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PCOS and pregnancy

7-minute read

What is PCOS?

Polycystic ovarian syndrome, or PCOS, is a common condition.

People with PCOS can have:

  • higher than normal levels of androgens (male-type hormones)
  • problems with ovulation (the release of eggs from the ovaries)
  • multiple cysts on the ovaries

This can affect your menstrual cycle, fertility and appearance.

If you have PCOS you may struggle to become pregnant and may be at higher risk of developing some pregnancy complications.

Illustration showing a normal ovary and a polycystic ovary.
Illustration showing a normal ovary and a polycystic ovary.

What are the symptoms of PCOS?

There are many signs and symptoms that are associated with PCOS. These can include:

Some of these symptoms (such as acne, excess face and body hair, and scalp hair loss) are due to increased levels of the hormones called androgens. These hormones are found in all females, but those with PCOS have slightly higher amounts.

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How is PCOS diagnosed?

It often takes a while to get a PCOS diagnosis. This is because the condition can mimic other problems. Sometimes, people only find out that they have PCOS when they have tests to find out why they are having trouble getting pregnant.

If you think you might have PCOS, see your doctor. Early diagnosis means that your symptoms can be treated early.

At your appointment, your doctor will:

  • ask about your symptoms
  • ask for your medical history
  • examine you

Your doctor may also recommend blood tests and an ultrasound scan to look for any cysts in the ovaries.

In general, to be diagnosed with PCOS, you need to have 2 out of 3 of the following;

  • irregular periods, or no periods
  • symptoms due to increased levels of androgen hormones, or a blood test showing you have increased levels of androgen hormones
  • an ultrasound scan showing multiple cysts on your ovary or ovaries

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Will PCOS affect my fertility?

If you have PCOS, you might struggle to get pregnant.

Fortunately, with lifestyle changes or infertility treatment, most people with PCOS can become pregnant. Talk to your doctor or fertility specialist for individual advice for your situation.

Can PCOS increase my risk of complications during pregnancy?

Having PCOS can increase your risk of some complications during pregnancy, such as:

If you have PCOS, you are also at increased risk of having a baby larger than expected for their gestational age. This comes with a higher risk of needing a caesarean delivery.

Babies born to people with PCOS have a higher chance of being admitted to a newborn intensive care unit.

Pregnant women with PCOS may have a higher risk of miscarriage and stillbirth. However, more research is needed in this area.

If you have PCOS and are pregnant, it is important you talk with your doctor. The risk of these complications can be reduced by monitoring your PCOS symptoms and taking extra care during your pregnancy.

What steps can I take to look after my health?

You can make lifestyle changes to manage your PCOS and look after your health. These include:

  • maintaining a healthy weight
  • eating healthily
  • exercising
  • managing stress
  • getting enough sleep

These lifestyle changes can reduce the symptoms of PCOS and improve your chance of falling pregnant.

If you are overweight, a 5% to 10% loss in weight can increase your fertility.

Speak to your doctor for guidance on how to make effective lifestyle changes.

How is PCOS treated?

Treatment for PCOS depends on each person. Speak to your doctor about the best treatment for you.

If you are trying to fall pregnant, your PCOS treatment will focus on:

  • restoring regular ovulation
  • weight loss
  • improving your general health and wellbeing

If you have made lifestyle changes and are still struggling to fall pregnant, your doctor may order fertility tests. They may also prescribe fertility medicines to help you ovulate. In some cases, they may recommend surgery.

Another possibility is in vitro fertilisation (IVF), which offers the best chance of conception. However, this can be expensive and is usually only considered when all other options have been unsuccessful.

If you are not trying to fall pregnant, your PCOS treatment will focus on:

  • reducing your symptoms
  • reducing your risk of long-term health issues, including heart disease and type 2 diabetes

Speak to your doctor. They can help you manage your PCOS symptoms by providing:

  • weight loss management strategies
  • treatment for sleeping problems
  • acne treatment
  • medicines, including hormonal contraception (birth control) to manage irregular menstruation

Dealing with infertility and PCOS symptoms can be difficult. You may experience feelings of depression and anxiety. Your doctor can refer you to a counsellor or psychologist for your mental health.

Resources and support

Visit the Jean Hailes website for more information on PCOS and its complications.

Hormones Australia also supplies information on PCOS, including questions to ask your doctor.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2022

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Need more information?

Polycystic Ovary Syndrome (PCOS) | Your Fertility

PCOS can be associated with a range of symptoms including irregular periods and difficulties getting pregnant

Read more on Your Fertility website

Fact sheets | Your Fertility

Polycystic ovary syndrome (PCOS) is the most common hormonal condition affecting women in their reproductive years

Read more on Your Fertility website

What is PCOS?

Polycystic ovary syndrome (PCOS) is the most common hormonal condition affecting women in their reproductive years.

Read more on Your Fertility website

Polycystic ovarian syndrome (PCOS) - Better Health Channel

Polycystic ovarian syndrome is a hormonal condition associated with irregular menstrual cycles, excess hair growth, acne, reduced fertility, and increased risk of diabetes and mood changes.

Read more on Better Health Channel website

Polycystic ovary syndrome (PCOS) | Dietitians Australia

PCOS is a common hormonal condition of the ovaries that can cause problems such as an irregular menstrual cycle, weight gain, impaired fertility and poor mental health. Diet and lifestyle changes are the first steps to manage PCOS, and an Accredited Practising Dietitian specialising in PCOS is the most qualified professional to help.

Read more on Dietitians Australia website

Fertility explained | VARTA

Fertility is the ability to conceive a child. Most of us take our fertility for granted but the process of reproduction is complex, so some people may experience difficulties when trying for a baby. There are a range of factors that can affect fertility. Taking care of your preconception health by modifying your lifestyle can improve your chance of a pregnancy and the health of your future child. Medical conditions such as polycystic ovary syndrome (PCOS) and endometriosis can reduce fertility, however it may just take longer to get pregnant. In some cases, medical procedures can be used to preserve fertility. Fertility preservation (freezing of gametes for later use) is used by people who are not ready to have a baby during their most fertile years or for those facing medical treatment that might impair their fertility. Understanding reproduction It is useful to understand how eggs and sperm are normally formed, and how conception occurs to understand the causes of infertility and how they are targeted in fertility treatment. The hormones which control the production of sperm and eggs are called gonadotrophins. There are two types of gonadotrophins: follicle-stimulating hormone (FSH) and luteinising hormone (LH). In men, they stimulate the testicles to produce sperm and testosterone. In women, they act on the ovaries where the eggs develop. The female sex hormones, oestrogen and progesterone, are produced by the ovaries when eggs mature and are released (ovulation).   For women, the production of sex hormones and the release of an egg is known as the menstrual cycle. It is counted from the first day of the period until the day before the start of the next period. In an average cycle of 28 days, ovulation happens on day 14. However, cycle length varies between women, and it is important to note that ovulation occurs earlier in women with shorter cycles and later in women with longer cycles. Sperm are produced at the rate of about 300 million per day. They take some 80 days to mature. Each sperm has a head, which contains the genetic material, and a tail, which propels it up through the vagina, uterus, and fallopian tubes where the egg is fertilised. Conception occurs when an egg and a sperm come together. At ovulation, an egg is released from the ovary into the fallopian tube. If sperm is present at that time, the egg can be fertilised. The fertilised egg then starts to divide and becomes an embryo. After ovulation, the ovary produces progesterone which prepares the lining of the uterus - the endometrium - for the growing embryo. A few days after implantation, the embryo starts to produce human chorionic gonadotrophins (HCG) - the hormone that gives a positive pregnancy test reading. If an embryo does not form or attach to the endometrium (implantation), the level of progesterone drops and the next period starts.

Read more on Victorian Assisted Reproductive Treatment Authority website

Good fertility health

Your age and your health can affect your chances of falling pregnant. Maintaining a healthy lifestyle may help you improve your fertility.

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All about Polycystic Ovary Syndrome (PCOS) | Jean Hailes

Read about causes, signs and symptoms of PCOS, as well as diagnosis and treatments available to help. Jean Hailes is Australia's leader in women's health.

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Ovulation and fertility - Better Health Channel

The female body shows several signs of ovulation and you may experience some or all of these signs.

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Planning to have a baby | VARTA

Planning ahead If you are thinking about having a baby in future, there are some things you can do to improve your chances. Preconception is the period leading up to getting pregnant. This is a great time for both men and women to focus on ways to improve their health, and increase the chance of pregnancy and having a healthy baby. The earlier you start the conversations about having a baby, the better. Here are some things you and your partner (if any) should start thinking about now: the number of children you would like to have the age at which you would like to have your first and last child improving your health before you try booking a preconception health check with your GP. Your Fertility has practical ideas for how you can improve your preconception health including checklists for men and women. Improving fertility Age is the most important factor affecting a woman’s chance of conceiving.  Female fertility starts to decline around age 30 and after age 35 the monthly chance of conceiving decreases more rapidly. Age can also affect a man’s fertility and the chance of having a healthy baby. Certain lifestyle factors for both men and women also affect the ability to conceive, the health of the pregnancy, and the health of the future baby. A healthy weight, a nutritious diet and regular exercise can significantly boost fertility, as can quitting smoking, stopping drug use and curbing heavy drinking. When you are ready to try for a baby, it is important to know when conception is most likely to happen. In an average cycle of 28 days, ovulation happens on day 14. However, cycle length varies between women, and it is important to note that ovulation occurs earlier in women with shorter cycles and later in women with longer cycles. However, pregnancy is only possible during the five days before ovulation through to the day of ovulation. These six days are the ‘fertile window’ in a woman’s cycle, and reflect the lifespan of sperm (five days) and the lifespan of the egg (24 hours). Your Fertility’s ovulation calculator can help you work out the fertile window. Medical conditions and fertility PCOS Polycystic ovary syndrome (PCOS) is a common hormonal condition affecting up to one in five women of childbearing age. The condition affects two hormones, insulin and testosterone (male-like hormones), which may be produced in higher levels and can impact on fertility. Women with PCOS are prone to irregular menstrual cycles due to absent or infrequent ovulation. While the majority of women with PCOS become pregnant without fertility treatment, they often take longer to fall pregnant and are more likely to need treatment (ovulation induction or IVF) than women without PCOS. Despite this, studies show little difference between the number of children born to women with PCOS than to those without. Conception may sometimes occur as a result of lifestyle modification or after receiving medication to assist with ovulation (ovulation induction) and advice regarding the timing of sex. The most successful way to treat PCOS is by making healthy lifestyle changes. Eating a healthy diet and exercising regularly is the best way to reduce symptoms and increase fertility. If you have difficulty conceiving, your GP may refer you to a specialist clinician. Monash Centre for Health Research and Implementation (MCHRI) has a list of questions that may be helpful. You can find more information and resources about PCOS at Your Fertility, Jean Hailes for Women’s Health and MCHRI. Endometriosis Endometriosis is a condition in which endometrium, the tissue that normally lines the womb (uterus), grows outside the uterus. Endometriosis may cause fibrous scar tissue to form on the uterus. It can also affect the ovaries, fallopian tubes and the bowel. Endometriosis may cause very painful periods and reduce fertility or cause infertility. You can find out more about endometriosis at Jean Hailes for Women’s Health and the Better Health Channel.

Read more on Victorian Assisted Reproductive Treatment Authority website

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