Women's Health

Is it PMS, pregnancy or something else? Sorting out the symptoms when you’re trying to conceive

Published: Feb. 7, 2024

The COVID-19 pandemic brought lifestyle and health changes that most of us never could have imagined. It made us hypervigilant. It trained us to monitor ourselves and our loved ones for the slightest symptoms. And with all the time that it’s allowed us to spend at home, many of us have found it easier than ever to analyze everything we’re feeling – physically and emotionally. 

For many pregnant women – or women trying to conceive – these pandemic-related aftereffects are undoubtedly amplified. Is this nausea normal? Could this fatigue mean pregnancy – or is it a symptom of COVID-19? Is now the right time to even have a baby? 

If you’re newly pregnant or in the trying-to-conceive camp, you’re likely dealing with a lot of anxiety and concern. So, let’s break down some of the most common symptoms women may experience when attempting to conceive during fertility treatment and once they’re pregnant.

Attempting to conceive

The hormonal changes associated with a normal menstrual cycle can cause a variety of symptoms in women. Although the first half of the cycle is generally easy, women may experience pelvic pain or pressure at the time of ovulation. This pain is generally unilateral and short-lived. 

During the second half of the cycle, women may have physical and behavioral changes consistent with premenstrual syndrome (PMS). The most common PMS symptoms include:

  • Anxiety

  • Bloating

  • Breast tenderness or heaviness

  • Fatigue

  • Irritability

Keep in mind: You can experience similar symptoms with fertility treatment, but if your symptoms occur with predictability each month and were present prior to starting treatment, it’s probably PMS.

Fertility treatment

Fertility treatments frequently involve some degree of superovulation (production of more than one egg at a time). This can result in:

  • A sense of fullness

  • Bloating

  • Pelvic pressure

The intensity of these symptoms is usually dependent on the amount of ovarian stimulation a woman receives as well as her response to that stimulation. These symptoms can last throughout the second half of her cycle but should start to resolve with menstruation. 

It’s common for fertility patients to remain on progesterone in the second half of their cycle, and progesterone can cause breast tenderness and fatigue. It’s your natural progesterone that causes these same symptoms prior to your period.


The first few weeks of pregnancy (up to six weeks gestation) are generally easy. For the most part, many women report feeling “normal.” As hormone levels continue to rise, however, women may begin feeling fatigued. This is the most common – and usually the first – symptom of early pregnancy. Women may feel the urge to nap daily.

Around this same time, nausea may develop. Nausea is generally not associated with PMS or fertility treatments, but some degree of nausea occurs in up to 90% of pregnancies. Avoiding an empty stomach by eating small, frequent meals can be helpful. Foods rich in protein or salt and low in fat are usually better tolerated than spicy or sweet foods. Nausea and fatigue will generally peak between eight and 10 weeks gestation before starting to improve – there is light at the end of the tunnel!

COVID-19, influenza and RSV

Although COVID-19, influenza and RSV can cause fatigue, they’re generally accompanied by other symptoms, including:

  • Body aches

  • Chills and/or fever

  • Coughing

  • Headaches

  • Runny nose

  • Sore throat

If you’re pregnant and experiencing these symptoms – or if you’ve been exposed to a circulating virus and are fatigued – get tested. Continue protecting yourself, your baby and your loved ones. 

For most women, their best defense against COVID-19, influenza and RSV is vaccination. You may be offered an RSV vaccine in your third trimester to help pass protection onto your unborn baby. But talk to your provider about which vaccines are right for you and if you have concerns about any of the symptoms you’re experiencing. 

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About the Author

Dr. Carolyn Maud Doherty always had an interest in medicine. She takes pride in the fact that patients can trust her to tell them exactly what their issues and options are.

“They know I’ll always give it to them straight,” she said. “And I think that’s important.”

She’s proud to be part of a health system that makes patient-care its top priority.


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Headshot of Reproductive Endocrinologist Carolyn Maud Doherty, MD, of Methodist Women's Hospital.