PCOS and Pregnancy

Polycystic ovarian syndrome (PCOS) is a hormonal imbalance related to the endocrine system and causes a host of complications. PCOS is also one of the leading causes of infertility, affecting more than five million women of reproductive age in the U.S.

For women with PCOS seeking help for infertility, pregnancy is possible with certain fertility treatments. The type of treatment depends on the severity of your PCOS and other factors, including age and whether you have other underlying conditions. There are specific risks associated with PCOS and pregnancy, so here we’ll also take a look at those risks and what can be done to lessen the possibility of developing certain issues during your pregnancy.

A PCOS Primer

PCOS occurs because of an imbalance of reproductive hormones. Your reproductive system is finely tuned to respond to changes in your hormones that signal your ovaries to mature, release your eggs and prepare your uterus for potential pregnancy. This happens every month during your reproductive years. If your egg isn’t fertilized that month, your hormones signal your uterus to shed the lining through your period.

When you have PCOS your body produces high amounts of the male hormone androgen. Normally, women produce androgens in very small amounts, but the high production of androgens confuses the body’s signals to the reproductive system and things go awry. Your ovaries can’t fully ovulate, cysts develop and because you don’t produce an egg, pregnancy isn’t possible. Your periods become irregular or don’t come at all. Other common PCOS symptoms include:

  • Abnormal hair growth on chest, abdomen,, back and face
  • Weight gain
  • Severe acne
  • Male pattern baldness
  • Dark, thick patches of skin underarms, on breasts and neck

Although excess androgens are usually the cause of PCOS, other factors may contribute. PCOS can be genetic (meaning a close female relative also has/had PCOS), be related to being overweight or obese, or occur because of an excess of insulin. If you suspect you may suffer from PCOS, don’t wait to alert your doctor.

PCOS and Conception

Because of PCOS’ effect on ovulation, it’s usually difficult for pregnancy to occur without treatment. For otherwise healthy women under age 35, irregular and missed periods may be connected to PCOS. However, because of the risks associated with PCOS and pregnancy (some of which are described below), you’ll want to work closely with your doctor to determine the best path forward.

If you do suffer from PCOS, don’t lose hope! Each case is unique and your doctor will discuss the best treatment option based on your specific diagnosis. There are medications that may work to balance your hormones and help you ovulate, or your doctor may recommend IVF as the greatest chance for pregnancy.

PCOS and Pregnancy Risks

PCOS does carry specific pregnancy complications and risks for both women and their babies including:

• Miscarriage: Women who are diagnosed with PCOS have a greater chance of miscarriage in the early months. While there may be a few reasons for this risk, most doctors believe the excess of androgens makes the uterus a less welcoming environment for the embryo.

• Gestational Diabetes: Gestational diabetes develops when the hormones produced in the placenta block the body from producing insulin causing blood sugar to rise. This form of diabetes, which occurs in about 10 percent of pregnant women in the U.S., typically goes away after delivery. While some women may develop Type 2 diabetes after giving birth, breastfeeding may lower that risk.

• Preeclampsia: Preeclampsia is a very dangerous pregnancy complication, and occurs when a sudden spike in blood pressure causes your blood pressure to remain very high. Your hands and face may swell, you may see spots and your vision may blur, and you may also suffer from nausea, vomiting and a severe headache. Preeclampsia usually comes on after the 20th week of pregnancy and, if caught early, is controllable. Your doctor will monitor you and your baby, though it may lead to an early delivery.

• Emotional Disorders: PCOS contributes to anxiety and depression during pregnancy, and if you have PCOS you are at a greater risk for developing postpartum depression.

Because PCOS puts you more at risk for these specific complications, it can also complicate delivery. For instance, as a result of gestational diabetes your baby may be larger requiring you to have a C-section. A larger than average baby may also need to spend time in NICU for observation. And as already stated, preeclampsia may result in an early delivery. Doctors do all they can to prevent a premature birth but when preeclampsia becomes dangerous for the mother and baby, there may not be a choice. That’s why strict monitoring throughout your pregnancy is vital when you have PCOS.

How to Minimize PCOS Risks

While PCOS does complicate both conception and pregnancy, with the right care and close observation the end result should be a healthy baby. Some things you can do to lower the risk for pregnancy complications with PCOS:

  • Exercise regularly
  • Monitor your blood sugar
  • Maintain a healthy weight
  • Eat a protein rich diet to control blood sugar spikes
  • Make sure you eat plenty of vegetables, whole grains and high fiber
  • Reduce the amount of carbohydrates you eat
  • Limit caffeine
  • Do not drink alcohol or smoke
  • Follow your doctor’s advice

If you suspect you may have PCOS or any other fertility issue and are trying to conceive, contact Rise Fertility. Together we’ll manage your diagnosis and find the best way for you to realize your dream of growing a family.

Ask Dr. Ghazal a Fertility Question!

Are you ready to RISE and end in baby steps?
Let's get started.