Polycystic Ovarian Syndrome (PCOS) is a condition that affects approximately 10 percent of women in their childbearing years. While there are several health complications associated with PCOS, women of childbearing age often find the most devastating symptom to be infertility. Today we’re looking at polycystic ovarian syndrome and pregnancy, giving common ways doctors’ help women overcome fertility challenges and the potential problems that may occur during pregnancy.
What is Polycystic Ovarian Syndrome?
The exact cause of PCOS is unknown but researchers believe there is a genetic component to the condition. It occurs when multiple cysts or follicles grow and remain in the ovaries rather than the typical ovulation process of one monthly sac containing an egg bursting and releasing the egg to be fertilized. With PCOS, women often do not get a monthly menstrual cycle or it is very erratic, which is why it causes a fertility problem.
The build-up of cysts is due to increased levels of the male sex hormone androgen. It is normal and necessary to have some amount of androgen but elevated levels can cause PCOS. This is why women with PCOS often experience abnormal hair growth, either in the form of excessive hair or hair loss. Other symptoms include weight gain, anxiety, depression, darkened skin, skin tags, acne, high blood pressure, high cholesterol and pelvic pain.
Additionally, women with PCOS often have higher levels of insulin, the hormone that helps the body break down and process sugar. An increase in insulin also stimulates the production of more androgen, perpetuating the cycle of PCOS. People with diabetes have trouble producing or regulating insulin, which results in a blood glucose imbalance. This also increases the risk of PCOS in women with diabetes.
Polycystic Ovarian Syndrome and Fertility Treatments
To treat infertility due to polycystic ovarian syndrome, doctors have found success with a few courses of action. First, losing weight to get as close as possible to an ideal BMI is a great step. Weight loss and maintaining a healthy weight helps regulate insulin. Medications such as Metformin and Glucophage used to treat symptoms of diabetes are often prescribed to women with PCOS who are trying to get pregnant. When insulin levels are in control, androgen levels will decrease, which will likely reduce cysts in the ovary and encourage regular ovulation.
Fertility medications like Clomid and Femara or hormone injections such as Gonadotropins and Follistim have shown positive results in helping women with PCOS become pregnant. Other treatments include a surgical procedure that removes part of the ovaries to hopefully reduce the presence of androgen that causes the cysts. Usually the last resort for women with PCOS who are trying to conceive is IVF.
Polycystic Ovarian Syndrome and Pregnancy Risks
Once a woman with PCOS does become pregnant, there are a few complications that may arise. She is more likely to have gestational diabetes due to the insulin imbalance the condition creates. She may also experience high blood pressure during pregnancy that can lead to heart problems or preeclampsia. Preterm births and birth via C-section are more likely in pregnant women with PCOS. In some cases PCOS can cause endometrial cancer.
It’s important for moms-to-be with PCOS to work closely with their doctors during pregnancy to ensure these symptoms are managed. Eating a healthy diet and continuing exercise during pregnancy are critical, as is monitoring blood glucose and blood pressure levels.
Sources: What to Expect and American Pregnancy