Preparing for Pregnancy If You Have PCOS

5 Ways to Increase Your Odds of a Healthy Birth

Pregnant Caucasian woman timing contractions in hospital
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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 will 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.

Here are 5 things you need to consider if you have PCOS:

Stop Smoking

Smoking has 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 doctor about smoking cessation aids that can help.

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.

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 within 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 antiobesity drugs like Xenical (orlistat).

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 doctor and make a plan to get it under control. This may mean improving your diet or increasing your activity level. These may be difficult changes to make but can make a world of difference to 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.

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 your attempts to get pregnant.

If you have menstrual difficulties, you may want to see your doctor 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.

A Word From Verywell

Most doctors 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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