Polycystic Ovarian Syndrome Complications

PCOS symptoms having mild nature at the start can lead to several complications if not controlled. Thus, diagnosing PCOS at an early stage is vital to preventing the exacerbation, which can cause severe complications.

Women with PCOS are at a high risk of developing the following conditions:

  • Type 2 Diabetes
  • Hypertension (high blood pressure)
  • Cholesterol and lipid abnormalities: High levels of triglycerides and low density lipoproteins (LDL; bad cholesterol) and low levels of high density lipoproteins (HDL; good cholesterol)
  • Metabolic syndrome — a cluster of signs and symptoms that indicate a significantly increased risk of cardiovascular disease
  • Nonalcoholic steatohepatitis (NASH) — a severe liver inflammation caused by fat accumulation
  • Anxiety and depression
  • Sleep apnea (when a person stops breathing periodically during sleep)
  • Endometrial cancer (cancer caused by thickening of the lining of the uterus) caused due to exposure to high levels of estrogen
  • Breast cancer

Polycystic Ovarian Syndrome Pregnancy Complications

If a woman with PCOS happens to get pregnant, the pregnancy is designated as “high-risk” and your doctor may refer you to a doctor who specializes in “high-risk pregnancy” cases.  Although, getting pregnant with PCOS should not be perceived as something detrimental, but one with PCOS should be cautioned of the risks involved. A woman with PCOS is at a higher risk of events such as miscarriage, gestational diabetes, and premature delivery. Hence, it requires thorough monitoring.

Below mentioned are a series of complications that a pregnant woman with PCOS is likely to encounter.

Early & Recurrent pregnancy loss

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 associated with a higher incidence of spontaneous EPL compared with the prevalence in the normally ovulating, naturally conceiving population.

How does early pregnancy loss

Androgens and EPL: 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 hyperinsulinemia are linked to EPL in PCOS sufferers

Endometrial Dysfunction and Early Pregnancy Loss: Endometrial secretory proteins (proteins secreted by the inner layer of uterus/womb) are imperative for 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 are at  a high risk for adverse pregnancy and birth outcomes and this may mandate a vigilant approach and thorough monitoring at every stage of pregnancy till the time of parturition.

Recurrent pregnancy loss (RPL), defined as two or more consecutive pregnancy losses before 20th week of pregnancy. The occurrence of this adverse event is highly common in women with PCOS.

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