Risk Factors Relating to PCOS and Miscarriages

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It's not uncommon to be concerned about your fertility if you have polycystic ovary syndrome (PCOS). Unfortunately, not only does PCOS make it difficult to get pregnant, it also makes it difficult to have a viable pregnancy.

Studies have shown that having PCOS increases your risk of having a miscarriage. Originally the miscarriage rate for women with PCOS was reported to be as high as 30 to 50 percent, but studies now say that rate might be higher. 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 percent 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
  • Infertility treatments
  • 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 a fertility specialist or your physician 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 doctor or a nutritionist. In some instances, your doctor 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 positive 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 physician’s orders, maintaining your metformin regimen may reduce your miscarriage risk.

If you are pregnant and taking Metformin, talk to your doctor 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 doctor'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 doctor 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 doctor’s advice.

If you do have a miscarriage, know that it is possible to go on and have a healthy pregnancy, even after recurrent miscarriages. Many women with recurrent miscarriages go on to have normal, healthy pregnancies.

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Article Sources

  • Chason, R.J. et al. A Diagnosis of Polycsytic Ovary Syndrome (PCOS) is associated with an increased likelihood of pregnancy loss with Assisted Reproduction. Fertility and Sterility. October 2010; 94(4); S25.
  • Palomba S, Falbo A, Orio F, Zullo F. Effect of preconceptional metformin on abortion risk in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Fertility and Sterility. 2009; 92(5): 1646-1658.
  • Thatcher, Samuel S. "PCOS: The Hidden Epidemic." Indianapolis: Perspectives Press, 2000.