PCOS and Pregnancy: What Are the Risks?

PCOS and Pregnancy: What Are the Risks?

PCOS and Pregnancy: Understanding the Challenges and Reducing the Risks

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders among women of childbearing age. Women with PCOS often worry about the implications of this condition on their fertility and the potential risks during pregnancy. This article aims to demystify these concerns by explaining the risks associated with PCOS during pregnancy and offering management strategies for a healthy pregnancy. For more information on how to conceive or support your body when you have PCOS, our blog is here to help.

What is PCOS?

The diagnosis of PCOS is characterized by an overproduction of androgens (male hormones), irregular ovulation, and/or polycystic ovaries visible on ultrasound. It is often associated with metabolic imbalances, such as insulin resistance and low-grade inflammation. These imbalances can interfere with how the body manages pregnancy, increasing the risk of complications.

PCOS and Pregnancy: The Main Risks

Miscarriages and PCOS

Women with PCOS are three times more likely to miscarry in the early months of pregnancy than women without PCOS. This increased risk is due to several factors, including excess androgens, prolactin, and LH hormones, as well as a progesterone deficiency.

Some research indicates that metformin may reduce the risk of miscarriage in pregnant women with PCOS, although results are not yet unanimous and require further studies for confirmation. Additionally, taking progesterone (Duphaston or Progestan) may reduce miscarriage risks related to progesterone deficiency. Furthermore, improving egg quality through a balanced diet and specific supplements can also play a crucial role in reducing miscarriage risks.

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PCOS and Pregnancy: Gestational Diabetes

This type of diabetes, caused by insulin resistance in women with PCOS, is diagnosed for the first time during pregnancy. Gestational diabetes is a type of diabetes that only affects pregnant women. It is characterized by elevated blood sugar levels, first diagnosed during pregnancy. Although it is usually temporary and disappears after childbirth, it can cause complications for both the mother and the fetus, such as excessive weight gain of the baby, low blood sugar levels, and respiratory problems. Additionally, women who have had gestational diabetes, as well as their children, are at a higher risk of developing type 2 diabetes later in life.

Solution: Follow a balanced diet by increasing protein and fiber intake, engage in daily walking, and closely monitor glucose levels under the supervision of a healthcare professional. It is important to understand that a woman suffering from gestational diabetes also suffers from insulin resistance, and after childbirth, the measures implemented during pregnancy to improve the condition should be continued.

To monitor and manage gestational diabetes, several tests are performed. Here are the main ones:

  1. Glucose Screening Test (Glucose Tolerance Test):
  • One-Hour Glucose Screening Test: A sugary solution is ingested, and blood glucose levels are measured one hour later. If levels are high, a more comprehensive glucose tolerance test is conducted.

  • Three-Hour Glucose Tolerance Test: After an overnight fast, a sugary solution is ingested, and blood glucose levels are measured while fasting and then one, two, and three hours after ingestion.

     2. Postpartum Monitoring:
  • Postpartum Glucose Tolerance Test: Conducted about six to twelve weeks after childbirth to check if gestational diabetes has resolved.
  • Regular Blood Glucose Monitoring: To monitor the long-term risk of developing type 2 diabetes.
  • HOMA Test for Insulin Resistance: To assess insulin resistance levels.

PCOS and Pregnancy: Risk of Hypertension

Gestational Hypertension: This is pregnancy-induced hypertension where blood pressure is elevated after the 20th week of pregnancy. This can reduce blood flow to the placenta, limiting oxygen and nutrient supply to the baby, and increasing the risk of complications like preeclampsia.

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and organ damage, such as to the kidneys and liver. Untreated, it can lead to eclampsia, causing seizures and potentially being fatal.

Solution: Regularly monitor blood pressure and follow your doctor's recommendations to manage this condition, which may include lifestyle changes or medications.

PCOS and Pregnancy: Risk of Preterm Birth

Women with polycystic ovary syndrome (PCOS) have an increased risk of preterm birth (before 37 weeks of pregnancy) due to several factors related to the hormonal and metabolic imbalances characteristic of this condition. Insulin resistance, high levels of chronic inflammation, and hormonal imbalances, particularly excess androgens, can affect placental health and trigger preterm labor. PCOS is also associated with an increased risk of gestational hypertension and preeclampsia, sometimes requiring early delivery to protect the health of the mother and baby. Preexisting health issues, such as obesity, are more common in women with PCOS and can also increase the risk of complications and preterm birth.

PCOS and Pregnancy: What Strategy?

  • Adopt a Healthy Lifestyle: A balanced diet and appropriate physical activity are essential before and during pregnancy. Focus on low glycemic index foods, avoid refined sugars, and consume quality proteins.

  • Take the Right Supplements: Choose an appropriate multivitamin before and during pregnancy. 

PCOS After Pregnancy

Much of the advice and information about PCOS focuses on pregnancy, but what happens with PCOS symptoms after pregnancy?

It's important to remember that some PCOS symptoms, such as hormonal imbalances and associated weight gain, may return and even worsen after pregnancy. Being pregnant and successfully giving birth does not mean that PCOS has disappeared.

That's why it's particularly important to maintain a healthy weight and diet during pregnancy to prevent these issues from worsening during the postpartum period, and to avoid exacerbating insulin resistance. Women with PCOS have a higher risk of developing gestational diabetes (diabetes during pregnancy).