PCOS and Pregnancy Loss
PCOS have many numerous reproductive repercussions starting with anovulatory cycles leading to lesser chances of conception and even loss of fertility. Even after successful conception, there are high chances of early loss of pregnancy (EPL). To add to it, if the woman with PCOS passes her third trimester, she may have to encounter later pregnancy complications like gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), preeclampsia, preterm delivery, and birth of small for gestational age (SGA) infant. Effective management of both reproductive and metabolic repercussions of PCOS forms a vital strategy in managing PCOS.
Risk of Early Pregnancy Loss in PCOS
PCOS women are at risk of EPL, defined clinically as first trimester miscarriage, which can occur in as high as 50% of pregnant women with PCOS-a rate which is 3 times higher than that in women without PCOS. Fertility treatment with ovulation-inducing agents is linked with higher rates of EPL compared to those in naturally conceiving women.
Luteinizing Hormone and Early Pregnancy Loss in PCOS
Several studies have linked elevated LH levels with EPL in women with PCOS. The likelihood of miscarriage was increased and conception rate decreased as compared to those with normal LH in PCOS women.
Androgens and Early Pregnancy Loss in PCOS
Hyperandrogenemia is postulated as a plausible cause of EPL in PCOS women. Presence of hyperandrogenemia and/or clinical hyperandrogenism is considered to be definitive for PCOS diagnosis. Elevated free/total testosterone ratios and isolated elevated free and total testosterone levels were found to be predictive of EPL in PCOS women in two different studies.
Insulin Resistance and Early Pregnancy Loss in PCOS
PCOS women are believed to be strongly associated with insulin resistance and compensatory hyperinsulinemia, which has been shown to be independently caused by excess fat tissue in the body (obesity). This is one of the factors responsible for EPL in pregnancy.
Endometrial Dysfunction and Early Pregnancy Loss in PCOS
Endometrial secretory proteins (proteins secreted by the inner layer of uterus/womb) are imperative to the development of fertilized egg and maintenance of pregnancy. The loss or abnormally low concentrations of these proteins are found in women with PCOS suffering from EPL, thus representing a strong association between these proteins and EPL. Women with PCOS are at high risk for pregnancy-related complications and hence need proper medical attention with thorough surveillance during this period till the time of delivery.
Polycystic Ovarian Syndrome Recurrent Miscarriage
Recurrent pregnancy loss (RPL), defined as two or more consecutive pregnancy losses before 20th week of pregnancy and is a frequently encountered adverse event in PCOS patients.
It is important to remember there is no permanent cure for PCOS. The symptoms will only be appropriately controlled and manage based on the treatment goals. For e.g: if you want to get pregnant, doctor will regularly treat you with ovulation inducing agents in order to improve your chances of getting pregnant.
Tips To Get Pregnant, Even With PCOS:
It is certainly a challenge whether is it possible to get pregnant with PCOS, but there are ways to overcome this challenge. Here are some valuable tips that will help you get pregnant even if you have been diagnosed with PCOS.
1. Diet Change:
It is important to switch over to a PCOS-friendly diet if one wants to increase the success rate of getting pregnant. Having healthy diet, such as fresh fruits, whole wheat, beans, nuts and fresh veggies can help in this regard. Avoid consuming meats, cheese, milk and fried foods, which have high amount of fats that can worsen obesity and exacerbate PCOS. Reduction of sugar and carbs from the diet can help control weight and getting hormone levels to normal.
Exercise helps in leading an active life, which is especially beneficial to a PCOS patient in getting rid of excess weight and reduce obesity. Exercising bestows you with additional benefits such as release of happy hormones called “endorphins” and reduce stress levels, giving you a “feel good” sensation. Additionally, exercise helps regularizing menstrual cycles by controlling the levels of the concerned hormones.
3. Healthy Lifestyle:
Smoking and drinking with PCOS will greatly cause hurdles in your attempts to get pregnant. Quit smoking and reduce your alcohol consumption. If you tend to experiment with recreational drugs, now would be the best time to stop this experimentation.
Stress can either exacerbate PCOS or won’t let the symptoms alleviate. Try to distress yourself by developing some hobby, so that the mind is constructively occupied and leaving no scope for any stress to develop and cause you trouble.
Making a few lifestyle changes and maintaining healthy habits can do wonders in the long-run, and help you in your attempts to get pregnant, ofcourse when combined with other factors such as life-style modifications and medications if needed.