Polycystic ovary syndrome (PCOS) is a fairly common health condition in women that results in a hormonal imbalance. A PCOS diagnosis indicates 'polycystic ovaries', which means that your ovaries have become enlarged and populated with multiple fluid-filled sacs (follicles). Although benign, these sacs or follicles lead to symptoms such as irregular periods, acne, excessive facial hair growth, and fertility issues.
Here are the answers to the most commonly asked questions about PCOS and pregnancy.
PCOS is a condition in which there is an overproduction of androgens (male hormones) in the woman's body. This affects the menstrual cycle and brings down the fertility rate. Therefore, the chances of conceiving naturally without intervention may be small.
PCOS is most likely to affect women who are overweight. Therefore, normalizing your weight can help regulate the hormonal imbalance caused by PCOS. This can be done with regular exercise and dietary modifications. Regaining your healthy weight naturally (diet and exercise) can ease the problems of acne, excess facial hair and infertility. Adequate exercise helps release endorphins (the ‘feel good’ hormones) that can reduce the stress levels and normalize your weight. Exercising regularly can also help regulate the glucose levels.
Medical intervention for PCOS involves the use of prescription drugs such as metformin (to regulate insulin) and ovulation drugs such as clomiphene citrate and letrozole (to stimulate ovulation). These drugs inhibit the production of estrogen and increase the follicle-stimulating hormone.
Ovarian drilling is a form of surgical intervention that helps lower the secretion of male hormones. This can also increase the chances of having a normal delivery.
The drugs administered for the treatment of PCOS are fairly safe and do not have any known side effects. However, it is important to take these drugs only with a doctor’s (OBGYN) prescription.
There are essentially three types of risks associated with a PCOS pregnancy.
It is essential to keep the blood sugar levels and the blood pressure under control at all times. It is recommended that you have your blood pressure monitored regularly. If the BP reading is higher than 140-90, it is important to start taking medication to keep it under control. It is also important to have your blood sugar levels tested every 15 days or once a month. Consult a dietician to prescribe a diet that can help control the blood sugar and blood pressure, while still providing you with all the essential nutrients. Make sure to exercise regularly during your pregnancy.
It is important that only a gynaecologist prescribes the medication for blood pressure during pregnancy, so that safer drugs (that do not have an side effects during pregnancy) can be administered.
PCOS patients are typically prescribed a low glycemic index diet during pregnancy. As per this diet, you should avoid eating fruits that can increase your blood sugar level, such as mango, chikoo or grapes. An excess of sugar intake puts you at a greater risk of developing gestational diabetes.
It is also essential to exercise regularly during pregnancy. In addition to the routine ultrasounds and blood investigations during the course of pregnancy, it is essential for women with PCOS to undergo the glucose challenge test, routine blood sugar tests (1-2 times a month) and regular blood pressure monitoring.
Yes, it is possible to have a normal pregnancy (free of complications) and a normal delivery even after you have been diagnosed with PCOS. However, this depends on your age, diet, exercise routine, blood sugar level and blood pressure.
In the case of a PCOS pregnancy, there is some risk of the baby developing autism. High blood sugar levels in the pregnant mother can cause Down’s syndrome and some other forms of developmental disorders; however, these can be identified and diagnosed during the pregnancy based on NDMB double marker scan at 12 weeks and the Level 2 ultrasound at 18 weeks.
* Approved by, Dr Rashmi Sharma, Origyn Fertility & IVF, New Delhi