Category: Did You Know?
How Does Polycystic Ovary Syndrome Affect Pregnancy?
Category: Did You Know?
Polycystic ovary syndrome (PCOS) is known as one of the most common hormonal disorders in females of reproductive age worldwide, with prevalence ranging from 5-26% of women.
Women with PCOS may suffer extremely heavy and irregular periods due to irregular – or a lack of – ovulation, and ovarian cysts. Additionally, due to an excess of testosterone (hyperandrogenism) women with PCOS may struggle with weight gain or obesity and excess hair growth, sometimes in the facial area. Other complications may include issues with insulin processing, which may contribute to weight gain and an increased risk of developing diabetes.
PCOS and Pregnancy
Many women with PCOS may also struggle with infertility for a variety of reasons. First, irregular ovulation can make it difficult to conceive naturally, leaving many to use alternative reproductive technologies such as in-vitro fertilization (IVF). Additionally, endometriosis or adenomyosis may accompany PCOS, creating a potentially hostile environment for embryos to implant. So, even if IVF or natural conception is successful, the pregnancy may struggle beyond the first term.
Eary pregnancy loss is also, unfortunately, a common complication of PCOS pregnancies. Women with PCOS tend to have a higher level of insulin resistance during pregnancy than those without PCOS. This may lead to gestational diabetes, putting the embryo at risk of not getting the nutrients it needs. Hyperandrogenism (excess testosterone) can also affect endometrial development, leaving less of a cozy home for an embryo to implant.
Finally, women with PCOS may be at a higher risk for pregnancy-induced hypertension (high blood pressure), which may also contribute toward preeclampsia. Preeclampsia involves high blood pressure and the presence of protein in urine and can lead to serious issues for mother and baby if left untreated. Impaired fibrinolysis, or the inability to break down blood clots, is also a risk, which may contribute to placental inefficiency.
Current Treatments
Current treatments for PCOS and PCOS-related complications tend to address the immediate medical concern. For help with infertility, many women and their partners may choose to use assisted reproductive technology.
Other options include lifestyle changes like weight loss and dieting. Some studies say that as little as a 5% decrease in body mass index may help with complications like gestational diabetes and hypertension.
Clinicians may recommend certain medications as well. For assistance with weight loss and gestational diabetes, GLP-1s or other diabetic medications like Metformin may be an option. Metformin may also help with fibrinolysis inefficiency (inability to break down blood clots) and is quite commonly prescribed to women with PCOS.
Lastly, hormonal birth control may help to regulate menstrual cycles, and can help regulate hormones, which may result in a more “regular” endometrial environment. However, when trying to conceive, women will need to come off birth control, which may mean the hormonal issues the birth control was helping regulate may become irregular again.
Key Points
- PCOS affects roughly 5-26% of females worldwide and can severely impact fertility and pregnancy.
- Complications that affect PCOS pregnancies may result in early pregnancy loss but are treatable in many cases.
- Speak with a sexual healthcare provider if you believe you may have PCOS or have known PCOS and are trying to conceive, as they may be able to help find a treatment that works for you and your fertility goals.
Resources
Kamalanathan, S., Sahoo, J., & Sathyapalan, T. (2013). Pregnancy in polycystic ovary syndrome. Indian Journal of Endocrinology and Metabolism, 17(1), 37. https://doi.org/10.4103/2230-8210.107830
McDonnell, R., & Hart, R. J. (2017). Pregnancy-related outcomes for women with polycystic ovary syndrome. Women’s Health, 13(3), 89–97. https://doi.org/10.1177/1745505717731971
Shukla A, Rasquin LI, Anastasopoulou C. Polycystic Ovarian Syndrome. [Updated 2025 Jul 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/
Vanky, E., & Løvvik, T. S. (2020). Polycystic ovary syndrome and pregnancy – from a clinical perspective. Current Opinion in Endocrine and Metabolic Research, 12, 8–13. https://doi.org/10.1016/j.coemr.2020.01.005
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