Polycystic ovarian syndrome, popularly known as PCOS, is a common hormonal condition in women. Women with this condition struggle to become pregnant and are at a higher risk of complications during pregnancy. PCOS and pregnancy often do not end well.
What is PCOS?
Polycystic ovarian syndrome is a condition where ovaries produce higher than normal levels of male hormones known as androgens. As a result, they hamper and affect a woman’s menstrual cycle, appearance, and even fertility.
In simpler words, it is a hormone problem that interferes with the reproductive system. Women with PCOS have larger ovaries than normal and such ovaries can have a lot of tiny cysts which contain immature eggs.
Some of the symptoms of PCOS include:
- Cysts on the ovaries
- Irregular menstrual periods
- Infertility
- Weight Gain
- Excessive face and body hair
- Acne
- Insulin Resistance
- Thinning or balding head hair
Diagnosis of PCOS and Pregnancy
Sometimes it is difficult to diagnose PCOS as the condition can mimic other problems. Most women find out about the condition when they have trouble getting pregnant.
If you see any signs of the above-mentioned symptoms or have the slightest doubt about you having PCOS, then you must see a doctor immediately. You can treat PCOS symptoms with an early diagnosis, which can reduce the risk of complications when you decide to get pregnant.
The diagnosis of PCOS is made with the help of a doctor who will talk to you about the symptoms and examine you. Further, you will have to undergo blood tests to check for male hormones and ultrasound scans to find cysts in the ovaries.
PCOS and Infertility
PCOS and pregnancy success is less as this condition makes it difficult for you to get pregnant. It is because of the presence of the high levels of male hormones called androgens that prevent the release of an egg.
Androgens are known as male hormones, as men have much higher levels of these hormones as compared to women. Androgens help in the development of male sex organs and other male traits. Androgens that are present in women are usually converted into estrogen, which stops the release of the egg.
If a healthy egg is not released, it cannot be fertilized by sperm, and you cannot get pregnant. PCOS can also make you miss your periods or make your menstrual cycle irregular. You should pay attention to that as it can be one of the first signs that might help you detect PCOS.
Risks for moms-to-be with PCOS
PCOS makes it a bit difficult for one to get pregnant due to hormonal imbalances. Around 60% of PCOS women are obese and may require reproductive technology to get pregnant. They may develop various medical complications for their entire life, which includes:
- Stroke
- Sleep Apnea
- High Cholesterol
- Insulin Resistance
- Type 2 Diabetes
- High Blood Pressure
- Increased Risk Of Endometrial Cancer
- Heart Disease, Etc
However, some complications of getting pregnant with PCOS may include,
- Miscarriage: Studies show that women getting pregnant with PCOS often face miscarriage in the early months of pregnancy.
- Preeclampsia: It results in the sudden rise of blood pressure after the 20th week of pregnancy, which can be dangerous for both the mom-to-be and the baby. It further affects the mother's brain, liver, and kidneys. If one fails to get treated, it develops into eclampsia. The conditions of eclampsia may result in organ damage, seizures, or death. Doctors recommend immediate delivery of the baby and placenta.
- Gestational diabetes: Women developing gestational diabetes may affect the fetus and even impact it after childbirth. They may have low blood sugar and find trouble breathing. Gestational diabetes even leads to the birth of larger babies than the average ones. They are more prone to the risks of shoulder dystocia. It is the condition when the shoulder of the baby gets stuck during labour.
. - C-section delivery: PCOS pregnancy has several complications, pregnancy-induced blood pressure, low or high blood sugar level, etc. It results in C-section delivery or surgical child delivery. Generally, it takes more recovery time than vaginal birth.
Risks for Baby
PCOD pregnancy affects both the mom-to-be and the fetus. Hence, strict monitoring is crucial for the woman and the baby. One of the potential risks of PCOS pregnancy for babies is preterm or premature birth, usually before 37 weeks of pregnancy. Preterm babies face severe health complications right after birth and might for their entire life.
Gestational diabetes during PCOS pregnancy may lead to cesarean delivery due to a large-sized baby.
PCOS And Breast-feeding
A woman, if getting pregnant with PCOS, is likely to continue managing symptoms even after pregnancy. However, the severity and the types of symptoms vary from person to person. Pregnancy and breastfeeding even help control the symptoms due to hormonal fluctuations.
It is entirely safe to breastfeed the baby even if you take insulin medication or metformin for controlling blood sugar. There isn't even an issue in pumping the milk, and a woman can easily breastfeed the child.
Whatever the risks or complications may be with PCOS pregnancy, frequent monitoring and proper lifestyle help lower such risks. It is essential to consult the gynaecologist for even a single severity to reduce life-threatening complications.
PCOS and Pregnancy: Do PCOS affect pregnancy?
Women with PCOS have a higher risk of complications during their pregnancy. Infants born to women with PCOS are at a higher risk of spending time in the intensive care unit or dying before, during, or after their birth.
PCOS and Pregnancy Complications
1. Preeclampsia
It is a condition where there is a sudden increase in the mother’s blood pressure after the 20th week of pregnancy. It can further affect the mother’s liver, kidney, and brain. If it is not treated at the right time, it can turn into eclampsia, leading to organ damage, seizures, and even death.
The current treatment for this condition is to immediately deliver the baby, even if it is preterm. Further, pregnant women with this condition will need a delivery with C-section, which can carry additional risks for the mother and the baby.
2. Preterm Birth
If the baby is delivered before 37 weeks of pregnancy, it is considered to be preterm. Such infants are at risk of many health problems right after birth and later in life. Also, some of these problems can be serious.
3. Pregnancy-induced High Blood Pressure
As the name suggests, it is a high blood pressure condition that occurs in PCOD pregnancy. It usually occurs in the second half of the pregnancy, and if not treated on time, it can lead to preeclampsia. This kind of blood pressure can also affect the delivery of the baby.
4. C-Section or Caesarean Delivery
PCOD pregnancy is most likely to result in C-sections because of the complications associated with PCOS, like high blood pressure. C-section is a surgical process, so the recovery can take longer for the mother as compared to the vaginal birth. It can carry risks for the infant as well.
PCOS and First Trimester Pregnancy
PCOS can cause a few complications in the first trimester of pregnancy itself, and it can result in:
1. Early Loss of Pregnancy or Miscarriage
Women with PCOS are at a three-time higher risk of a miscarriage in the early months of the pregnancy as compared to women without PCOS. Some studies show that metformin might reduce the risk of miscarriage in pregnant women with PCOS. However, there are no solid claims for the same, and thus, more research needs to be done on this.
2. Preterm Birth
If a baby is delivered before 37 weeks of pregnancy, it is considered preterm. A preterm infant is at risk for many health problems, both during and after birth, and some of these issues can be serious.
How to get pregnant with PCOS?
Many women have experienced PCOS and pregnancy success because of the right lifestyle and treatment.
Some of the lifestyle changes that you can make are:
1. Maintain a Proper Weight
A lot of women with PCOS struggle with their weight. However, some women have PCOS but are not overweight. However, losing even 5% of the extra weight will also help increase your fertility levels and decrease the symptoms of PCOS.
Include movement in your routine by going for a walk or taking the steps. You can even choose to exercise for just 30 minutes daily.
2. Eat a Balanced Meal
Any woman who is planning to get pregnant needs to have the right amount of nutrients. Reduce the intake of sugary foods, unhealthy fats, and simple carbs. Instead, switch to:
- Whole grains like brown rice and oats
- Fish and Chicken
- Beans and Lentils
- Fresh and cooked fruits and vegetables
You should also eat certain vitamins and minerals as they help in PCOS pregnancy. You can consult your doctor for the supplements of these nutrients that help with fertility.
- Vitamin E
- Vitamin D
- Vitamin C
- Vitamin B6
- Vitamin B12
- Folic Acid (Vitamin B9)
- Coenzyme Q10
3. Balance Blood Sugar Levels
Getting pregnant with PCOS is tough but not impossible. However, if you are having trouble getting pregnant, then your doctor will surely check your blood sugar levels as PCOS can sometimes affect them. PCOS makes your body less sensitive to insulin and can result in type-2 diabetes, which can cause fertility problems.
Thus, balancing your blood sugar levels can help you to get pregnant. All you need to do is eat a healthy diet that is rich in fibers, proteins, and healthy fats. Getting proper exercise with strength training can also help a lot. In some cases, your doctor might give you medication that can help improve your blood sugar levels.
4. Medications
During PCOS, your body can make both male hormones (testosterone) and female hormones (estrogen). Too much or too little of these hormones can make it difficult to get pregnant. Thus, your doctor will prescribe certain medications to help with the condition so that you can experience PCOS and pregnancy success.
How Can I Prevent Miscarriage With PCOS?
Women with PCOS are at a higher risk of miscarriages. Thus, it is a good idea to be in continuous touch with a gynecologist as they can monitor your pregnancy and suggest adjustments if needed.
There are a lot of different factors that lead to miscarriages in a woman with PCOS. A lot of theories have been proposed to explain miscarriages and PCOS, but none of them has been able to find the exact cause of the association.
However, some of the factors are:
- Obesity- It increases the infertility rate, and so, you must lose weight before getting pregnant
- Fertility treatments- Increased miscarriage rate is observed in women with PCOS taking IVF treatments
- Hyperinsulinemia- Elevated insulin levels in the blood lead to miscarriage, and thus, it is important to regulate your blood sugar levels before getting pregnant.
In a Nutshell…Does PCOS Affect Pregnancy
Yes, PCOS can affect pregnancy. However, getting pregnant with PCOS is not impossible. You will have to make a few lifestyle changes and follow a healthy diet with a good exercise routine to get pregnant with PCOS.
At the same time, it is a good habit to notice changes in your body to detect and treat the symptoms early on. PCOS is reversible with the right doctor consultation and medication in the early stages.
FAQS
Can You Get Pregnant Naturally With PCOS?
Yes, it is possible for women with PCOS to get pregnant naturally by altering their lifestyle. Some of the lifestyle changes that reduce the symptoms of PCOS are:
- Losing weight
- Managing Stress
- Eating a nutrient-rich diet
Does PCOS Increase the Chance of Twins?
It does not increase the chance of twins. However, a few studies found that 9% of women with PCOS delivered twins.
Can You Pass PCOS to Your Daughter?
Yes, studies do suggest that PCOS can be passed from the mother to the daughter. You can also pass on a few irregularities like insulin conditions to the son.
Is PCOS Worse After Pregnancy?
It depends from woman to woman. The hormone levels will change after the pregnancy, and so you should get yourself checked accordingly. However, it is a good idea to work on yourself and control PCOS symptoms before getting pregnant, as that will help you more to deal with it after pregnancy.
References
- M. Mikola, V. Hiilesmaa, February 2021; Obstetric outcome in women with polycystic ovarian syndrome - https://academic.oup.com/humrep/article/16/2/226/649607
- Contemporary OB/GYN, July 19, 2011; PCOS and Genetics - https://www.contemporaryobgyn.net/view/pcos-and-genetics
