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PCOS and pregnancy may seem like incompatible ideas, given how the mainstream narrative runs.
PCOS is understood to be the most common cause of infertility in women, which, it may seem, could affect your chances of getting pregnant. How true is that?
If you’re one of the 6 to 15% of women worldwide with Polycystic Ovary Syndrome (PCOS) who are trying to get pregnant, then you probably have many questions. Questions like, “Will I ever get pregnant?” or “How long will it take me to get pregnant?”
You soon learn that in order for you to get pregnant, there is a very small window in your menstrual cycle when fertilization happens. This window of opportunity gets even harder to figure out if your menstrual cycle isn’t exactly, well, cyclic.
If you are trying to conceive and wondering how PCOS affects your chance of getting pregnant and your pregnancy then read on.
In this article, we’ll talk about PCOS and its symptoms, getting pregnant with PCOS, pregnancy with PCOS and related complications, and the care you can take when pregnant with PCOS.
What Is PCOS?
Polycystic Ovary Syndrome (PCOS) is a condition indicating hormonal imbalance in women. It happens due to the excessive production of androgens or male hormones.
Oftentimes, there is a delay in diagnosis or it goes undiagnosed until a woman wishes to conceive. This happens due to the unavailability of a single test for the diagnosis of PCOS.
Doctors usually rely on symptoms associated with PCOS to detect the condition. Symptoms may vary in each individual, though women affected by PCOS have known to commonly face some or all of the following.
Symptoms of PCOS:
- Excessive hair on body
- Male pattern baldness
- Acne
- Irregular and/or painful periods
- Development of cysts on ovaries seen on an ultrasound
- Excessive weight gain
- Suppressed ovulation or anovulation
Suppressed ovulation means you are not necessarily ovulating every menstrual cycle. This makes it very difficult for you to track your fertile days. This means that even though you get your menstrual cycle each month, fertilization will not happen if there is no egg released.
Anovulation means you don’t ovulate at all. In this case pregnancy is not possible due to lack of eggs released from your ovary. Anovulation is the #1 cause of infertility in women.
Read More : Anovulation: Everything you need to know about the #1 cause of infertility
One way to track your ovulation is using a fertility tracker. Inito’s at-home Fertility Monitor can help. This reliable instrument has proved effective by increasing chances of conception by 89%, tracking your cycles timely and accurately.
Women with PCOS have to undergo a lot, given the roller coaster of hormonal changes. Not to mention, the added stress of whether or not you can successfully conceive with PCOS is worrying.
If you do get pregnant with PCOS, then you are considered to be at a higher risk for complications during your pregnancy, labor, and delivery. These complications are:
- Miscarriage
- Gestational diabetes mellitus
- Development of hypertensive disorders of pregnancy
- Preterm labor
- Operative delivery
But hear it from us – the good news is, a lot of women diagnosed with PCOS are able to get pregnant without intervention or treatment. We’ll get to that a bit later in the article.
Let us first begin by understanding why there lies a strain between PCOS and pregnancy and why your health condition may prove to be an obstacle in reproductive processes.
How to Know If You’re Pregnant with PCOS?
Such is the wonder of the human body that the signs and symptoms of pregnancy are quite similar to your periods. This might be even more confusing when you have irregular periods with PCOS.
When you’re trying to conceive, the best way to determine whether you are pregnant is by taking a home pregnancy test around 7 days after your missed period.
You may start experiencing symptoms early on since implantation occurs at 7DPO–10 DPO (days past ovulation). It is a good idea to take a pregnancy test even if your menstrual cycle isn’t regular or if you are not experiencing any of the symptoms listed below.
Here are a few early pregnancy symptoms to watch out for:
- Missed period
- Morning sickness
- Increased tiredness or fatigue
- Sore breasts
- Mood swings
- Lower back pain
It’s worth noting that false-negative results are quite a possibility with PCOS due to the hormonal imbalance. So, it is advisable to take the test at least 7 days after your missed period.
The chance of a false positive is quite rare. But it could be possible if there is a problem with the test, like an expired test kit or if the test was read incorrectly.
Pregnancy tests measure the Human Chorionic Gonadotropin (hCG) levels in your body to determine pregnancy.
A false positive is also possible if you’re undergoing any fertility treatment as it might interfere with your hCG levels.
PCOS and First Trimester of Pregnancy
Women with PCOS are at risk of EPL (early pregnancy loss), defined clinically as first trimester miscarriage. EPL occurs in 30 to 50% of PCOS women compared with 10 to 15% of women without PCOS.
A few causes of increased risk of EPL in women with PCOS are:
- Insulin resistance
- Elevated levels of luteinizing hormones (LH) and androgens like testosterone
- Impaired endometrial receptivity (implantation failure)
- Obesity
After knowing that you are pregnant with PCOS and successfully completed your first trimester, the cycle of worry doesn’t end there. You might now be wondering what are the complications that can arise in later stages of pregnancy with PCOS and how to avoid them.
Complications of Pregnancy With PCOS
For pregnant women, PCOS brings a higher risk of complications in the later stages of pregnancy. These complications include:
- Pregnancy-induced hypertension and preeclampsia
This is a type of high blood pressure that occurs after the 20th week of pregnancy. If not treated, it might lead to preeclampsia.
Preeclampsia is a serious condition that affects the mother and the to-be-born baby.
It affects the kidney, lung, and brain function of the mother. If untreated, it might lead to seizures, organ damage, and even death.
The most common route taken during such times is delivering the baby even if it is preterm.
Depending on the severity of the condition and the gestational age, your doctor may discuss with you a scheduled delivery. - Gestational diabetes
This is a type of diabetes that occurs only in pregnant women. In most cases, it is treatable and doesn’t cause severe complications in the mother or the baby.
Gestational diabetes may lead to larger than average babies. This in turn might have complications during delivery.
Due to the size of the baby, a c-section may be suggested by your doctor. Premature birth is a possibility.
You may also be prescribed insulin to manage gestational diabetes during pregnancy. - Preterm delivery
Babies delivered before the gestational age of 37 weeks are called preterm. Preterm babies are at a higher risk of health issues at birth and also later stages of life. - C-section or cesarean delivery
C-section delivery happens due to the complications that PCOS brings with it like hypertension and preeclampsia.
C-section is a surgical procedure performed to deliver the baby. Recovery from a surgery takes longer.
Also, like any other surgery, it comes with risks for both the mother and the infant.
Successful Pregnancy with PCOS
As we mentioned above, reproductive issues with PCOS are common, starting with irregular menstrual cycles leading to suppressed ovulation or no ovulation at all. This is the #1 cause of infertility in women diagnosed with PCOS.
When trying to conceive with PCOS, managing symptoms is the path to success.
So, how do we go about managing PCOS when trying to conceive?
Lifestyle changes are one of the go-to doctor recommended steps before any kind of treatment or external interventions. These could be:
Maintaining a healthy BMI (Body Mass Index)
- About 40 to 80% of women with PCOS are overweight. Fat cells in your body release estrogen which can interfere with insulin production in your body. Lower insulin production results in hormonal imbalance and leads to PCOS.
- Studies show that reducing 5 to 10% of your body weight can help you control your PCOS symptoms by helping you with hormonal imbalance. This will in turn help you increase your chances of ovulation leading to a successful pregnancy.
Curbing insulin resistance with diet and exercise
- Insulin resistance is seen in 70-95% of PCOS patients who are obese or overweight. Whereas, insulin resistance is only seen in 30 to 75% of PCOS patients who are not overweight (also called patients with lean PCOS).
- Foods high in sugar, simple carbohydrates, and unhealthy fats cause your blood glucose levels to rise. This gives a signal to your pancreas to spike your insulin levels which leads to insulin resistance in your body.
- A diet rich in whole grains, lean protein, healthy fats, fruits, and vegetables can help your body reduce insulin spikes.
- Exercise is very important when it comes to managing your PCOS symptoms. Moderate to high-intensity aerobic exercises like swimming, dancing, yoga, or hiking can really help with managing insulin resistance.
- Exercise not only has physical benefits but also helps release endorphins. Endorphins help your body to relax and bring about hormonal balance, which has ripple effects on your reproductive system helping you get pregnant.
Keeping track of your ovulation:
- If you have PCOS, tracking your ovulation will help you know if you have anovulatory cycles. Irregular menstrual cycles make it difficult to accurately track your cycles.
- 70-75% of women seeking help for infertility have anovulatory cycles and are diagnosed with PCOS. Your doctor will either do an ultrasound to check your follicle growth or request blood tests to check progesterone levels in your body to determine whether you ovulate.
- Your doctor may also prescribe fertility-inducing drugs to help you ovulate.
Best Age to Get Pregnant With PCOS
You are born with all the eggs you’ll ever have in your lifetime. That number is approximately around 2 million at birth; 300-500 thousand at puberty; 2500 at age 37; and 1000 at age 51.
PCOS or not, experts believe that the best time to get pregnant is between your late 20s and early 30s. After that, the number of eggs decreases rapidly. Also, the quality of eggs starts deteriorating after the age of 35.
The age factor becomes even more important when you’re dealing with PCOS as it brings with it complications like menstrual cycles with irregular or no ovulation, which can potentially delay conception.
How to Take Care of Yourself When Pregnant With PCOS?
The most important thing to know about pregnancy with PCOS is that complications are quite real. It is best to keep your doctor informed about the changes in your body during your pregnancy.
A healthy diet and exercise routine with the necessary prescribed medicines under the supervision of your healthcare provider will keep complications to a minimum.
Keeping a positive attitude will keep stress and anxiety at bay. Rest assured, many women with PCOS have had healthy pregnancies and birth experiences.
The takeaway here is to stay hopeful and keep trying. It is possible to get pregnant with PCOS by managing your symptoms.
Learn more : Get Pregnant with PCOS: Your Complete Guide
You’ve got this momma!
To Sum It Up!
- It’s no news to you that PCOS affects your chances of getting pregnant. Irregular menstrual cycles are common with PCOS. It becomes difficult to predict your fertile window or time of ovulation when your menstrual cycle is irregular.
- At the same time, PCOS can bring with it complications like irregular ovulation or no ovulation at all. But, it doesn’t mean that you cannot get pregnant. At-home fertility monitors can help you track your ovulation and fertile window.
- A healthy diet and exercise will help you manage your PCOS symptoms like insulin resistance and increase your chances of getting pregnant. Your healthcare provider may prescribe fertility-inducing medications for the same before any other treatments or procedures.
- Maintaining a healthy diet and exercise routine after getting pregnant with PCOS will help you sustain a healthy pregnancy. Working with your healthcare provider throughout your pregnancy will give you confidence and keep stress and anxiety away.
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- Pregnancy in polycystic ovary syndrome – PMC
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283441/
- Pregnancy Outcome in Women with Polycystic Ovary Syndrome – PMC
- Female Age-Related Fertility Decline | ACOG
- Pregnancy in polycystic ovary syndrome – PMC
- The Role of Polycystic Ovary Syndrome in Reproductive and Metabolic Health: Overview and Approaches for Treatment – PMC
- Pregnancy in polycystic ovary syndrome – PMC
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861983/
- Physical activity, body mass index, and ovulatory disorder infertility
- ABC of subfertility: Anovulation – PMC
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