Polycystic Ovary Syndrome (PCOS) and Pregnancy

Women with polycystic ovary syndrome (PCOS) may struggle to get pregnant and are at higher risk of developing complications during pregnancy and labour. However, with the right interventions, women with PCOS are able to have a baby.

What is PCOS?

Polycystic ovarian syndrome (PCOS) is a hormonal condition where the ovaries produce too much male hormones called androgens. High levels of androgens interfere with the release of eggs (ovulation) and cause irregular periods.

Other symptoms may include excessive hair growth on face or body, acne, weight gain and insulin resistance. PCOS affects approximately 4%-20% of women of childbearing-age [1].

Do only overweight women have PCOS?

Although PCOS is associated to obesity, not all women with PCOS are overweight. A small but distinct proportion of women with PCOS have normal or below than normal body weight. This is termed ‘lean PCOS’.

Complications of PCOS

Infertility: PCOS is a common cause for anovulation, where the eggs fail to ovulate. Women with PCOS may also have infrequent or no periods. This is due to the disruption in hormones levels that are important in cycle regulation.

Risks involved in pregnancy and labour: It was found that PCOS brings higher risk of complications during pregnancy such as gestational diabetes or high blood pressure. For the baby, the potential risks are miscarriage, premature birth or larger size babies (requiring caesarean delivery).

What can be done?

For women who are trying to conceive, these are the following steps that can help manage the symptoms of PCOS.

1. You can maintain a healthy weight through exercise and right diet. Occasionally, bariatric surgery may be recommended.
2. You may be prescribed fertility medications by the doctor to help with ovulation.
3. You may want to have intrauterine insemination (IUI)-related procedures.
4. You may consider having In-Vitro Fertilisation (IVF), which provides the best chance of conceiving.

For pregnant women with PCOS, it is important to speak to your doctor to monitor PCOS symptoms and take precautions during pregnancy and delivery.

Take-away message

Thankfully, with the right interventions or treatment, there is hope for women with PCOS to have a healthy baby. Therefore, it is encouraged that women who suffer from PCOS seek medical help from a reproductive specialist, if symptoms persist or gradually become more severe.

References

1. Deswal, R., Narwal, V., Dang, A., & Pundir, C. S. (2020). The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. Journal of Human Reproductive Sciences, 13(4), 261.