Pregnancy with PCOS: Tips for Women Suffering from PCOS

Pregnancy with PCOS: Tips for Women Suffering from PCOS

Getting pregnant with polycystic ovarian syndrome (PCOS) can be difficult and PCOS is one of the leading causes of infertility. According to the CDC, PCOS is one of the most common causes of female infertility, affecting 6 to 12 percent (as many as 5 million) of US women of reproductive age.

What is PCOS?

PCOS affects up to 7% of reproductive age women. The common signs and symptoms associated with PCOS are irregular menstrual periods, infertility, obesity, acne, and excessive hair growth on the body. Ultrasound examination of the ovaries will reveal many small fluid filled sacs, called follicles, in the ovaries. Not all women with PCOS will have all of the signs and symptoms of PCOS.

The cause of PCOS is not known but it may be related to insulin resistance, increased levels of androgens (male type hormones) and an irregular menstrual cycle due to infrequent of lack of ovulation.

PCOS can affect the ability of women of childbearing age to conceive. When the female body produces elevated levels of androgen hormones, including the hormone testosterone, it can cause a woman’s ovaries to not properly develop a mature egg for release (ovulation) each menstrual cycle. Ovulation is necessary for pregnancy to occur.

A fertility specialist can diagnose polycystic ovary syndrome by taking a thorough menstrual history and performing an ultrasound of the ovaries and a few hormone blood tests.

What are the Options for PCOS Treatment?

Treatment for PCOS is individualized, depending on a patient’s goals and symptoms.

If a woman is not trying to become pregnant in the immediate future, birth control pills may be prescribed to help reduce the impact of increased androgens (acne and hair growth) and restore a normal menstrual pattern, which is important to protect the uterine lining and reduce the risks of pre cancer and cancer and heavy bleeding associated with the build-up of menstrual lining without a regular bleed. If women would like to avoid using birth control pills, cyclic progesterone, or a progesterone IUD (intrauterine device) can be used to reduce risks related to the uterine lining.  Spironolactone can be used to reduce hair growth and lessen acne. Insulin sensitizing medications can be used to help the body respond to insulin.

Manage long-term complications of PCOS. PCOS affects the entire body, not just reproduction. PCOS increases a women’s lifetime risk of Type 2 diabetes, cardiovascular disease, and uterine pre cancer and cancer. Both sleep apnea and depression rates are higher in women with PCOS. Maintaining a healthy diet and exercise routine is essential. Regular screening for diabetes, high blood pressure and cholesterol is recommended. For obese women weight loss as little as 5% has been shown to regulate menstrual cycles and improve insulin and cholesterol levels and lessen acne and excessive hair growth.

For those who hope to become pregnant, weight loss for obese women may result in normal ovulatory cycles and is highly recommended. Ovulation induction with medications such as clomiphene citrate or letrozole are often effective. Women who do not ovulate even with high doses of these medications may require injectable hormones to stimulate ovulation. If these treatment options do not result in a successful pregnancy, a physician may recommend more advanced reproductive technology, such as in vitro fertilization (IVF).

PCOS and In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is a very effective fertility treatment available for PCOS patients.  IVF treatment offers the highest success rates and quickest time to pregnancy of any Assisted Reproductive Technology (ART).  Research has shown that clinical pregnancy and live birth rates are similar for PCOS patients and women who ovulate normally without PCOS.

To learn more about this topic and speak to one of our physicians about fertility treatment, you can request a consultation here.

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