Getting Pregnant with PCOS in Nigeria: Medical Tests and Understanding Your Options

Kofo stared at the test strip like it might disappear.

Two pink lines. Not one. Two.

Her hands trembled as she blinked once, then again. No mistake.

The second line was still there, faint but visible.

It was the moment she had imagined over and over again in her head for nearly five years.

Yet now that it was real, Kofo didn’t know whether to scream, cry, or kneel down and pray.

Tears welled up in her eyes. Not tears of fear or frustration this time, but tears of disbelief , joy and relief.

After all the pills, the injections, the failed cycles, the unsolicited advice, the awkward family gatherings filled with side glances and questions, this was her moment.

“I’m pregnant,” she whispered to herself, still not fully believing it.

For many Nigerian women living with PCOS (Polycystic Ovary Syndrome), moments like this feel like distant dreams.

Fertility challenges are one of the most heartbreaking parts of the condition. And it doesn’t help when people around you casually say things like “just relax” or “it will happen in God’s time.” Because when your periods are irregular or you barely ovulate, trying to conceive can feel less like a journey and more like an endless waiting room.

Here’s the truth: Having PCOS means you might need extra support to make pregnancy happen. And that is absolutely okay.

It doesn’t mean you’re less of a woman. It doesn’t mean your body is broken. It simply means your path to motherhood is a unique journey, and that’s nothing to be ashamed of.

In this step-by-step guide, you'll learn the key fertility tests doctors recommend, and the treatment options available in Nigeria.

From simple lifestyle changes like adjusting your diet and tracking ovulation, to more advanced options like fertility medications, IVF, and even surrogacy.

Whether you're just starting to ask questions or you've been trying for years like Kofo, this guide is for you, because every woman deserves to understand her body and her choices.

Step 1: Blood tests to check hormones and ovulation

Doctors usually begin by checking your hormones through blood tests. These tests help figure out if your hormones are balanced and  if you are ovulating (releasing an egg each month).

When you get your results, you'll often see something called reference ranges beside each value. These ranges show what’s considered normal and help the doctor (and you) understand what the numbers mean.

1. LH and FSH

LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone) control your menstrual cycle and ovulation. In PCOS, LH is usually higher than FSH, which can stop ovulation.

2. Day 21 Progesterone test

This test is done 21 days after your period starts (if your cycle is regular). Low progesterone level suggests you didn’t ovulate that month.

3. AMH (Anti-Müllerian hormone)

It tells how many eggs you still have left (your ovarian reserve). Women with PCOS often have high AMH levels, which means their ovaries may contain many small follicles. However, high AMH doesn’t always translate to better fertility. It may simply reflect the presence of immature eggs.

4. Prolactin and TSH (thyroid-stimulating hormone)

High levels of prolactin, a hormone usually linked to breastfeeding can actually stop ovulation from happening. That means your body might not release an egg regularly.

Another important hormone doctors check is TSH. If the levels are too low or too high, it can mess with your menstrual cycle and affect your chances of getting pregnant.

These tests help doctors rule out other possible reasons for irregular periods, not just PCOS.

5. Testosterone and DHEA-S

These are male-type hormones (androgens). Women with PCOS often have higher levels, which can affect egg quality, cause acne, facial hair, or scalp hair thinning.

Step 2: Imaging and reproductive organ tests

These tests examine your ovaries, uterus, and fallopian tubes.

Pelvic ultrasound

This scan checks if your ovaries look polycystic (many small follicles) and if the lining of your womb (endometrium) is healthy. Not all women with PCOS have cysts, and not all cysts mean you have PCOS.

HSG (Hysterosalpingography)

This is a special X-ray test where dye is passed through your womb and fallopian tubes.

It checks if your tubes are open and if your womb has any blockages or unusual shape.

Often done after trying to conceive for 6–12 months or before starting fertility treatment.

Step 3: First-line fertility treatments for PCOS in Nigeria

Doctors usually start with basic lifestyle changes and oral medications before moving to more advanced options.

Lifestyle adjustments

For some women with PCOS, especially those living in larger bodies, gently reducing weight by just 5–10% can help restart ovulation naturally. But this isn’t about chasing unrealistic body goals, it’s about supporting your hormones in the way your body uniquely responds.

When paired with regular, enjoyable movement like taking walks, dancing, or doing low-impact home workouts, you should notice positive changes in menstrual cycle, energy levels, and mood.

Some women also find time-restricted eating (like eating all meals within a 10-hour window) helpful for managing insulin and supporting hormonal balance. Just be sure to listen to your body and speak to a doctor or nutritionist before starting.

Eat balanced meals with less sugar, more vegetables, lean proteins, and whole grains. It doesn’t have to be anything fancy, everyday Nigerian meals can be modified for better health. Small changes go a long way.

Ovulation medications

Letrozole (Femara): This is often more effective than Clomid for women with PCOS. It works by encouraging the ovaries to release an egg, especially in those who haven’t responded well to other treatments.

Clomid (Clomiphene): A long-time first choice for ovulation support. Clomid helps stimulate the ovaries, though it may not work for everyone with PCOS.

Metformin: Originally a diabetes drug, Metformin helps improve insulin sensitivity, which is often a hidden issue in PCOS. For many women, it also helps regulate cycles and support ovulation when combined with lifestyle changes.

Step 4: Assisted Reproductive Technologies (ART)

If lifestyle changes and medications don’t lead to pregnancy, your doctor may recommend the following treatments:

Intrauterine Insemination (IUI)

Sperm is placed directly inside your womb using a small tube around ovulation time.

It’s less invasive and cheaper than IVF, but still requires some planning and testing.

In Vitro Fertilization (IVF)

Your eggs are collected, fertilized in a lab, then placed in your womb. It is often done if you don’t respond to ovulation meds, have blocked tubes, or if other treatments fail.

PCOS IVF success in Nigeria varies depending on clinic experience, your age, and your overall health. Always ask about success rates during consultation.

Step 5: Advanced fertility options for women with PCOS

When getting pregnant naturally isn’t possible, other options exist.

1. Surrogacy

Another woman carries the pregnancy for you. Your egg and your partner’s sperm (or a donor’s) are used.

It is commonly considered after repeated IVF failure or if carrying a pregnancy is risky. Surrogacy laws are still evolving in Nigeria, so it’s important to seek legal guidance before starting the process.

2. Egg freezing

Your eggs are collected and frozen for future use. This is useful if you want to delay pregnancy or protect your fertility before certain treatments.

It's also an option for younger women with PCOS who aren’t ready yet but want to keep the option open.

3. Egg donation

If your eggs are low in quality or quantity, donor eggs may be used. The donated egg is fertilized and transferred into your womb via IVF.

Talking to your doctor about getting pregnant with PCOS in Nigeria

Be honest and direct with your doctor. It helps them create a treatment plan that works for you. You can ask questions like:

“Am I ovulating regularly?”

“What fertility options are affordable and available in Nigeria?”

“Can I explore medication options before considering IVF?”

Share your emotional struggles too. Fertility issues can affect your mental health. A good doctor should offer or refer you for emotional support as well.

Where to get fertility treatment in Nigeria

When searching for a fertility clinic, look for:

• Experience in treating PCOS and women’s hormone health.

• Offer fertility tests and not just IVF

• Give clear explanations and price breakdowns

• Provide emotional support and counseling

  
  

Cities like Lagos, Abuja, Ibadan, Enugu, and Port Harcourt have several well-known fertility clinics, though services may differ by location and budget.

PCOS doesn’t end your dreams of motherhood

Getting pregnant with PCOS in Nigeria is achievable. Many Nigerian women with PCOS have successfully gotten pregnant/become mothers through natural ovulation with timed intercourse, ovulation medications, IVF, or surrogacy.

Whether you're just beginning your journey or you've been trying for years, the path to motherhood with PCOS is possible, and it doesn't have to be lonely. With the right information, support, and care, you can take confident steps forward.

Need Support or Have Questions?

Join the PCOS Conquerors WhatsApp Support Group today. This is your space, a safe, supportive corner where you can share your wins, ask your burning questions and get real-time advice. Connect with women who truly understand what you're going through.

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider regarding any medical concerns, symptoms, or conditions, including Polycystic Ovary Syndrome (PCOS). The experiences shared here are meant to reflect common realities faced by Nigerian women with PCOS, but every woman’s journey is different. Do not ignore or delay seeking professional help based on something you’ve read here.

If you suspect you have PCOS or any other health condition, please speak to your doctor or a licensed healthcare professional.

References

1. Egwu, Michael, "Fertility Treatments of Women in Nigeria: Using Long Versus Short Protocols" (2020). Walden Dissertations and Doctoral Studies. 8281. https://scholarworks.waldenu.edu/dissertations/8281 

2. A Comparative Study Of Efficacy Of Letrozole Versus Clomiphene Citrate In Ovulation Induction In Patients With Polycystic Ovarian Syndrome. (2024). African Journal of Biomedical Research, 27(4S), 3092-3096. https://doi.org/10.53555/AJBR.v27i4S.4155

3. National Institute for Health and Care Excellence (NICE). Fertility Problems: Assessment and Treatment. NICE Clinical Guideline [CG156], 2021. https://www.nice.org.uk/guidance/cg156