PCOS and Pregnancy Loss
The reproductive issues with PCOS are manifold starting with anovulatory cycles leading to subfertility. Post conception, PCOS women are at increased risk for early pregnancy loss (EPL). After having successfully passed the first trimester, they commonly 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 tackling of metabolic and reproductive issues relating to pregnancy forms the cornerstone of management of PCOS.
Risk of Early Pregnancy Loss in PCOS
PCOS women are at risk of EPL, defined clinically as first trimester miscarriage. EPL occurs in 30 to 50% of PCOS women compared with 10 to 15% of normal women. The EPL rate in PCOS women has been difficult to establish due to several confounding factors. 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.
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 hypothesized to be another probable cause of EPL in PCOS women. Hyperandrogenemia and/or clinical hyperandrogenism is currently considered as an essential prerequisite for diagnosis of PCOS. 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 contributed by obesity prevalent among PCOS women. Insulin resistance and hyperinsulinemia is associated with Early pregnancy loss in women with PCOS.
Endometrial Dysfunction and Early Pregnancy Loss in PCOS
Implantation of embryo is affected by the endometrial receptivity which seems to be affected in PCOS. Initial attachment of the embryo is mediated via certain cell adhesion molecules which are decreased in PCOS women. Endometrial secretory proteins are pivotal for implantation and maintenance of pregnancy. Both these proteins were shown to be significantly lower in women with EPL in first trimester.
Women with PCOS are at increased risk of adverse pregnancy and birth outcomes and may need increased surveillance during pregnancy and parturition.
Polycystic Ovarian Syndrome Recurrent Miscarriage
Recurrent pregnancy loss (RPL), defined as two or more consecutive pregnancy losses before 20th week of pregnancy is a frequent obstetric complication. The clinical association of RPL in polycystic ovarian syndrome (PCOS) is more than common.
It is important to remember there is no permanent cure for PCOS. Usually, your symptoms would be treated based on your goals. Hence, if you are trying to conceive, the doctor will try to induce regular ovulation using a wide variety of treatment options.
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 you want to conceive. This means consuming fresh fruits, whole wheat, beans, nuts and fresh veggies. You also should be looking to cut down your intake of processed foods as well as foods that are high in saturated fats. Avoid consuming meats, cheese, milk and fried foods. Reduce your intake of carbohydrates and sugar, as it will help you lose weight and also work towards normalizing your hormone levels.
If you want to reduce those excess pounds you are carrying and spur ovulation, it is best to begin leading an active lifestyle if you haven’t been doing it. Exercising will also release endorphins, which are feel good hormones. They reduce your stress levels and help you feel happy. When you lose weight, it will increase the chances of ovulation and also improve your menstrual cycle. Exercising regularly can normalize your insulin and glucose levels and this helps to regularize your menstrual cycle.
3. Healthy Lifestyle:
Smoking and drinking with PCOS will greatly hamper your pregnancy goals. 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.
You may be yearning to get pregnant, but your PCOS could be posing a huge obstacle in fulfilling this desire. This can cause you to get stressed and anxious about your health. Stress also can trigger PCOS. So, just relax and try to de-stress. Cultivate a hobby or treat yourself to regular spa treatments to relax and rejuvenate your body and mind. Taking time off from your daily routine can help you relax.
Making a few lifestyle changes and maintaining healthy habits can go a long way when you have PCOS and want to get pregnant. You also should consult a doctor and maintain a positive outlook to live. These few measures will help you not only overcome your condition, but also in getting pregnant successfully.