Everything You Need To Know About PCOS And Pregnancy

A recently published study conducted by the Karolinska Institute and the Finnish Institute of Health and Welfare found that babies born to women with polycystic ovary syndrome (PCOS) had an increased risk of neuropsychiatric disorders like autism and ADHD. On its face, this news may be startling to women who have PCOS, but it’s important to understand that new research studies like this one must be interpreted carefully. So, in the spirit of PCOS Awareness Month, we are providing clarity on what these specific findings mean for women with PCOS and breaking down what women need to know about how PCOS affects pregnancy more broadly.

Having PCOS Does Not Automatically Equate To Being Infertile

Dr. Fahimeh Sasan, the founding physician and OB-GYN at the New York-based health and fertility clinic, Kindbody, says a common misconception about PCOS is that it equates to infertility. She says the truth is more nuanced; it is possible to conceive with PCOS but it may be more challenging to do so. Dr. Sasan explains that “some women with PCOS get pregnant easily” while others may need some fertility help in the form of ovulation induction, intrauterine insemination, or in-vitro fertilization. “It just depends on their age and their fertility,” she says.

For women with PCOS who are considering trying to conceive, Dr. Sasan recommends first starting a conversation with their doctor. What should follow is a thorough assessment of the female patient’s hormonal health which could include genetic screening, thyroid and other hormone tests, and a review of family medical history. As women go through this process of understanding their PCOS, Dr. Sasan emphasizes the importance of also being aware that PCOS affects every woman differently. “PCOS is a very broad spectrum disorder. No two women with PCOS are going to be the same,” she says. 

To Optimize Pregnancy Success, Start Healing PCOS Through Diet and Exercise ASAP

There is one fact, however, that Dr. Sasan says is true across the board for women with PCOS: addressing their health and balancing their hormones from an early age gives them a better chance to successfully conceive and experience a healthy pregnancy. She encourages her young patients to start thinking about their future family plans from a young age because “[addressing PCOS] is a long battle and the sooner you’re aware of medical issues the longer time you have to address them.” 

Regardless of a woman’s age when she receives a PCOS diagnosis, Dr. Sasan says it is essential that she include a dietitian or nutritionist in her care plan. Seeking out personalized professional nutritional advice is important because, according to the U.S. Department of Health & Human Services (DHS), there is limited medical knowledge about what causes the condition in the first place. As a result, there is no medical cure for the condition. But harnessing the healing power of nutrition and exercise has been proven to reduce the symptoms of PCOS. Dr. Sasan clarifies that this does not mean resorting to fad diets, but rather seeking out “true nutritional consultations” with professionals.

How PCOS May Increase The Risk of Pregnancy Complications

Healing PCOS through diet and exercise may also help decrease the risk of pregnancy complications, according to Monash University’s International Evidence-Based Guidelines for the Assessment and Management of Polycystic Ovary Syndrome. This may be critical for women hoping to conceive as several National Institutes of Health studies have found that women with PCOS have a higher risk for miscarriage, gestational diabetes, preeclampsia, pregnancy-induced high blood pressure, preterm birth, and cesarean delivery. The risk of these complications is known to increase further in women with PCOS who are also obese. However, Dr. Sasan says “it has been proven that if you lose weight before entering pregnancy, you are going to have a healthier pregnancy and your risk of [pregnancy complications] can be reduced.”

But according to the recent Karolinska Institute and Finnish Institute of Health and Welfare study, PCOS was associated with neuropsychiatric disorders in offspring regardless of a woman’s pre-pregnancy weight. This study, which was the largest to date and ran from 1996 to 2018, found that babies born to women with PCOS had a small “increased risk of neuropsychiatric disorders including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorders (ADHDs) and tic disorders.”

In an email, the first author of the paper, Xinxia Chen explained that “women with PCOS should not be too worried” by the study’s findings for two reasons. First, this is the first study to connect an increased risk of neuropsychiatric disorders in offspring with maternal PCOS so these findings still need to be validated with more research. Second, Chen explains that the “absolute risk” of PCOS-exposed offspring developing neuropsychiatric disorders is 700 children per 100,000 births.

Chen acknowledged in a follow-up email that losing weight by diet and exercise is a treatment strategy for women with PCOS but that, at present, it is impossible “to fully ‘address’ PCOS, due to a lack of knowledge on its [cause] and specifically targeted medications.” 

What this really means is that for women with PCOS to have more answers and more control over their health, much more research needs to be done on this disorder that, according to DHS, affects one in 10 American women. The National Polycystic Ovary Syndrome Association says that 0.1% of government, corporate, foundation, and community funding is currently being directed at PCOS awareness and support organizations “despite being one of the most common human disorders.” For now, women with PCOS who are hoping to conceive need to take initiative in regards to their hormonal health by having informed conversations with their doctors, addressing this disorder as early as possible, seeking professional guidance from a nutritionist, and losing weight, if necessary.

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