Pregnant with PCOS

Pregnant women with PCOS face a number of challenges before, during and after their pregnancies. To address these concerns, Yale’s infertility specialists and Maternal-Fetal Medicine specialists at the Yale PCOS Program provide on-site consultations prior to conception and throughout pregnancy for women likely at high risk for pregnancy-related complications.

Pregnancy Risks
• Infertility – Due to ovulation disturbances, women with PCOS may find it difficult to get pregnant. YFC boasts one of the highest success rates in the region for managing PCOS-related infertility, offering individualized management strategies to minimize the risks of ovarian hyperstimulation and multiple pregnancy while maximizing success of fertility treatments. Fertility therapies include ovulation induction strategies, injectable hormones, aromatase inhibitors and in vitro fertilization.

We also recommend lifestyle interventions that may help with spontaneous ovulation.
• Miscarriage – Women with PCOS may be at increased risk for spontaneous miscarriage. Contributing factors include elevated insulin levels (insulin resistance) and high levels of luteinizing hormone (LH) or androgens (male hormones). Miscarriage risk can be reduced by lowering insulin levels through weight loss or with insulin-lowering medicines such as Metformin. Women with elevated homocysteine levels may also require increased folic acid.
• Pregnancy Complications – Women with PCOS are particularly at risk for gestational diabetes, which may increase the risk of birth defects, miscarriage, preeclampsia, preterm delivery, macrosomia (excessive birth weight) and birth injury. Weight reduction and lowering insulin levels before pregnancy are beneficial to ensuring a healthy pregnancy.
• Multiple Pregnancy – Pregnancy with more than one fetus increases the overall risk for pregnancy-related complications in women with PCOS. Because they are at high risk for multiple pregnancy following fertility treatment compared to women with other causes for infertility, our goal is to minimize this risk by utilizing gentler treatment protocols that reduce the likelihood of multiple gestation.
In addition to working with high-risk pregnant women with PCOS, YFC monitors all PCOS pregnancy outcomes to help the medical community understand the fetal and perinatal implications of PCOS.

Risks to Children of Women with PCOS
Studies suggest that PCOS diagnosis may have implications for the children of women with PCOS.
• Daughters of women with PCOS may grow up to exhibit the characteristic features of PCOS.
• Weight problems, insulin resistance and high cholesterol are consistently seen in children of women with PCOS.

Healthy lifestyle and healthy weight goals are therefore important not just for women with PCOS, but also for their children.