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PCOS and pregnancy

Polycystic ovary syndrome, or PCOS, is the most common hormonal condition in women of reproductive age, affecting between five and 10 per cent of women.

To be diagnosed with PCOS, a woman must have at least two of the three key symptoms. In addition, other possible causes that can mimic PCOS must be ruled out. The three key symptoms of PCOS are:

  1. abnormal periods: either absent periods (three to six months with no period), or irregular periods (periods that start more than 35 days apart on average)
  2. evidence of high male hormones: this can be either elevated male hormone levels on tests, or physical symptoms of high male hormones such as acne, loss of hair on the scalp, or male-pattern hair growth on the body or face
  3. polycystic ovaries seen on ultrasound

While absent periods can be caused by many factors, irregular periods are very often the result of PCOS.

“When you have irregular periods, it turns out that probably 85 to 90 per cent of those women are going to have PCOS,” says endocrinologist Dr. Laredo, chief of staff at Women’s College Hospital. “So it’s a very easy single question to ask, and for that reason it’s very useful for many different healthcare providers.”

PCOS can affect fertility. Because of their irregular or infrequent periods, women who have the condition may take longer to get pregnant than other women. Treatment for women with PCOS who are trying to conceive often includes controlling their cycles so they ovulate more regularly.

Because women with PCOS may take longer to get pregnant than other women, Dr. Laredo talks to her PCOS patients about family planning as early as possible so they can make informed decisions about timing pregnancy. Declining fertility after age 35, in addition to the extra time it may take a woman with PCOS to conceive, may make it increasingly difficult to get pregnant as they get older.

However, it’s also crucial for women with PCOS to be aware that they can become pregnant.

Although some women with PCOS may struggle to conceive, others have the reverse problem: undiagnosed pregnancies. Because some women with PCOS believe they can’t get pregnant, they may not use appropriate birth control. Then if they do get pregnant, their irregular cycles mean they aren’t surprised if they don’t get a period for three or four months. They don’t know they are pregnant, and don’t get appropriate prenatal care.

“That’s a really important message: PCOS doesn’t mean you can’t get pregnant,” Dr. Laredo says.

PCOS is also linked with pregnancy complications.

“Women with PCOS have a higher risk of gestational diabetes, which means developing diabetes during pregnancy,” Dr. Laredo says. “That creates risk for bigger babies, and also indicates higher risk for future diabetes in the mother. They are also at increased for pregnancy-induced hypertension, which can lead to preeclampsia and eclampsia.”

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: Jan. 16, 2015

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