PCOS and pregnancy can present complex challenges, one of which is an increased risk of miscarriage. It is believed that hormonal imbalances associated with PCOS can occasionally contribute to miscarriages. Furthermore, PCOS may be linked to a higher miscarriage risk because many women with this condition grapple with weight gain, and obesity is associated with an elevated likelihood of miscarriage. Elevated insulin levels in the bloodstream may also play a role in this risk. Some research has indicated that women with PCOS have a higher probability of experiencing a miscarriage, with estimates suggesting that 30-50% of women with PCOS may face a miscarriage compared to 10-15% of women without PCOS. Additionally, there are reports of an increased miscarriage rate among those with PCOS who undergo IVF treatments. However, it’s important to note that research in this area remains limited, and there is no conclusive evidence establishing a direct causative link between abnormal ovarian morphology, high testosterone levels or elevated luteinizing hormone due to PCOS and miscarriage. Pregnancy occurring in a PCOS patient can present complex challenges.
Understanding PCOS and Its Impact on Pregnancy
Polycystic ovarian syndrome, commonly known as PCOS, is a prevalent medical condition. Individuals with PCOS may exhibit the following characteristics:
- Elevated levels of androgen, which are typically male-type hormones.
- Challenges related to ovulation, which refers to the release of eggs from the ovaries.
- The presence of multiple cysts on the ovaries.
These factors can influence your menstrual cycle, fertility and physical appearance. If you have PCOS, you might encounter difficulties when attempting to conceive and may face an increased susceptibility to certain pregnancy-related complications. PCOS can elevate the likelihood of certain pregnancy complications, including:
- Elevated blood pressure.
- Gestational diabetes.
- Premature delivery.
Moreover, individuals with PCOS face an increased risk of giving birth to babies with a higher birth weight than expected for their gestational age, which in turn heightens the probability of requiring a Caesarean section. Infants born to individuals with PCOS are more likely to necessitate admission to a neonatal intensive care unit. Pregnant women with PCOS may also be at a heightened risk of experiencing miscarriages and stillbirths; however, further research is necessary to establish the extent of these risks. If you have PCOS and are pregnant, it is crucial to engage in discussions with your health care provider. These potential complications can be mitigated by closely monitoring your PCOS symptoms and exercising extra caution throughout your pregnancy.
The Relationship Between PCOS and Miscarrying
Regardless of whether you have PCOS or not, every pregnancy carries inherent risks. In women who don’t have PCOS, the risk of miscarriage or early pregnancy loss stands at approximately 10-15%. In contrast, women with PCOS face a risk that is approximately three times higher than the norm. Numerous experts posit that the elevated rate of early pregnancy loss in women with PCOS can be attributed to related factors, such as a higher prevalence of insulin resistance, hyperandrogenemia and obesity. While various theories have been put forth to elucidate the increased miscarriage risk in PCOS, the precise cause of this association remains unknown.
Factors contributing to this elevated risk include:
- Obesity: Obesity is linked to an increased likelihood of spontaneous miscarriage, especially among individuals undergoing fertility treatments.
- Fertility Treatments: Women with PCOS undergoing treatments like in vitro fertilization (IVF) and those prescribed ovarian induction agents often experience an elevated rate of miscarriages.
- Hyperinsulinemia: PCOS commonly involves elevated insulin levels in the bloodstream, and obesity can exacerbate this condition, impacting miscarriage rates.
- Luteinizing Hormone (LH): Reports indicate that inappropriately elevated LH levels may contribute to an increased risk of miscarriage due to abnormal follicular development and anovulation.
- Endometrial Dysfunction: Several studies suggest that PCOS may lead to inadequate endometrial blood flow, potentially linked to hyperinsulinemia.
Risk Factors for Pregnancy Loss
A miscarriage, often referred to as a spontaneous abortion, is the unforeseen termination of a pregnancy within the initial 20 weeks of gestation. It’s essential to understand that the term ‘miscarriage’ does not imply any fault on your part in managing the pregnancy. The majority of miscarriages are not within your control and transpire when the fetus ceases to develop. A risk factor refers to a characteristic or behaviour that enhances the likelihood of an individual developing a disease or condition.
Risk factors associated with miscarriage encompass:
- Age: Research indicates that the risk of miscarriage ranges from 12% to 15% for individuals in their 20s and escalates to around 25% for those aged 40 and above. Most miscarriages related to age stem from chromosomal abnormalities, where the fetus possesses missing or extra chromosomes.
- Previous Miscarriage: If you have experienced a previous miscarriage, your likelihood of encountering another miscarriage is slightly elevated, approximately 25%, which is only marginally higher than that of individuals who haven’t had a miscarriage.
- Health Conditions: Specific health conditions, such as unmanaged diabetes, infections or complications concerning your uterus or cervix, can amplify the risk of miscarriage.
It is advisable to engage in a conversation with your pregnancy care provider regarding the risk factors associated with miscarriage. They can assess your risk following a review of your medical history.
Managing PCOS for a Healthy Pregnancy
Here are some recommendations for a healthy pregnancy:
- Aim for 30 minutes of exercise five times a week to help manage your weight. Exercising is beneficial even if you don’t lose weight. However, consult your fertility specialist before starting any physical activity, especially if you’re undergoing fertility treatments that may require activity limitations.
- Minimize medication usage. If you’re seeking medical treatment for any other condition, inform your health care provider about your pregnancy. Some medications are safe during pregnancy, while others are not. Discuss all your medications and supplements with your doctor to ensure their safety for pregnancy.
- Take prenatal vitamins as prescribed by your obstetrician. Your doctor may recommend a multivitamin with folic acid a month before you begin trying to conceive. Folic acid reduces the risk of neural tube defects in developing babies when taken before pregnancy.
- Collaborate with your doctor and dietitian to plan a diet tailored to your specific needs. The diet should prioritize complex, low-glycemic carbohydrates like whole grains, leafy greens and legumes, be low in cholesterol and fats and have a moderate protein content. A high dietary fibre intake is important, as it can reduce insulin requirements in pregnancies with diabetes.
- Maintain healthy blood glucose levels both before and during pregnancy. Effective measures to prevent gestational diabetes include regular blood sugar monitoring, a well-balanced eating plan, insulin injections (if necessary) and regular physical activity.
- Limit your consumption of caffeinated beverages such as coffee, tea, soda and hot chocolate. Excessive caffeine intake can increase the risk of miscarriage and may result in low birth weight in babies. Pregnant women can safely consume up to 200 mg of caffeine per day, equivalent to 2 cups of instant coffee.
Consult a PCOS Doctor
Experiencing a miscarriage is an immensely emotional moment for prospective parents, and it’s completely natural to grieve this loss. It’s crucial to bear in mind that a miscarriage is not preventable, and it is not the result of any actions on your part. If you are contemplating pregnancy, it is advisable to get a free consultation with Veera Health experts and seek answers to any queries you may have. We understand that it is absolutely acceptable to feel sadness during this period. We encourage you to seek support from your family, friends and online support groups, or consider consulting a licensed counsellor.
Learn More With Veera
Conceiving and sustaining a pregnancy with PCOS is achievable. By implementing specific lifestyle adjustments consistently, you can not only effectively address the symptoms but also minimize the chances of encountering pregnancy complications. For personalized support and expert care from a team well-versed in PCOS, consider joining Veera Health’s dedicated PCOS program!