature follicles that release eggs (aka what needs to happen in order to get pregnant). 

My PCOS diagnosis would set the stage for my fertility journey, conceiving my two eldest boys via in vitro fertilization (IVF), but little did we know what our entire fertility journey would look like.

What it was like to be diagnosed with PCOS while trying to conceive

Having PCOS meant my ovaries had a ton of follicles, but I wasn’t ovulating. After the initial rounds of testing (and many, many doctor appointments), my doctor, husband, and I all agreed that the best course of action was going to be IVF, which eliminates the need to ovulate. I’d be put on a course of medications that would stimulate my ovaries and prepare my follicles to release eggs. These would later be fertilized with the hopes of creating embryos (that could be implanted).  

Finding out that I had PCOS after dealing with so much uncertainty, and then coming up with a plan was actually a relief. It was like, OK, this is the problem, and here’s the solution. I was an ideal IVF candidate because I had so many follicles and my doctors presented it as being a route to getting pregnant that would offer a high chance of success, which felt really comforting to me at my age.

Still, I had a hard time knowing that my body was the problem. I know it's not that I did anything wrong, but I did feel guilty about not being able to conceive without medical help. I had a really hard time letting go of the fact that I would never be able to pee on a stick and find out I was pregnant.

The road to conceiving my two eldest boys

The process of preparing to retrieve eggs to fertilize was difficult. At one point, I was giving myself three shots in my stomach every day. I was taking these giant horse pills. I was swollen. I was crying and throwing up all the time. I was so tired. On top of that, I was going in every other day for transvaginal ultrasounds, and it was a solid 30-minute drive to our fertility clinic. We also had to take out a $30,000 loan to pay for our treatment. It was really emotional and taxing. 

And even though I wasn't pregnant, my doctors advised that I treat my body like it was while preparing for the retrieval: I wasn’t able to enjoy a glass of wine when going to dinner with friends, I was trying to eat really, really healthy so I had to constantly think about what I was putting in my body – and in general, I had to take it pretty easy (which for me, meant a lot of naps!). I didn't feel like myself because I wasn't able to live my normal life, and that took a toll on me. Everything was changing. And although I wanted it to change, because I wanted to be a mom, it was still a shock to the system. 

In June of 2019, after four months of ultrasounds, and appointments, and one entire month of shots, I had my egg retrieval. It was the first time I had ever put on a hospital gown and been under anesthesia. It was just a whole bunch of new stuff, and it was very anxiety-inducing. 

Thankfully, I was heartened that the retrieval resulted in 39 eggs, 20-something of which were mature and could be fertilized. We kept 10 on ice and fertilized the rest, and we ended up with three healthy embryos that could be implanted. 

After our doctor shared the news, I decided I didn't want to wait to implant one. We just wanted to keep the train moving, so we prepped for an embryo transfer two months later. The transfer was actually pretty easy – I didn't have to be put under, and it took all of 15 minutes. The hardest part was just having to keep a full bladder for hours leading up to it (this allowed them to see my uterus more clearly during the ultrasound-guided transfer). And a week after the procedure, we got the phone call that we were pregnant! I still have the voicemail from my doctor saved on my phone. It was just pure joy. 

Our first son Miles was born in early April 2020. Two years later, we used another of our embryos to conceive our second son, Henry, who was born in September 2022. IVF the second time was harder. I had a toddler at home to take care of, so I couldn’t just lay around and be sad and sick all the time. But at least this time I knew what to expect.

When I talked to my ob-gyn about getting pregnant in spite of my PCOS diagnosis, she said, 'It happens. Never say never,' acknowledging that she’s seen other women get pregnant on their own after having done IVF.

- Cathy Peshek

But then, the unexpected happened

My husband and I always toyed with the idea of having three kids. I really wanted three, but after having two kids in two years, I needed a break. We were going to wait until Henry was 3 years old to use our third embryo. But then when he was just under 2 years old, life had different plans for us.

Around late February, I just wasn't feeling like myself. I was emotional, agitated, and nauseous. I remember my husband asking if everything was okay, multiple times a day. Turns out, I had an ovarian cyst rupture, which can be a downstream effect of PCOS. I went into my doctor’s office, and she had me leave a urine sample, and because my left ovary was looking swollen during that appointment, my doctor said she wanted to follow up with an ultrasound the following day. 

While I was driving home from her office, she called me. I figured I must have left something behind or they had a question for me. My doctor said, “Hey, the pregnancy test turned positive.” I was at a loss for words, yet managed to sputter, “Say what?” She explained that she was suspicious that something else was going on so she checked my urine, and all of the tests were positive: I was pregnant. I just started laughing. When you have infertility issues, you almost forget how babies are made, and I was just stunned, thinking, “Wait, how did I get pregnant?”

I went in the next day for the ultrasound, and sure enough, I was nine weeks pregnant. Everyone we shared the news with was shocked, saying “Oh my gosh, congratulations. You must be so excited that it happened naturally,” or “It’s such a gift.” But in reality, it took me a while to really be happy about it. I was anxious wondering how I would manage with my two other kids and wondering if there was something wrong with the baby or my pregnancy. When you go through IVF, you’re preparing your body for pregnancy before it happens, constantly making sure everything is healthy and safe with tests and check-ins. So not taking those same steps this time was hard for me to wrap my head around. Plus, it was a huge life-changing thing that we were not expecting.

When I talked to my ob-gyn about getting pregnant in spite of my PCOS diagnosis, she said, “It happens. Never say never,” acknowledging that she’s seen other women get pregnant on their own after having done IVF. And while I appreciated her honesty, I still couldn't believe that it happened to me.

My third son, Owen, was born on September 10, 2024. He was born early via an emergency C-section at 31 weeks because I had what's called a uterine window, or a thinning of the uterine wall due to my previous two C-sections. Doctors told me he was in respiratory failure when he was born since his lungs hadn't fully developed. The pediatric team whisked him away to the NICU and my husband followed. Before they sewed me back up, I had my fallopian tubes removed in a procedure called a salpingectomy. Adam and I had agreed beforehand that this was the best option for us to prevent future pregnancies. Three rambunctious boys is our limit.

My third baby is here now, and I wouldn't have it any other way 

Owen was in the hospital for 58 days, and his NICU stay was truly draining on all of us. The first month he was there, I cried every day when I left him. He was so small and hooked up to every machine, and it was so hard to see. I was sad to leave my other two boys at home to go visit for a few hours each day, but I knew it was important for Owen – and for me. The day he came home was such a great day. Now, we’re all home, taking it one day at a time, figuring out life as a family of five – plus our adorable dog Bowie, of course. 

Reflecting on my journey, I only wish I had known to be more aware of my health. It sounds so cliché and simple, but I had never even heard of PCOS before I was diagnosed with it. I am so grateful for my support system of doctors, friends, and family members. They've helped us with the expected outcomes, but also the many twists and turns we never saw coming. Getting pregnant naturally after enduring all we did during the process of IVF has filled me with so many emotions over the last year. In the end, we feel like this is what was supposed to be – and our family is truly complete. I'm a mom of three boys now – so I'm buckling up for an even wilder ride in the years to come!  

Note: Women with PCOS can get pregnant on their own, but many women with PCOS will have to use IVF or make major lifestyle changes to conceive. Always talk to your provider to discuss the plan that's right for you.