pcos + pregnancy: understanding the obstacles ahead

Affecting 1 in 10 women of childbearing age, Polycystic Ovary Syndrome (PCOS) (also known as Stein-Leventhal syndrome), is a hormonal disorder that affects the reproductive and metabolic systems. The hormonal imbalance causes problems in the ovaries, the organ responsible for making the egg that is released during a healthy, monthly cycle. When PCOS is present, the egg may not develop correctly before release or may not be released at all. This often leads to enlarged ovaries, rimmed with small cysts. How does all of this affect a woman's reproductive cycle? Improperly developed eggs or eggs that are not released during ovulation lead to problems such as infertility, and PCOS is in fact known to be a leading cause. The condition can occur at any point after puberty, but most women do not discover they have it until their 20s and 30s, when having trouble getting pregnant.

Causes + Other Health Issues

The exact cause of PCOS is currently unknown. Most doctors believe that several factors play a role, including genetics. Two other possibilities include higher than normal levels of androgens or "male hormones", which prevent ovulation from occuring, and higher than normal levels of insulin, which could lead to other health problems like obesity and type 2 diabetes. Other health issues that could follow include anxiety and depression, cardiovascular disease and even endometrial cancer. PCOS also does not discriminate against age or across races or ethnicities, and your chances are even higher of receiving a diagnosis if you have a female relative who has it, whether or not they have been previously diagnosed. Research shows that 50% of women who have PCOS go undiagnosed.

Signs of PCOS

There are a number of symptoms for PCOS, and the condition can be confirmed by blood test, ultrasound, a pelvic exam, and simply reading the clues of your body. A few of the more common symptoms of PCOS include:

*irregular or missed menstrual cycles *cysts on ovaries (as seen via ultrasound) *acne (on the face, chest and back) *excessive hair (on the face or chin, and other body parts where men typically have more hair) *thinning hair or male-pattern baldness *weight gain *pelvic pain, such as severe cramps *excessive fatigue If you have experienced any or several of these symptoms, including trying but failing to get pregnant for more than one year, it may be time to discuss these symptoms with your doctor. Your medical care team can work with you on a plan for trying to manage your symptoms, while also setting you up to successfully reproduce. While there is currently no known cure, there are several lifestyle changes to help manage symptoms. Taking birth control pills will help restore hormone imbalances and regulate the cycle, losing weight, lowering insulin resistance levels, and taking androgen blockers to deal with the excess hair and acne are three of the most common possibilities. The overall goal is to get your symptoms under control and take it a few steps further should you choose to induce ovulation in attempts to get pregnant. However, it is important to know that should you get pregnant, you may need to stop taking some of the prescribed medications. Talk to your doctor to better manage your situation.

Pregnancy: Beyond a Diagnosis

So what does all of this mean if you wish to get pregnant and have received a PCOS diagnosis? You might be wondering if the odds are stacked against you and is it even possible? While it may not be easy, there are options to help you on your way. Here are a few places to start in helping your chances of getting pregnant with PCOS: *lose weight (consider a dietician for nutrition therapy) *get physical --- exercise is key

*try medication to help induce ovulation and release eggs

*engage in timed intercourse

*attempt intrauterine insemination

*be open to In Vitro Fertilization

*consider minor ovarian surgery

A few things to consider if you are successful at getting pregnant with PCOS is that there are risks to you and your baby during pregnancy. There are known higher than normal rates of:

*Miscarriage

*Gestational diabetes (which can lead to larger than normal babies)

*Preeclampsia

*Preterm birth

*Longer labors

*Delivery by C-section

It is important to also understand due to a number of factors, including larger babies and higher morbidity rate at the time of delivery, that your baby has a higher risk of spending more time in a neonatal intensive care unit (NICU) after labor and delivery.

Whether you've been dealing with PCOS for years or have recently received a diagnosis, it is important to know that pregnancy is a possibility with the condition. Many women with PCOS have children, though it may have taken a little more time to get there. Begin talking with a reproductive endocrinologist in order to best understand how to increase your chances of getting pregnant, and focus on getting proper medical care before, during, and after pregnancy. This will ensure a healthy pregnancy and a healthy baby at delivery.