Polycystic Ovarian Syndrome (PCOS) and Pregnancy

Polycystic ovary syndrome (PCOS) is a hormonal disorder that causes a woman to have infrequent or prolonged menstrual periods. PCOS can cause elevated male hormone levels, resulting in excess facial and body hair (known as hirsutism), and in some cases severe acne and male-pattern baldness. The condition may also cause the ovaries to develop fluid-filled follicles and fail to release eggs regularly, which can lead to fertility problems.

Early Signs of Pregnancy

Given that PCOS can cause a number of pregnancy issues, it is important to be aware of signs you might be pregnant, so you can talk with your doctor about the challenges ahead. Common early indicators of pregnancy include:

• Missed period. If you have a regular menstrual cycle and a week has passed since you expected the start of your period, that may be a sign you are pregnant. However, if you have PCOS, your periods may be more unpredictable.
• Swollen, tender breasts. Hormonal changes early in pregnancy can make your breasts sensitive.
• Fatigue. During early pregnancy, levels of the hormone progesterone increase rapidly, making you feel tired and sleepy.
• Morning sickness. Nausea, with or without vomiting, that can’t be attributed to an illness can be a sign of pregnancy. This is true no matter what time of day it occurs.
• Increased urination. The volume of blood in your body increases when you are pregnant, which causes your kidneys to process more fluid and move it to the bladder.
• Moodiness. Pregnancy hormones may cause you to feel especially emotional.
• Bloating. Changing hormone levels can produce a bloated sensation similar to what you might have when you are about to start your period.
• Light spotting. When a fertilized egg attaches to the lining of the uterus, it can cause what is known as implantation bleeding. This occurs 10-14 days after conception.

If you have PCOS and think you might be pregnant, contact your doctor.

Treating PCOS

While PCOS cannot be cured, there are treatments your doctor can provide that will help alleviate the symptoms. For example, birth control pills containing artificial estrogen and progestin can help regulate your menstrual cycle by reducing androgen production. Also, as significant weight gain can affect hormone levels, your doctor may advise you to achieve and maintain a healthier weight.

PCOS and Pregnancy

If you have PCOS and wish to become pregnant, a doctor with specific expertise in reproductive medicine (known as a fertility specialist) can work with you to increase your odds of conceiving and carrying to term. They may give you medications to help you ovulate, including:

• Clomiphene—This is an anti-estrogen drug that is also called Clomid or Serophene. You take it when your menstruation cycle first starts.
• Metformin—Your doctor may prescribe Metformin, a diabetes medication, if your body does not respond to clomiphene.
• FSH + LH—Your doctor might prescribe a drug that blends two hormones if you do not respond to clomiphene and metformin. The medication contains both a follicle-stimulating hormone (FSH) and a luteinizing hormone (LH). You receive this drug by injection.
• Letrozole—If other drugs do not work, your doctor might try letrozole. This medication is also known as Femara.

Can I get pregnant with PCOS?

Yes, you can get pregnant with PCOS. You may be able to get pregnant naturally with lifestyle changes, a balanced weight, and by treating your PCOS symptoms. You may also require fertility treatments to get pregnant.

Can I Have a Healthy Pregnancy With PCOS?

If you become pregnant your healthcare provider will work closely with you throughout your pregnancy to ensure you and your baby remain healthy. Women with PCOS who do become pregnant are at higher risk for difficult pregnancies and delivery. This can include increased miscarriage risk early in pregnancy, preeclampsia, gestational diabetes, preterm birth, and cesarean section (C-section) delivery.

What Precautions Do I Need to Take During Pregnancy With PCOS?

For women experiencing PCOS and pregnancy, taking certain precautions is essential for reducing the risk of complications. First and foremost, it is important to closely follow your doctor’s recommendations for diet, exercise, and medication. Maintaining a healthy lifestyle is crucial for managing PCOS and achieving a successful pregnancy. In addition, regular monitoring of your health is essential for detecting any early signs of complications.

Learn More or Seek Help from Baptist Health

It can be difficult to navigate PCOS and pregnancy, but you’re not alone. Baptist Health has highly-qualified, compassionate care teams to walk with you every step of the way. Learn more about our Mother & Baby services, or find a Baptist Health provider near you.