Ask the experts
I have been diagnosed with Polycystic Ovarian Disease (PCOD). 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 PCOD more prone to miscarriage?
Women with PCOD who become pregnant do not require special medications to treat PCOD 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 PCOD need to be watched closely for development of gestational diabetes (diabetes that develops during pregnancy). Insulin treatment does not treat infertility associated with PCOD. (Insulin may be used in a woman with PCOD 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 PCOD symptoms. Clomiphene and other medications are sometimes used to improve fertility in women with PCOD. However, many women with PCOD can become pregnant without medication, even if they only ovulate intermittently. Only women with PCOD who have truly tried and not become pregnant may receive evaluation to see if medications such as clomiphene may be helpful.
Women with PCOD do have an increased risk of miscarriage, and a physician may use certain medication prior to medically inducing ovulation.
Medical Author: Carolyn
Janet Crandall, M.D.
Medical Editor: William Shiel, MD, FACP, FACR
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