Doctor's Responses Archive

Viewer Question

I have been diagnosed with Polycystic Ovarian Disease (PCO). I had a miscarriage in the 9th week of my pregnancy. I am pregnant again. What are the chances of a miscarriage? (note: I am now taking progesterone). Are women with PCO more prone to miscarriage?
Signed, JH

Doctor's Answer

Women with PCO who become pregnant do not require special medications to treat PCO while they are pregnant. Special attention is paid to heart risk factors, such as blood pressure and blood sugar. In fact, these should be addressed as well as possible before pregnancy, because elevated blood sugar or blood pressure can have adverse consequences during pregnancy.

Women with PCO need to be watched closely for development of gestational diabetes (diabetes that develops during pregnancy). Insulin treatment does not treat infertility associated with PCO. (Insulin may be used in a woman with PCO who has already developed clear-cut elevated blood sugars, because pills that control blood sugar are contraindicated during pregnancy. The pills are felt to pose a danger to the fetus). In contrast, although they are not ready for widespread use, insulin sensitizing agents such as glucophage in preliminary work, may help improve certain PCO symptoms. Clomiphene and other medications are sometimes used to improve fertility in women with PCO. However, many women with PCO can become pregnant without medication, even if they only ovulate intermittently. Only women with PCO who have truly tried and not become pregnant may receive evaluation to see if medications such as clomiphene may be helpful.

Women with PCO do have an increased risk of miscarriage, and a physician may use certain medication prior to medically inducing ovulation.

Thank you for your question.

Medical Author: Carolyn Janet Crandall, M.D.
Medical Editor: William Shiel, MD, FACP, FACR
Last Editorial Review: 7/8/2004

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