- Dr. Singh, ND
Reducing Pregnancy-Related Complications in PCOS
Polycystic Ovarian Syndrome is a common cause of infertility, estimated to be the cause of 5-20% of infertility cases, depending on demographics. The condition tends to have different phenotypes (physical symptomatic presentations), varying from cystic ovaries, increased hair growth (common locations include the back, upper lip, jawline, abdomen, arms, and thighs), and/or obesity/overweight.
Because the time to pregnancy is usually longer for Women with PCOS, women dealing with this condition are more likely to undergo fertility investigations and treatments. However, IVF success rates tend to be lower with this condition as the response to assisted reproductive technologies (ARTs) can be lower.
Alarmingly, the risk for early pregnancy loss (EPL) is almost 3-5x higher in Women with PCOS! It is hypothesized that this increased risk of EPL is due to a variety of factors: a change in the endometrium quality that reduces implantation success, increased obesity/adipose tissue, insulin resistance, among other factors. Other risks during IVF include a higher need for medications and a higher risk for Ovarian Hyper-stimulation Syndrome (OHSS), higher rates for embryo transfer cancellation, and lower quality embryos.
During Pregnancy, Women with PCOS are at a much higher risk for gestational diabetes, pregnancy-related hypertension, preeclampsia, and caesarean section. There is also an increase in inflammatory markers in Women with PCOS, which is associated with lesions in the placenta consistent with inflammation. It is hypothesized that this may contribute to some of the complications associated with pregnancy.
Strategies to reduce complications with PCOS:
A recently published review on the topic mentions the use of low-dose aspirin to help reduce the risk of poor placenta growth.
There is a potential role for a higher folic-acid supplementation to help reduce the risk of some of the above complications.
In terms of lifestyle recommendations, smoking cessation is vital, as well as exercising 5 times a week (30 min workouts each time, with at least 3 of them being aerobic exercise), along with dietary changes to help support fat loss and a healthy BMI. This can help reduce the insulin resistance commonly seen in PCOS.
This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor or Primary Care Provider.
Mcdonnell, R., & Hart, R. J. (2017). Pregnancy-related outcomes for women with polycystic ovary syndrome. Womens Health, 13(3), 89-97.