How Does PCOS Affect Pregnancy?

Published July 12th, 2022 by Bridget Reed
Fact Checked by
Camille Freking
Medically Reviewed:
Chris Riley

Several different factors can affect pregnancy.

Something as simple as the foods you eat can have major effects on the childbearing period and the outcome of the birth overall.

But underlying conditions such as polycystic ovary syndrome (PCOS) can complicate a pregnancy, and certain risks are heightened if you have PCOS while bearing a child.

Let’s look at the different ways this condition can affect a pregnancy.

What Is PCOS?

PCOS stands for polycystic ovarian syndrome, and it’s a hormonal disorder that’s common among adult individuals with female reproductive organs.

With PCOS, the ovaries produce an abnormal amount of androgens (hormones that regulate the development of male characteristics). 

While this hormone occurs naturally in those with female reproductive organs, it is usually only in small amounts.

Often, this causes numerous tiny fluid-filled sacs (cysts) to form in the ovaries, potentially making it harder for them to release eggs regularly.

pcos

What Are Some Potential Causes of PCOS?

It’s not exactly clear what causes PCOS. However, it is thought to be related to insulin resistance.

Many people with PCOS are insulin resistant, meaning that insulin builds up in the body and may lead to higher androgen levels. High androgen levels can also be associated with obesity and genetics.

What Are Common Symptoms of PCOS?

There are a few signs and symptoms of PCOS, some of which are more common than others.

They include:

  • Irregular periods or missed periods
  • Signs of higher levels of androgen, like increased body hair, severe acne, or male-pattern baldness
  • Weight gain 
  • Oily skin
  • Enlarged ovaries; cysts on the ovaries
  • Infertility
  • Skin tags on the skin, neck, or armpits
  • Dark patches of skin on the armpits or under the breasts

What Are PCOS Treatment Options?

PCOS is more easily treatable if you see a gynecologist or other healthcare provider early on. Treatment usually depends on the severity of symptoms, age, and overall health.

If you plan to become pregnant, your treatment options are also a bit more limited. A change in diet and activity is the first line of treatment that is usually effective and doesn’t require invasive treatments. 

Physical activity and healthy eating can support healthy weight loss, lower blood glucose levels, and make it easier to ovulate. It can also reduce the symptoms associated with PCOS.

Additionally, you might take medications to cause ovulation, making it easier for the ovaries to release eggs regularly.

Of course, these medications come with risks, such as an enhanced chance of multiple births and ovarian hyperstimulation (when the ovaries release too many hormones).

Suppose you’re not planning on becoming pregnant. In that case, your treatment may include contraception like birth control pills to control menstrual cycles, diabetes medications to control insulin levels, supplements, or a change in diet and activity.

How Is PCOS Related to Pregnancy Complications?

PCOS affects pregnancy because it can affect implantation and puts child-bearers at a higher risk of developing certain complications during pregnancy.

Let’s look at some of those potential complications so you know what to expect.

Miscarriage

Women with PCOS are at a higher risk of pregnancy loss compared to those who do not have this condition.

Individuals with PCOS are about three times more likely to miscarry. A miscarriage usually includes a large amount of bleeding and pain in the abdomen or back.

A limited amount of evidence suggests metformin may reduce the risk of miscarrying for pregnant women with PCOS. Metformin helps control the amount of glucose, or sugar, in the bloodstream. With that said, other studies have not confirmed this finding.

Preeclampsia

Preeclampsia is a pregnancy complication marked by a sudden increase in blood pressure after the 20th week of pregnancy, affecting several internal organs like the kidneys, liver, and brain.

Preeclampsia can turn into eclampsia (new onset of seizures or coma) if left untreated. 

The primary treatment for preeclampsia is to deliver the baby, even if it is preterm. Women with this condition may also require a C-section delivery, which carries additional risks for the mother and child.

Gestational Diabetes

Gestational diabetes is a type of diabetes that only pregnant women can get, and those with PCOS are at an increased risk.

It occurs when the body can’t make enough insulin during pregnancy, increasing blood sugar levels.

Gestational diabetes is often due to the enhanced cravings and unhealthy eating patterns that are prominent during pregnancy. About 50 percent of women with gestational diabetes go on to develop type 2 diabetes. Checking your blood sugar, eating healthfully, and being active can reduce your risk.

Preterm Birth

If an infant is delivered before 37 weeks after pregnancy, a baby is considered “preterm.”

The earlier a baby is born, the higher the risk of congenital disabilities or other anomalies. The health risks can be seen both right after birth as well as later on in life.

Cesarean Delivery

A cesarean delivery, often known as a C-section, is prominent in women with PCOS due to pregnancy-related complications like high blood pressure. Sometimes, the delivery must be a cesarean rather than a typical vaginal birth.

C-sections are surgical procedures that can carry risks, but they are often effective for delivering a child when PCOS is a factor.

How Can You Prevent PCOS?

There is no proven way to prevent PCOS. However, you can take small steps early to reduce your symptoms and risks.

These steps include eating nutritious foods and exercising to manage your weight, as well as going to routine doctor or fertility specialist visits to ensure you and your baby’s wellness until term.

Does PCOS Make It Harder To Get Pregnant?

You can still get pregnant if you have PCOS. However, it does make it a little bit harder to conceive.

The hormonal imbalance associated with PCOS can interfere with the growth and release of eggs during ovulation, and if you can’t ovulate, you can’t get pregnant.

You can raise your chances of getting pregnant by tracking your menstrual cycle to identify your fertility window, having frequent sex during your fertile window, and striving for a healthy lifestyle of nutritious eating and exercise.

In Conclusion

PCOS, or polycystic ovary syndrome, is a hormonal disorder common among adult people with female reproductive organs. It causes them to produce an abnormal amount of androgen, which can form cysts on the ovaries. 

PCOS can make it more difficult to become pregnant and increase the risk of congenital disabilities or other complications during pregnancy, including miscarriage, preterm birth, gestational diabetes, or c-section delivery.

PCOS is most easily treatable through lifestyle changes such as healthy eating and exercise and medications to control ovulation cycles. You can still have a healthy pregnancy with PCOS; it can just be a bit more difficult.

References, Studies and Sources:

Polycystic Ovary Syndrome (PCOS) | Johns Hopkins Medicine

Polycystic ovary syndrome (PCOS) - Symptoms and causes | The Mayo Clinic

Does PCOS affect pregnancy? | NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development

Metformin | MedlinePlus Drug Information

Eclampsia | MedlinePlus Medical Encyclopedia.

Gestational Diabetes | CDC

Polycystic ovary syndrome | Office on Women's Health.