PCOS: How does it affect pregnancy?

How PCOS affects pregnancy

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Trying to fall pregnant can be a minefield. Between tracking your cycle, figuring out when you’re ovulating, and wondering about sperm quality — there are a lot of variables in the mix. And that’s before you even factor in pre-existing hormonal disorders like polycystic ovaries. 

If you are one of the 21% of women of reproductive age with Polycystic Ovary Syndrome, you might be wondering about getting pregnant with PCOS or the relationship between PCOS and fertility

We spoke to qualified nutritionist Monique Cormack, who specialises in women’s health, about how PCOS affects pregnancy. 

Does PCOS impact fertility? 

PCOS can impact fertility because it causes hormonal changes, which can mean that you do not ovulate as regularly as someone without PCOS. Raised levels of androgens and insulin affect the normal maturation and release of an egg from the ovary. 

When ovulation isn’t occurring or isn’t occurring frequently, this obviously makes it much more difficult to conceive. PCOS is also an inflammatory condition, and chronic inflammation may affect egg quality.

Can I get pregnant with PCOS naturally? 

Yes! Not every person with PCOS will experience hormonal obstacles to conceiving and statistics suggest around 30% of women with PCOS will actually have no problems falling pregnant. 

Additionally, even if you are experiencing irregular menstrual cycles, lifestyle changes may help you ovulate more regularly and conceive naturally. Diet and exercise are effective tools in improving your chances of conception with PCOS. There are also medical options that are not IVF, which you can discuss with a doctor — in case you are worried that’s the only option.

Is pregnancy with PCOS high risk? 

Being pregnant when you have PCOS is not a high risk per se, however, research indicates that pregnant women with PCOS do have a higher risk of some pregnancy complications including gestational diabetes, high blood pressure, preeclampsia, and preterm birth. 

It is important to discuss any concerns you may have with your pregnancy health care team, so that you can receive the appropriate support. Your team will be able to monitor you for any potential issues.

PCOS side effects

Although the name suggests PCOS is concerned mainly with the ovaries, it can present with a wide range of symptoms, from mild to more severe. Signs and symptoms may include:

  • Period and fertility issues such as amenorrhea (no period) or irregular periods
  • Difficulty conceiving
  • Excess facial and/or body hair (hirsutism)
  • Scalp hair loss (alopecia)
  • Acne typically around the jawline
  • Darkening of the skin, typically around the armpits and neck area
  • Weight gain or difficulty losing weight
  • Mood changes including depression, anxiety, low self-esteem, and poor body image

Women with PCOS may also be at a greater risk for developing issues including insulin resistance, type 2 diabetes, cardiovascular disease, sleep apnoea, and cholesterol abnormalities.

How to diagnose Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder estimated to affect 12–21% of women of reproductive age.

PCOS is formally diagnosed when you meet the Rotterdam diagnostic criteria, which requires two of the following three conditions to be met:

  • Infrequent or irregular ovulation (irregular is where your periods are usually longer than 35 days apart).
  • Hyperandrogenism (elevated androgens). This means a higher level of reproductive hormones that are usually more dominant in men. Hyperandrogenism might be seen physically, such as excess body hair typically on the face or scalp hair loss. It may also be seen on blood tests such as elevated testosterone.
  • Polycystic ovaries were seen on an ultrasound. Polycystic means the appearance of multiple “cysts” in your ovaries, which are actually not cysts but lots of immature follicles containing eggs.

Contrary to popular belief, PCOS cannot be diagnosed based on ovarian cysts alone. As the path to getting a formal diagnosis can be tricky, it’s thought that up to 70% of women with PCOS remain undiagnosed!

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