Preparing for Pregnancy If You Have PCOS

5 Ways to Increase Your Odds of a Healthy 9 Months

Getting ready for any pregnancy, especially your first, can seem daunting. If you have polycystic ovary syndrome (PCOS), those fears can be further amplified. Most fertility experts advise women with PCOS to get their health in order before trying to conceive.

You may not need to make a complete overhaul of your diet or lifestyle, but making a few simple changes can often make a huge difference in the health of your pregnancy.

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Monitor Your Cycles

Many women with PCOS have irregular menstrual cycles, which means that they may not be ovulating regularly or reliably. This can severely hamper attempts to get pregnant.

If you have menstrual difficulties, you may want to see your healthcare provider or a reproductive endocrinologist for help early on. There are certain medications, like Femara (letrozole), that you can take to induce ovulation and help you get pregnant quicker.

Take Prenatal Vitamins

Prenatal vitamins are a must if you get pregnant. Not only to do they help ensure optimal nutrition for you and your baby, but they also help protect against neural tube defects. A prenatal vitamin has higher amounts of certain vitamins and minerals like vitamin D, choline, folate, and docosahexaenoic acid (DHA) which are essential for a healthy pregnancy. 

According to a 2016 review in the Journal of Obstetric, Gynecologic & Neonatal Nursing, women should start prenatal vitamins three or more months before trying to conceive. A B-complex vitamin called myo-inositol may also promote fertility by increasing insulin sensitivity, menstrual regularity, and ovulatory function.

Lose Weight

Being significantly overweight or obese can put you at risk for developing pregnancy complications, including preeclampsia, gestational diabetes, and preterm labor. It can even reduce your ability to conceive and lead to infertility.

This is particularly important for women with PCOS because they are at an already higher risk of being overweight or obese. In the United States, some studies report that the prevalence of overweight and obesity in women with PCOS may be as high as 80%.

There are multiple methods to treat obesity in people with PCOS. In addition to diet and exercise, there are pharmaceutical treatments that may have some mitigating effects on weight, such as metformin (used to improve insulin resistance) and obesity drugs like Xenical (orlistat) and Wegovy (semaglutide).

Manage Your Blood Sugar

Women with PCOS are more likely to have insulin resistance than women without. Prospective studies have shown that between 31% and 35% of women with PCOS have impaired glucose tolerance. When these women become pregnant, they are at a higher risk of developing gestational diabetes.

If your blood sugar isn’t well-controlled, see your healthcare provider and make a plan to get it under control before you conceive. This may mean improving your diet or increasing your activity level. These may be difficult changes to make, but they can make a world of difference in the health of your pregnancy.

Irrespective of pregnancy, all women with PCOS who have insulin resistance need to be treated. In addition to diet, aerobic exercise, resistance training, and metformin, drugs like Actos (pioglitazone) and Avandia (rosiglitazone) may help increase insulin sensitivity and promote ovulation.

Stop Smoking

Smoking in women with PCOS is associated with increased insulin resistance and metabolic dysfunction, both of which can complicate pregnancy or make it more difficult to become pregnant.

Smoking has also been linked to premature delivery and pregnancy loss.

If you intend to become pregnant, give yourself the time you need to effectively quit smoking. If you have trouble doing so, speak with your healthcare provider about smoking cessation aids that can help.

A Word From Verywell

Most healthcare providers now recommend a preconception counseling appointment with your obstetrician. The goal of this visit is to discuss your health and how to prepare for a pregnancy.

You can also update basic screening tests to make sure there aren’t any infections or serious medical issues that need to be addressed before becoming pregnant. In addition, you should discuss topics like smoking cessation, weight management, or blood glucose control if needed.

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5 Sources
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  2. Lin AW, Kazemi M, Jarrett BY, et al. Dietary and physical activity behaviors in women with polycystic ovary syndrome per the new international evidence-based guideline. Nutrients. 2019;11(11). pii: E2711. doi:10.3390/nu11112711

  3. Flannery CA, Rackow B, Cong X, Duran E, Selen DJ, Burgert TS. Polycystic ovary syndrome in adolescence: impaired glucose tolerance occurs across the spectrum of BMI. Pediatr Diabetes. 2013;14(1):42-9. doi:10.1111/j.1399-5448.2012.00902.x

  4. Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance?. Fertil Steril. 2012;97(1):18-22. doi:10.1016/j.fertnstert.2011.11.036

  5. Legro RS, Chen G, Kunselman AR, et al. Smoking in infertile women with polycystic ovary syndrome: baseline validation of self-report and effects on phenotype. Hum Reprod. 2014;29(12):2680-6. doi:10.1093/humrep/deu239

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