Risk Factors Relating to PCOS and Miscarriages

Polycystic ovary syndrome (PCOS) can make it difficult to get pregnant, and it also makes it difficult to have a viable pregnancy. There are several reasons for PCOS-associated fertility risks.

Pregnant African American mother holding her stomach
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The overall risk of miscarriage is 10-15% for all women. Studies have shown that having PCOS increases your risk of having a miscarriage, with rates reported to be as high as 30% to 50%.

If you have PCOS and are undergoing assisted reproductive therapy, such as in-vitro fertilization (IVF) or intrauterine insemination (IUI), you are two times more likely to have a miscarriage.

If you haven't been diagnosed with PCOS but have had a miscarriage or multiple miscarriages, you should be evaluated for PCOS, as one study found that PCOS was present in approximately 40% to 80% of women with recurrent miscarriages.

Factors That May Increase Miscarriage Risk

There are a number of different factors related to PCOS which can increase your miscarriage rate. These include:

  • Insulin resistance or elevated insulin levels
  • Higher luteinizing hormone (LH) levels, which can be increased by elevated insulin
  • Elevated testosterone levels
  • Obesity
  • Genetic abnormalities

Some of these factors can be prevented or reduced through lifestyle changes, like diet and exercise, or medication. If you are trying to conceive and having difficulties, speak with your healthcare provider or a fertility specialist about factors related to PCOS that might be making it hard to get pregnant.

Altered hormone levels and the PCOS-related factors listed above are greatly affected by diet and lifestyle and may be improved by working with your healthcare provider or a nutritionist. In some instances, your practitioner may choose to prescribe anti-diabetic medication such as metformin in an effort to treat PCOS.

Metformin has traditionally been used as an oral drug to help control diabetes, but studies have shown that metformin has beneficial effects on reducing miscarriage rates in women with PCOS since insulin levels also seem to play a factor in miscarriage.

While it is best to follow your healthcare provider’s orders, maintaining your metformin regimen may reduce your miscarriage risk.

If you are pregnant and taking metformin, talk to your healthcare provider before you change your dose or stop taking metformin.

Is It Possible to Prevent a Miscarriage?

In most cases, it is not possible to prevent a miscarriage. If you are pregnant, the best thing you can do for yourself and your pregnancy is to take care of yourself and follow your healthcare provider's instructions. In many cases, miscarriage is due to a genetic abnormality. If a fetus has a nonviable chromosomal abnormality, nothing can be done to prevent a miscarriage.

If you have a high-risk pregnancy, your healthcare provider may place you on bed rest or pelvic rest. While it is not clear if this can actually prevent a miscarriage, it is still best to follow your practitioner’s advice.

If you do have a miscarriage, know that it is possible to get pregnant again and have a healthy pregnancy, even after recurrent miscarriages.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Chakraborty P, Goswami SK, Rajani S, et al. Recurrent pregnancy loss in polycystic ovary syndrome: role of hyperhomocysteinemia and insulin resistance. PLoS ONE. 2013;8(5):e64446. doi:10.1371/journal.pone.0064446

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By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."