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PCOS and pregnancy

3-minute read

Polycystic ovarian syndrome, or PCOS, is a common hormonal condition in women. Women with PCOS can struggle to become pregnant and are at higher risk of developing complications during pregnancy. However, by managing the symptoms, many women with PCOS can become pregnant and have a healthy baby.

What is PCOS?

PCOS is a condition where the ovaries produce higher than normal levels of male hormones (androgens). This can affect a woman's menstrual cycle, fertility and appearance. Symptoms of PCOS include:

Diagnosis

It often takes a while for women with PCOS to get a firm diagnosis, as the condition can mimic other problems. Sometimes women having trouble getting pregnant find they have PCOS.

If you think you might have PCOS, it is important you see your doctor to find the cause of your symptoms. With early diagnosis, the symptoms of PCOS can be treated early. This reduces the risk of complications if you do decide to become pregnant.

At your appointment, your doctor will:

  • talk to you and examine you
  • take a blood test to check for male hormones
  • arrange ultrasound scans to look for cysts in the ovaries

PCOS and infertility

If you have PCOS, you might struggle to get pregnant. This is because the high levels of male hormones prevent the release of an egg (ovulation).

You can increase your chances of getting pregnant by:

  • being a healthy weight — even a 5 to 10% loss in weight has been shown to significantly increase the chance of becoming pregnant
  • healthy eating
  • exercise
  • monitoring ovulation and timing sexual intercourse around ovulation

If you have made some changes and that still hasn't helped, your doctor might order fertility tests and prescribe fertility medications to help you ovulate.

If medications don't work, your doctor might suggest surgery to remove a tiny amount of tissue that produces excess male hormones in the ovaries.

Another option 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.

Fortunately, with lifestyle changes or infertility treatment, the majority of women with PCOS do become pregnant.

PCOS and pregnancy

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

Women with PCOS also have a higher likelihood of needing a caesarean delivery because their babies might be larger than expected for their gestational age.

Babies born to women with PCOS have a greater risk of dying around the time of delivery and of being admitted to a newborn intensive care unit.

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 PCOS symptoms and taking extra care during your pregnancy.

Find out more about PCOS complications.

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

Last reviewed: January 2020


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Polycystic Ovary Syndrome (PCOS) | Your Fertility

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

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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

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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.

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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.

Read more on Pregnancy, Birth & Baby website

Polycystic ovarian syndrome (PCOS) - Better Health Channel

betterhealth.vic.gov.au

Read more on Better Health Channel website

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