Women with PCOS have irregular periods, and some have numerous small cysts on the ovaries that can affect fertility. Pregnant women with PCOS may experience complications during pregnancy.
Women with PCOS have irregular periods, and some have numerous small cysts on the ovaries that can affect fertility. Pregnant women with PCOS may experience complications during pregnancy.

PCOS stands for polycystic ovary syndrome. People with this condition have irregular periods, and some have numerous small cysts on the ovaries that can affect fertility. An imbalance of hormones causes the condition, but experts are not sure what causes this hormonal imbalance.

PCOS is one of the most common causes of infertility in women. According to the CDC, anywhere from 6-12% of women in the US have the syndrome. If you have PCOS, it is possible to get pregnant, but it might take longer than average. You also might be more likely to require fertility treatments to get pregnant.

PCOS and pregnancy

People who get pregnant with PCOS may experience complications during pregnancy. They have a higher risk of:

Having PCOS can also affect your baby, triggering low or high birth weight. Babies born to mothers with PCOS are also more likely to require treatment or observation in the neonatal intensive care unit (NICU).

If you are pregnant and have been previously diagnosed with PCOS, make sure your doctor checks you for gestational diabetes by the time you are 20 weeks along. 

People with PCOS are three times more likely to have a miscarriage than those who don't have the condition. However, there are things you can do to reduce the risk. Precautions include getting to a healthy weight before getting pregnant and taking folic acid during pregnancy.

Getting pregnant with PCOS

Getting pregnant with PCOS may take longer than it will for people who don't have the condition. Contact your doctor if you are under age 35 and have been trying for 12 months or more, or over age 35 and trying for six months or more. They can recommend fertility treatments and connect you with a fertility specialist if needed.

Experts are not sure whether being overweight causes PCOS or whether having PCOS makes you more likely to be overweight. Either way, losing weight and making healthy lifestyle changes can help reduce the hormonal imbalances that people with PCOS experience. This leads to more regular periods and ovulation and higher levels of fertility. Losing just 5-10% of your body weight has been shown to give you a greater chance of getting pregnant.

If you have irregular periods, doctors are likely to recommend treatments using hormonal injections or pills to help you ovulate, so you will know when you can expect a fertile window. Once you are fertile, you can try having sex normally, or you can receive intra-uterine insemination. During this procedure, your doctor inserts sperm directly into your uterus during your most fertile time.

If this first step isn't successful, your doctor may recommend in-vitro fertilization. During this treatment, your doctor will give you several injections over a period of time to stimulate egg release from your ovaries. Once they are released, your doctor will remove the eggs in an outpatient surgical procedure. Then, your medical lab team will combine sperm with your eggs to create embryos. They will then implant one or more embryos into your uterus. You can choose to have any extras frozen.

If these treatments don't work, your doctor may recommend a surgery called laparoscopic ovarian drilling (LOD). This procedure can reduce an excess of androgens and normalize your menstrual and ovulation cycles. During this surgery, doctors use heat or a laser to destroy some of the tissue of the ovaries that produce androgens like testosterone.

The surgery also creates a few openings in the lining of the ovaries, which is thicker in people with PCOS. These openings may help you ovulate more regularly for 6-8 months following the procedure. Your doctor may recommend this procedure if you have high levels of these androgens due to PCOS and have not responded to other treatments.

Different treatment options have different success rates, but many people who have PCOS will be able to get pregnant.

How do treatments for PCOS affect pregnancy?

Some treatments for PCOS prevent pregnancy altogether. Common treatments to reduce symptoms and normalize the menstrual cycle include hormonal birth control options like the pill, the patch, the ring, or a hormonal IUD.

Some people with PCOS benefit from anti-androgen medications. These prescriptions lower the levels of androgens like testosterone in the body. This can reduce some PCOS symptoms like facial hair growth, scalp-based hair loss, and acne. However, these medications can cause problems during pregnancy, and you should not take them if you are planning to become pregnant. 

What are the symptoms of PCOS?

Having difficulty getting pregnant is one symptom of polycystic ovary syndrome. Other symptoms include:

  • Irregular periods (or not getting a period at all)
  • Losing hair on the scalp (male-pattern baldness)
  • Growing excess facial and body hair
  • Trouble losing weight
  • Gaining weight quickly
  • Acne
  • Oily skin
  • Cysts on the ovaries
  • Ovaries that are larger than usual
  • Skin tags on neck and in armpits
  • Dark or thick skin on the back of the neck, in the armpits, or under the breasts

In addition to these symptoms, people with PCOS may have a higher risk of:

How do doctors diagnose PCOS?

To be diagnosed with PCOS officially, you must have two out of three of the following conditions met:

  • Irregular periods or no periods
  • Polycystic ovaries diagnosed via a transvaginal ultrasound
  • More than average facial and body hair or lab tests showing a high level of testosterone 

Your doctor may also perform a pelvic exam as part of your appointment to diagnose PCOS.

You should always contact your doctor if you have irregular periods or experience infertility and want to get pregnant. You can also contact your doctor if you have signs of a hormonal imbalance like excess body and facial hair growth, also called hirsutism or the development of male-pattern baldness.

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Medically Reviewed on 3/28/2022
References
SOURCES:

Centers for Disease Control and Prevention: "PCOS (Polycystic Ovary Syndrome) and Diabetes."

Johns Hopkins Medicine: "Polycystic Ovary Syndrome (PCOS)."

Mayo Clinic: "Polycystic Ovary Syndrome (PCOS)"

National Women's Health Network: "Can I Get Pregnant if I Have PCOS?"

NHS: "Treatment."

OASH Office on Women's Health: "Polycystic ovary syndrome."

pregnancybirth&baby: "PCOS and pregnancy."

Tommy's: "PCOS and fertility: everything you need to know."

Your Fertility: "I have PCOS, and I want to have a baby; what do I need to know?"