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PCOS and Pregnancy: What are the risks?

Polycystic Ovary Syndrome is a hormonal condition that plagues a large proportion of women of reproductive age. It can affect up to 30-50 per cent of women of fertile age in India. Though PCOS makes conception and childbirth difficult, it is possible. If you are struggling with a PCOS-related condition, understanding your condition is the first step toward a healthy pregnancy. Here is everything you need to know about PCOS and how you can improve it.

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PCOS

Does PCOS cause infertility?

PCOS is known to make conception difficult and may cause infertility. However, while the chances are reduced, women with PCOS can get pregnant naturally. The complications of PCOS are usually treatable with medical guidance and lifestyle changes.
 

Obesity

Women who are obese are more likely to suffer from PCOS. Once excessive weight is gained, women may find weight loss extremely challenging. Obesity leads to other health complications such as diabetes, high BP, and high cholesterol.

Hormonal imbalance

PCOS usually leads to two types of hormonal imbalances: high androgen and high insulin levels. All women produce small amounts of androgens or “male hormones.” But PCOS makes the body produce more testosterone, leading to excess facial and body hair, male-pattern baldness, and acne. Similarly, women also develop “insulin resistance,” causing high insulin levels in the bloodstream. This can also interfere with ovulation and fertility.
 

Irregular ovulation

One of the most telling signs of Polycystic Ovarian Syndrome is absent or irregular periods. Normally, one mature egg is released every menstrual cycle. But due to excess testosterone in women with PCOS, the eggs do not mature or release. Without ovulation, the sperm cannot fertilize the egg, leading to infertility.

 

Risks for the mother

If you suffer from PCOS, pregnancy comes with additional risks for the mother and the child. Constantly monitoring health throughout the pregnancy and keeping an eye on any complications is important.

Preeclampsia

Preeclampsia is a dangerous condition marked by a sudden onset of high blood pressure, usually after 20 weeks of pregnancy. This can affect multiple organs, such as the kidney and liver. If left untreated, the condition can also lead to death.

Increased chances of miscarriage

Recent studies have stated that women with PCOS are three times more likely to miscarry than healthy women. This may be due to excess androgens. High insulin levels can also affect the health of the uterus, leading to early loss of pregnancy. Though there is limited evidence, certain medications in PCOS fertility treatment are said to decrease the risk of miscarriage.


Gestational diabetes

In women with PCOS, the risk of diabetes increases with pregnancy. Though gestational diabetes only occurs in pregnant women and is treatable, high insulin levels may continue after pregnancy due to polycystic ovary syndrome. If not controlled, gestational diabetes can affect the pregnancy, even leading to stillbirth.
 

Risks for the baby

If the mother has PCOS, the baby also has some risks during pregnancy and at childbirth. The chances of some conditions like type 2 diabetes are higher in babies throughout their life.  

Other complications to the child include:

Preterm birth

Mothers with PCOS have a higher chance of giving birth prematurely, that is, before 37 weeks of gestation. Babies born preterm have several short-term and long-term complications such as breathing and heart problems. They may also need to be kept in intensive care.
 

Higher birth weight

Babies of women who suffer from PCOS are usually larger for their gestational age. As a result, such women often give birth through C-section as the vaginal birth of larger babies can lead to additional complications.

Inherited PCOS

If the baby is a girl, there are higher chances of the baby inheriting PCOS. A study shows that daughters of women with PCOS have a five times higher chance of being diagnosed with the condition.

Tips to increase chances of pregnancy with PCOS

If you have PCOS and want to get pregnant, it is best to seek medical advice. Doctors will first determine your condition as not all women with polycystic-looking ovaries have PCOS. Once confirmed, the doctor will suggest appropriate treatment.
 

Along with medications, doctors usually recommend certain lifestyle changes that can help you conceive and keep PCOS under control. Here are some tips you can follow to stay healthy and increase your chances of conception.
 

Exercise and Weight Loss

Nearly half of all women with Polycystic Ovary Syndrome are obese. To get back on a regular menstrual cycle, you need to lose and maintain your weight within healthy limits. Even though weight loss is difficult, regular exercise and diet make it easier to reach your desired weight. However, this is not a solution on its own to increase your chances of pregnancy.
 

Reduce Stress

While infertility can be stressful, it is essential to take care of your mental health. Stress is known to aggravate the symptoms of PCOS. Hence including healthy mental habits in your everyday routine is a necessity. Try practising meditation and have a positive approach to situations.
 

Medications And Treatment

While lifestyle changes are helpful, they aren’t enough to treat PCOS-related infertility. Many women benefit from medications that regulate the menstrual cycle. These hormone supplements may be taken orally or through injections. They help the ovaries release a mature egg that can be naturally fertilised.

Other medications can also help maintain your androgen and insulin levels, which are essential for your overall health. Apart from this, assisted reproductive technologies such as IVF are also beneficial for women with PCOS.
 

IVF