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PCOS and Getting Pregnant

You're pregnant and excited, but PCOS can create the need for you to take extra steps to assure you have a safe and joyful delivery.

Women with PCOS (Polycystic Ovarian Syndrome) who become pregnant may experience more health problems than the general population, including gestational diabetes, pregnancy-induced high blood pressure, miscarriage and premature delivery.

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

Gestational Diabetes

Even though you may never have had diabetes you may experience high blood sugar levels during pregnancy, which is also known as gestational diabetes. This complication affects about four percent of all pregnant women. Studies have shown that women who have been diagnosed in pregnancy with gestational diabetes are found to have a higher prevalence of PCOS on subsequent screening. The risk is believed to be greater in obese women with PCOS who require ovulation induction in order to conceive. Ovulation induction is a procedure in which women who are infertile are treated with medication to stimulate the development of mature follicles in their ovaries to facilitate the growth of eggs.

If you have been diagnosed as having PCOS before pregnancy you should be screened for gestational diabetes in early pregnancy, with referral to a specialized obstetric diabetic service if abnormalities are detected. You should also be screened for abnormal glucose tolerance in pregnancy and, if appropriate, referred for antenatal management by an obstetrician with special interest in pregnancy and diabetes.

Pregnancy-Induced High Blood Pressure

Some studies have demonstrated that you are at a higher risk of pregnancy-induced high blood pressure if you have PCOS. However, other studies showed no relationship between PCOS and the development of hypertension during pregnancy. A woman with borderline hypertension before pregnancy is more likely to have increased blood pressure in pregnancy, but most doctors check all patients for blood pressure issues. You should ensure that your physician documents your blood pressure throughout the pregnancy.

Miscarriage and Insulin Resistance

If you have PCOS and are successful at becoming pregnant, you could be at higher risk of miscarriage than those who don’t have PCOS. Some studies put the rate of miscarriage for women with PCOS at 45 per cent, as compared to the national average of 15 per cent . PCOS is a syndrome of hormone imbalances; women who suffer from it have some hormones at too high of levels while others are too low.

If you are pregnant and have PCOS, elevated levels of insulin may interfere with the normal balance between factors promoting blood clotting and those promoting the breakdown of the clots. High insulin levels may actually result in increased blood clotting at the interface between the uterine lining and the placenta, leading to placental insufficiency, which is the failure of the placenta to supply nutrients to the foetus and remove toxic wastes. The result is miscarriage.

Premature Delivery

PCOS is associated with a 30 to 40 per cent rate of early pregnancy loss (EPL), defined as miscarriage during the first trimester. In most cases no apparent cause can be identified but, in addition to defects in the developing embryo, adverse alterations in endometrial function may play a role. Insulin dysfunction has been identified as an independent risk factor for EPL.

Studies in PCOS suggest that hyperinsulinemia suppresses endometrial expression of glycodelin, a protein whose circulating concentration may reflect endometrial function. Glycodelin is secreted by the endometrium and may inhibit the endometrial immune response to the embryo, and likely plays a critical role during implantation and in the maintenance of pregnancy.

Pre-eclampsia and Macrosomia

Pre-eclampsia is a dangerous complication of pregnancy, involving high blood pressure, protein traces in the urine and edema (abnormal fluid accumulation in parts of the body). It is one of the most dangerous complications that can occur during pregnancy and is a major cause of both maternal and child death during pregnancy and immediately after birth. Macrosomia is the term for a newborn with an excessive birth weight. Factors associated with fetal macrosomia include gestational diabetes and Diabetes Mellitus, demonstrating once again a link to hormonal disorder.

Pre-eclampsia and Macrosomia

You can take certain steps to improve your overall health that may also be helpful in ensuring a HEALTHY and complication-free pregnancy in the future. These steps include improving your overall diet, increasing your exercise, reducing your stress levels and balancing your hormonal systems and getting a sufficient and balanced supply of the right vitamins and minerals. Because there is no single solution that reverses Polycystic Ovarian Syndrome or Insulin Resistance, we feel you need to rely on a multi-faceted approach to improving or reversing these conditions.

Treatment of your PCOS may help increase your chances of conceiving and having a HEALTHY pregnancy.