Women with polycystic ovary syndrome (PCOS) are at higher risk for certain problems or complications during pregnancy. In addition, infants born to mothers with PCOS are at higher risk of spending time in the neonatal intensive care unit or dying before, during, or right after birth.
Fortunately, with lifestyle changes or infertility treatment, most people with PCOS can become pregnant. Talk to your doctor or fertility specialist for individual advice for your situation.
About 75% to 80% women with PCOS will ovulate after CC, and a conception rate of 22% per cycle has been reported.
In fact, research has suggested that women with PCOS are more likely to have a miscarriage with 30-50% of PCOS women likely to miscarry compared to 10-15% of women without PCOS.
PCOS pregnancies are higher risk, but that doesn't mean a mother with PCOS can't deliver a healthy full-term baby. However, pregnancy complications like high blood pressure make a cesarean delivery (C-section) more likely.
Polycystic Ovary Syndrome and Miscarriage
In women with PCOS, however, the risk is about three times the normal risk. Many specialists believe that the rate of early pregnancy loss in PCOS women is due to other related factors, including a higher incidence of insulin resistance, hyperandrogenemia, and obesity.
It is important to remember that some of the symptoms of PCOS, such as hormonal imbalance and associated weight gain, can return and even worsen after pregnancy – and that being pregnant and successfully giving birth does not mean that PCOS has gone away.
It is clinically tested that a first-trimester miscarriage can occur in 50% of pregnant women with PCOS, a rate which is three times higher than that in women without PCOS.
The best way to prevent miscarriage in women with polycystic ovarian syndrome (PCOS) is to normalize hormone levels to improve ovulation, and normalize blood glucose and androgen levels. Recently, more doctors are prescribing the drug metformin to help with this.
Can pregnancy cure PCOS? No, unfortunately, PCOS is a chronic condition. However, it is not uncommon for women with PCOS to experience a cessation of their symptoms while they are pregnant.
Women with PCOS may be more likely to have multiples (twins, or more). One study found that while the multiple pregnancy rate is 1.1% in the average population, it is 9.1% for women with PCOS patients.
However, in older “lean” PCOS women, who by this time usually have become hypo-androgenic, egg quality is, indeed, negatively affected, unless androgen levels are appropriately pre-supplemented, starting at least 6-8 weeks prior to IVF cycle start.
Risk factors for a high-risk pregnancy can include: Existing health conditions, such as high blood pressure, diabetes, or being HIV-positive. Overweight and obesity. Obesity increases the risk for high blood pressure, preeclampsia, gestational diabetes, stillbirth, neural tube defects, and cesarean delivery.
A medicine called clomifene may be the first treatment recommended for women with PCOS who are trying to get pregnant. Clomifene encourages the monthly release of an egg from the ovaries (ovulation). If clomifene is unsuccessful in encouraging ovulation, another medicine called metformin may be recommended.
When the congenital abnormalities were analysed by the type of malformation, cardiovascular and urogenital malformations were more common in the offspring of women with PCOS; cardiovascular (1.5% compared with 1.0%, OR 1.37, 95% CI 1.01–1.87) and urogenital defects (2.0% compared with 1.4% OR 1.36, 95% CI 1.03–1.81).
It's also important to note that some women with PCOS find it easy to get pregnant with a first or second child but then struggle with infertility in later pregnancies, something known as secondary infertility.
Mothers with PCOS may struggle to produce enough milk or some may make an overabundance of it. Women with a diagnosis require careful monitoring by a health care provider before and after the birth of their baby.
Women with PCOS are more likely to experience heart and psychiatric complications during the postpartum period. 7 These include postpartum preeclampsia, congestive heart failure (a poorly pumping heart that causes fluid buildup in the lungs), and postpartum depression.
Use of metformin throughout pregnancy in women with PCOS has shown to reduce the rates of early pregnancy loss, preterm labor, and prevention of fetal growth restriction.
Post-PSM data showed that the late abortion rate was significantly higher in the PCOS group than in the non-PCOS group only in twin pregnancy (9.50% vs. 3.96%, OR: 2.55, 95%CI 1.10-5.89). There were no statistical differences in other pregnancy outcomes.
Furthermore, both univariate and multivariable analysis identified PCOS as a risk factor for an embryo/fetus to be chromosomally abnormal, with odds ratios of 1.957 (95% confidence interval, 1.067-3.590) and 2.008 (95% confidence interval, 1.038-3.883), respectively.