Pregnancy in pcos complication

Pregnancy complications in women with polycystic ovary syndrome

Review

. 2008 Jan;26(1):72-84.

doi: 10.1055/s-2007-992927.

Carolien M Boomsma¹, Bart C J M Fauser, Nick S Macklon

Affiliations

Affiliation

¹ Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands. [email protected]

PMID: 18181085
DOI: 10.1055/s-2007-992927

Review

Carolien M Boomsma et al. Semin Reprod Med. 2008 Jan.

. 2008 Jan;26(1):72-84.

doi: 10.1055/s-2007-992927.

Authors

Carolien M Boomsma¹, Bart C J M Fauser, Nick S Macklon

Affiliation

¹ Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands. [email protected]

PMID: 18181085
DOI: 10.1055/s-2007-992927

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. There is an increasing body of evidence indicating that PCOS may have significant implications for pregnancy outcomes and long-term health of a woman and her offspring. Whether or not PCOS itself or the symptoms that coincide with PCOS, like obesity and fertility treatment, are responsible for these increased risks is a continuing matter of debate. Miscarriage rates among women with PCOS are believed to be increased compared with normal fertile women, although supporting evidence is limited. Pregnant women with PCOS experience a higher incidence of perinatal morbidity from gestational diabetes, pregnancy-induced hypertension, and preeclampsia. Their babies are at an increased risk of neonatal complications, such as preterm birth and admission at a neonatal intensive care unit. Pre-pregnancy, antenatal, and intrapartum care should be aimed at reducing these risks. The use of insulin sensitizing drugs to decrease hyperinsulinemic insulin resistance has been proposed during pregnancy to reduce the risk of developing preeclampsia or gestational diabetes. Although metformin appears to be safe, there are too few data from prospective, randomized controlled trials to support treatment during pregnancy.

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Polycystic ovarian syndrome (PCOS) and pregnancy – symptoms and treatments

Polycystic ovarian syndrome (PCOS) and pregnancy – symptoms and treatments | Pregnancy Birth and Baby beginning of content

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What is PCOS?

Polycystic ovarian syndrome, or PCOS, is a common condition.

People with PCOS can have:

higher than normal levels of androgens (male-type hormones)
problems with ovulation (the release of eggs from the ovaries)
multiple cysts on the ovaries

This can affect your menstrual cycle, fertility and appearance.

If you have PCOS you may struggle to become pregnant and may be at higher risk of developing some pregnancy complications.

Illustration showing a normal ovary and a polycystic ovary.

What are the symptoms of PCOS?

There are many signs and symptoms that are associated with PCOS. These can include:

irregular menstrual periods
cysts on the ovaries
infertility
weight gain
acne
depression
excessive face and body hair
thinning or balding head hair
insulin resistance (where your cells don't respond to insulin and your blood sugar levels rise)

Some of these symptoms (such as acne, excess face and body hair, and scalp hair loss) are due to increased levels of the hormones called androgens. These hormones are found in all females, but those with PCOS have slightly higher amounts.

CHECK YOUR SYMPTOMS — If you are feeling unwell and not sure what to do next, check your symptoms using the healthdirect Symptom Checker tool.

How is PCOS diagnosed?

It often takes a while to get a PCOS diagnosis. This is because the condition can mimic other problems. Sometimes, people only find out that they have PCOS when they have tests to find out why they are having trouble getting pregnant.

If you think you might have PCOS, see your doctor. Early diagnosis means that your symptoms can be treated early.

At your appointment, your doctor will:

ask about your symptoms
ask for your medical history
examine you

Your doctor may also recommend blood tests and an ultrasound scan to look for any cysts in the ovaries.

In general, to be diagnosed with PCOS, you need to have 2 out of 3 of the following;

irregular periods, or no periods
symptoms due to increased levels of androgen hormones, or a blood test showing you have increased levels of androgen hormones
an ultrasound scan showing multiple cysts on your ovary or ovaries

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Will PCOS affect my fertility?

If you have PCOS, you might struggle to get pregnant.

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.

Can PCOS increase my risk of complications during pregnancy?

Having PCOS can increase your risk of some complications during pregnancy, such as:

high blood pressure
gestational diabetes
premature birth

If you have PCOS, you are also at increased risk of having a baby larger than expected for their gestational age. This comes with a higher risk of needing a caesarean delivery.

Babies born to people with PCOS have a higher chance of being admitted to a newborn intensive care unit.

Pregnant women with PCOS may have a higher risk of miscarriage and stillbirth. However, more research is needed in this area.

If you have PCOS and are pregnant, it is important you talk with your doctor. The risk of these complications can be reduced by monitoring your PCOS symptoms and taking extra care during your pregnancy.

What steps can I take to look after my health?

You can make lifestyle changes to manage your PCOS and look after your health. These include:

maintaining a healthy weight
eating healthily
exercising
managing stress
getting enough sleep

These lifestyle changes can reduce the symptoms of PCOS and improve your chance of falling pregnant.

If you are overweight, a 5% to 10% loss in weight can increase your fertility.

Speak to your doctor for guidance on how to make effective lifestyle changes.

How is PCOS treated?

Treatment for PCOS depends on each person. Speak to your doctor about the best treatment for you.

If you are trying to fall pregnant, your PCOS treatment will focus on:

restoring regular ovulation
weight loss
improving your general health and wellbeing

If you have made lifestyle changes and are still struggling to fall pregnant, your doctor may order fertility tests. They may also prescribe fertility medicines to help you ovulate. In some cases, they may recommend surgery.

Another possibility is in vitro fertilisation (IVF), which offers the best chance of conception. However, this can be expensive and is usually only considered when all other options have been unsuccessful.

If you are not trying to fall pregnant, your PCOS treatment will focus on:

reducing your symptoms
reducing your risk of long-term health issues, including heart disease and type 2 diabetes

Speak to your doctor. They can help you manage your PCOS symptoms by providing:

weight loss management strategies
treatment for sleeping problems
acne treatment
medicines, including hormonal contraception (birth control) to manage irregular menstruation

Dealing with infertility and PCOS symptoms can be difficult. You may experience feelings of depression and anxiety. Your doctor can refer you to a counsellor or psychologist for your mental health.

Resources and support

Visit the Jean Hailes website for more information on PCOS and its complications.

Hormones Australia also supplies information on PCOS, including questions to ask your doctor.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:

Australian Family Physician (Polycystic ovary system), Jean Hailes (PCOS), Royal Australian College of General Practitioners (Polycystic ovary system - clinical guidelines), The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (Long-term consequences of PCOS - statement)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2022

Need more information?

Polycystic Ovary Syndrome (PCOS) | Your Fertility

PCOS can be associated with a range of symptoms including irregular periods and difficulties getting pregnant

Fact sheets | Your Fertility

Polycystic ovary syndrome (PCOS) is the most common hormonal condition affecting women in their reproductive years

What is PCOS?

Polycystic ovary syndrome (PCOS) is the most common hormonal condition affecting women in their reproductive years.

Polycystic ovarian syndrome (PCOS) - Better Health Channel

Polycystic ovarian syndrome is a hormonal condition associated with irregular menstrual cycles, excess hair growth, acne, reduced fertility, and increased risk of diabetes and mood changes.

Polycystic ovary syndrome (PCOS) | Dietitians Australia

PCOS is a common hormonal condition of the ovaries that can cause problems such as an irregular menstrual cycle, weight gain, impaired fertility and poor mental health. Diet and lifestyle changes are the first steps to manage PCOS, and an Accredited Practising Dietitian specialising in PCOS is the most qualified professional to help.

Fertility explained | VARTA

Fertility is the ability to conceive a child. Most of us take our fertility for granted but the process of reproduction is complex, so some people may experience difficulties when trying for a baby. There are a range of factors that can affect fertility. Taking care of your preconception health by modifying your lifestyle can improve your chance of a pregnancy and the health of your future child. Medical conditions such as polycystic ovary syndrome (PCOS) and endometriosis can reduce fertility, however it may just take longer to get pregnant. In some cases, medical procedures can be used to preserve fertility. Fertility preservation (freezing of gametes for later use) is used by people who are not ready to have a baby during their most fertile years or for those facing medical treatment that might impair their fertility. Understanding reproduction It is useful to understand how eggs and sperm are normally formed, and how conception occurs to understand the causes of infertility and how they are targeted in fertility treatment. The hormones which control the production of sperm and eggs are called gonadotrophins. There are two types of gonadotrophins: follicle-stimulating hormone (FSH) and luteinising hormone (LH). In men, they stimulate the testicles to produce sperm and testosterone. In women, they act on the ovaries where the eggs develop. The female sex hormones, oestrogen and progesterone, are produced by the ovaries when eggs mature and are released (ovulation). For women, the production of sex hormones and the release of an egg is known as the menstrual cycle. It is counted from the first day of the period until the day before the start of the next period. In an average cycle of 28 days, ovulation happens on day 14. However, cycle length varies between women, and it is important to note that ovulation occurs earlier in women with shorter cycles and later in women with longer cycles. Sperm are produced at the rate of about 300 million per day. They take some 80 days to mature. Each sperm has a head, which contains the genetic material, and a tail, which propels it up through the vagina, uterus, and fallopian tubes where the egg is fertilised. Conception occurs when an egg and a sperm come together. At ovulation, an egg is released from the ovary into the fallopian tube. If sperm is present at that time, the egg can be fertilised. The fertilised egg then starts to divide and becomes an embryo. After ovulation, the ovary produces progesterone which prepares the lining of the uterus - the endometrium - for the growing embryo. A few days after implantation, the embryo starts to produce human chorionic gonadotrophins (HCG) - the hormone that gives a positive pregnancy test reading. If an embryo does not form or attach to the endometrium (implantation), the level of progesterone drops and the next period starts.

Good fertility health

Your age and your health can affect your chances of falling pregnant. Maintaining a healthy lifestyle may help you improve your fertility.

Polycystic ovarian syndrome and breastfeeding | Australian Breastfeeding Association

What is polycystic ovarian syndrome?Polycystic ovarian syndrome (PCOS) is a complex hormonal condition that affects 5% to 10% of women of reproductive age. Features of PCOS can include fertility problems, acne, obesity, excess body hair growth and an increased risk of developing type 2 diabetes.1PCOS and milk supply

All about Polycystic Ovary Syndrome (PCOS) | Jean Hailes

Read about causes, signs and symptoms of PCOS, as well as diagnosis and treatments available to help. Jean Hailes is Australia's leader in women's health.

Ovulation and fertility - Better Health Channel

The female body shows several signs of ovulation and you may experience some or all of these signs.

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How to get pregnant with polycystic ovaries?

Polycystic disease is a common hormonal disease that affects the functioning of a woman's ovaries. The dangers of PCOS include irregular menstrual periods, excessive hair growth, acne, weight gain, and other problems. Left untreated, PCOS can even lead to infertility. In this article, we will tell you more about causes of polycystic , polycystic ovaries and pregnancy , and also give an answer to the question: “ Is it possible to give birth with polycystic ovaries? ".

What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have menstrual irregularities and elevated levels of male hormones (androgens). Numerous small collections of fluid (follicles) may form in the ovaries, and an egg may not be released regularly. This condition should not be confused with multifollicular ovaries, because with multifollicular ovaries, ovulation and a normal menstrual cycle can persist, unlike polycystic disease.

50-75% of cases of endocrine infertility. 20-22% of marital infertility. It is detected in 5-16% of women of reproductive age. These are the figures for the diagnosis of "Polycystic Ovary".

Symptoms of polycystic ovary syndrome

Polycystic ovary syndrome is accompanied by characteristic symptoms, upon noticing which it is necessary to seek advice from an endocrinologist or gynecologist. For some women, symptoms begin around the time of their first menstrual period. Others discover symptoms of PCOS only after they have gained a lot of weight or have problems getting pregnant. In some cases, PCOS may be asymptomatic.

The most common symptoms of PCOS:

Irregular periods. Lack of ovulation prevents the lining of the uterus from falling off every month. Some women with PCOS have fewer than eight periods a year, or none at all.

Severe bleeding. The lining of the uterus builds up over a longer period of time, so menstruation may be heavier than usual.

Hair growth . More than 70 percent of women with this condition grow hair on their face and body, including on their back, abdomen, and chest. Excess hair growth is called hirsutism.

Acne . Male hormones can make the skin more oily than normal and cause breakouts on areas such as the face, chest, and upper back.

Weight gain. Up to 80 percent of women with PCOS are overweight or obese.

Male pattern baldness. The hair on the scalp becomes thinner and may fall out.

Darkening of the skin. Dark patches of skin may develop in body folds, such as the neck, groin area, and under the breasts.

Headaches. Hormonal changes may cause headaches in some women.

Irregular periods

Infrequent, irregular periods, long or no periods are the most common symptom of PCOS. For example, with PCOS, you may have fewer than nine periods a year, more than 35 days between periods, and abnormally heavy periods.

Hyperandrogenism

Hyperandrogenism is a disease characterized by high levels of androgens. It is more common in women than in men. Symptoms of hyperandrogenism may include acne, seborrhea (inflammation of the skin), hair loss on the scalp, increased body or facial hair, and infrequent or absent periods.

Hyperandrogenism is a defining feature of women and young girls with PCOS. Polycystic disease causes a malfunction of the ovaries or adrenal glands, which leads to the production of excess androgens (male sex hormones).

Anovulation

Anovulation occurs when an egg is not released from the ovary during the menstrual cycle. The egg is essential for pregnancy. Since several hormones are involved in ovulation, there are many causes of anovulation, one of which is PCOS. Chronic anovulation is a common cause of infertility.

Diagnosis

There is no test to definitively diagnose polycystic ovary syndrome (PCOS). The doctor will likely begin by discussing your medical history, including menstrual periods and weight changes. A physical exam will include checking for signs of excessive hair growth, acne, and weight gain.

Your doctor may recommend:

Gynecological examination. A physician visually and manually examines the reproductive organs for growths or other abnormalities.

Blood tests. A blood test is given to determine the level of hormones. This will help rule out possible causes of menstrual irregularities or excess androgens that mimic PCOS. An additional blood test may also be needed to measure insulin resistance as well as fasting cholesterol and triglyceride levels.

Ultrasound examination (ultrasound). The doctor will check the appearance of the ovaries and the thickness of the lining of the uterus. A rod-shaped device (sensor) (transvaginal ultrasound) is inserted into the vagina, which emits sound waves and converts them into images on a computer screen.

Is it possible to get pregnant with PCOS

How to get pregnant with PCOS? Getting pregnant with PCOS can be difficult, but that doesn't mean it's impossible. While PCOS can affect your hormones and therefore your fertility, there are medical treatments and lifestyle changes you can make to improve your chances of pregnancy.

Is it possible to get pregnant with polycystic ovaries? To get pregnant, you must ovulate, which PCOS most often prevents. Women who do not ovulate regularly with PCOS do not release enough eggs for fertilization. Pregnancy with PCOS is further complicated by the fact that PCOS causes a hormonal imbalance that changes the quality of cervical fluid, making it difficult for sperm to survive.

It is impossible to say categorically that PCOS is infertility, but PCOS is one of the main causes of infertility in women.

Is it possible to get pregnant with PCOS? And although there are no exact statistics on the chances of pregnancy, 70 to 80 percent of women with PCOS have fertility problems. PCOS disrupts the normal menstrual cycle and makes it difficult to conceive.

Is it possible to get pregnant with PCOS? Polycystic ovary syndrome is not a sentence and it is possible to get pregnant, albeit problematic. However, if PCOS is left untreated, the chances of getting pregnant decrease with age.

It is possible to get pregnant with polycystic disease, but most often pregnancy with polycystic disease is difficult. This condition can increase the risk of pregnancy complications. Women with PCOS are twice as likely to have a preterm birth than women without. They are also at greater risk of miscarriage, high blood pressure, and gestational diabetes. However, by managing the symptoms, many women with PCOS can become pregnant and have a healthy baby.

How to get pregnant with PCOS? Women with PCOS can become pregnant using fertility treatments that improve ovulation. Losing weight and lowering your blood sugar can increase your chances of a healthy pregnancy.

Pregnancy planning for PCOS

How to get pregnant with PCOS? While your chances of getting pregnant with PCOS may be lower, there are a few things you can do to increase those chances.

Call your doctor. How to get pregnant with polycystic ovaries? Normalization of hormones and menstruation is the first step. Your doctor may prescribe medications to help your body deal with insulin better and regulate your menstrual cycle.

Maintain a healthy weight. Is it possible to get pregnant with PCOS? Weight loss can lower insulin levels, androgen levels, and restore ovulation. Ask your doctor about a weight management program and meet with a nutritionist regularly for help with your weight loss goals.

Eat right. Polycystic Ovarian Diet includes sugary foods, simple carbohydrates and unhealthy fats. Add to your menu: fresh and cooked fruits and vegetables, whole grains such as brown rice, oats and barley, beans and lentils, chicken, fish.

Be active. Exercise helps lower blood sugar levels. How to get pregnant with insulin resistance? If you have PCOS, increasing daily activity such as walking, exercising, walking can help treat or even prevent insulin resistance, control your weight, and avoid developing diabetes.

Lead a healthy lifestyle. Follow a healthy lifestyle with PCOS, give up bad habits, unhealthy diet, lack of sports and irregular sleep.

Treatment for PCOS

Treatment for PCOS focuses on your individual problems such as infertility, acne or obesity. Also, the direction of PCOS treatment largely depends on whether a woman is planning a pregnancy or not. Specific treatment may include lifestyle changes or medications.

How to treat PCOS?

Lifestyle changes

Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise. Even small weight loss - like losing 5 percent of your body weight - can improve your condition. Can you get pregnant with PCOS? Losing weight can also increase the effectiveness of medications your doctor recommends to treat PCOS and help with infertility.

Treatment with drugs for polycystic ovaries

To regulate the menstrual cycle, the doctor may recommend:

Combination birth control pills. Estrogen and progestin tablets reduce androgen production and regulate estrogen. Hormone regulation can reduce the risk of endometrial cancer and correct abnormal bleeding, excess hair growth, and acne. Instead of pills, you can use a skin patch or vaginal ring containing a combination of estrogen and progestin.

Progestin therapy. Daily progestin may: restore normal hormonal balance, regulate ovulation, stop excessive hair growth, protect against endometrial cancer, and help get pregnant with sleep deprivation.

How to induce ovulation in PCOS? To help induce ovulation in PCOS, your doctor may recommend:

Clomiphene is a fertility medication that can help women with PCOS get pregnant.

Metformin is a drug used to treat type 2 diabetes. It also treats PCOS by increasing insulin levels.

Operation

How to get pregnant with PCOS? Surgery may be an option to improve fertility if other treatments don't work. Ovarian drilling is a procedure in which tiny holes are made in the ovary using a laser or a thin, heated needle to restore normal ovulation and the possibility of pregnancy with PCOS.

Important! To determine the right treatment and choose the right drug, you need to consult a doctor!

Help Doc.ua: you can make an appointment with a gynecologist-endocrinologist on the website.

Polycystic ovaries - is it possible to get pregnant?

Polycystic ovaries - is it possible to get pregnant?

Polycystic ovaries - an unpleasant but common disease that prevents conception and pregnancy. Statistics show that many women suffer from this disease and, of course, they are concerned about the question: if polycystic ovaries - is it possible to get pregnant ?

Medicine, even very modern, unfortunately, cannot give an exact answer to the question of why polycystic ovaries occur. Many experts suggest the presence of hereditary factors, infectious diseases, early abortions, stress in adolescence, and even frequent colds. In fact, polycystic disease is the appearance on the ovary or ovaries of cystic formations containing undeveloped eggs, therefore, in the presence of polycystic ovaries, pregnancy is very problematic.

What is PCOS

Hormone-dependent disease PCOS occurs due to a malfunction in the body's production of hormones such as insulin, which provokes the production of androgens, male sex hormones that suppress the production of women. As a result, the production of full-fledged eggs is impossible, and it is almost impossible to get pregnant. Polycystic ovary disease is often asymptomatic, and many women are unaware of it until they decide to have a baby. Nevertheless, polycystic ovaries have certain symptoms, with the manifestation of which it is better to immediately contact a urologist so that you can become pregnant.

Some manifestations that may indicate the presence of polycystic ovaries

Polycystic ovaries is fraught for a woman not only with infertility, but also with other serious consequences, such as rupture of a cyst or ovary, oncological diseases. Possible manifestations of polycystic ovaries:

weight gain without a visible increase in calorie intake is an indirect sign that is present in almost all diseased women;

eruptions like acne on the face and other parts of the body;

male pattern increase in body hair;

increases the work of the sebaceous and sweat glands, making the skin and hair more oily than usual;

ultrasound fixes a disproportionate increase in the ovaries;

menstrual disorders;

bleeding between periods.

The question that arises in women who are diagnosed with polycystic ovaries: is it possible to get pregnant and how dangerous it is, is very relevant, because bearing a child in the presence of untreated polycystic disease can become a serious burden not only for the health of the mother, but also for the fetus too .

Possible pregnancy complications in polycystic ovaries

Fetal complications:

threatened miscarriage or miscarriage;

premature delivery;

fetal fading or arrest in development.

Complications in future mothers:

significant increase in body weight;

increased blood pressure;

development of diabetes.

If diagnosed polycystic ovaries, is it possible to get pregnant must be decided with the attending physician at the medical center, but only after undergoing appropriate treatment and better under supervision. Modern new generation drugs do not contribute to weight gain and give good results for ovulation, so half of the patients can successfully conceive as a result.

Advanced and complex cases of polycystic ovaries are more difficult to treat because cystic formations are too numerous. The question arises - is it possible to get pregnant with complex polycystic ovaries. There is a way out - surgical removal of ovarian cysts through small incisions using a minimally invasive laparoscopy method. Small incisions are made with a laser or an electrode and the egg is released into the uterine cavity, but after a successful operation, it is necessary to become pregnant as soon as possible in order to give birth to the desired child.
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