PCOS and Pregnancy

What you need to know about polycystic ovarian syndrome.

Polycystic ovarian syndrome (PCOS) is a condition that affects a woman's menstrual cycle, fertility, hormones, insulin production, circulatory system, and appearance. Women have both male and female hormones, but women who have PCOS have higher levels of male hormones. They experience irregular or absent menstrual cycles and small cysts on their ovaries. It is estimated that 5-10 percent of women who are of childbearing age have PCOS.

Can PCOS cause infertility or difficulty conceiving?

PCOS is considered a leading cause of female infertility. It reduces the ability of the ovaries to mature and release eggs into the uterus. Other reproductive symptoms of PCOS include the creation of polycystic ovaries, characterized by multiple cysts and small follicles; chronic anovulation, or an inability to ovulate; and hormonal imbalance.

Women with PCOS frequently suffer from chronic anovulation, a condition that can cause them to go through fewer than eight menstrual cycles each year. Frequently, they skip their periods altogether. Furthermore, the hormonal imbalance associated with PCOS can result in symptoms ranging from an excess of estrogen or androgen to decreased levels of progesterone (the hormone important to the menstrual cycle) and resistance to insulin.

What happens with PCOS during pregnancy? What are the dangers involved?

Women with PCOS may experience more health problems than the average pregnant person. Factors of which to be aware include:

  • High blood sugar levels, which can lead to diabetes
  • Pregnancy-induced high blood pressure
  • Premature delivery
  • Preeclampsia (high blood pressure, protein traces in the urine)
  • Macrosomia (a newborn with an excessive birth weight)

These serious problems mean it's extremely important to address PCOS and make the lifestyle changes necessary to reverse it, as well as the underlying cause of insulin resistance. This is vital to prevent the health issues that can compromise long-term wellness for both mother and child during and after pregnancy.

Insulin resistance reduces the insulin sensitivity of a person's cell walls. Glucose has to pass through the cell walls to be converted to energy. Insulin assists this process. When the cell walls have become de-sensitized to insulin by insulin resistance, the process can break down. Glucose cannot get into the cell and remains in the bloodstream, causing elevated blood sugar levels. This process can lead to weight gain and obesity, key factors in creating PCOS.

What should PCOS patients do about the condition before, during, and after pregnancy?

Metformin (Glucophage) is a drug often prescribed for women with PCOS who are trying to get pregnant and in the early stages of pregnancy. Metformin improves the cell's response to insulin, and it helps to move glucose into the cell. As a result, the body will not be required to make as much insulin, which helps to balance the hormones in PCOS. Weight loss through exercise and changes in diet can also be effective in treatment for PCOS during pregnancy. Women should seek out a specialist who can provide nutritional and fitness guidelines to enhance their weight loss success. This is critical for the health of mom and baby.

Infertility specialists typically treat hormonal symptoms, in particular the excessive level of androgen, by prescribing low-dose oral contraceptives. This approach should reduce acne and unwanted hair growth; however, the latter symptom may require electrolysis, waxing, or another removal method performed in conjunction with medical treatment.