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What Is Polycystic Ovarian Syndrome (PCOS)?

Why Does PCOS Cause Problems With Getting Pregnant?

The reason women with PCOS have problems getting pregnant is that this condition prevents the ovaries from making the hormones needed for an egg to fully mature. The follicles (cysts that form and contain the egg) may start to grow, but ovulation does not occur. Instead, many of the follicles remain as cysts.
Because ovulation doesn't occur, the hormone progesterone is not made. Without this hormone, a woman's menstrual cycle becomes irregular or absent. Also, the ovaries in women with PCOS make a higher-than-normal amount of androgens, which also prevents ovulation.
Although it may be more difficult for some women with PCOS to become pregnant, it is possible. However, the key to pregnancy is successful ovulation. For some women who are overweight, this may mean simply losing some weight to have more regular menstrual cycles. Other women may need to take medications to help stimulate ovulation. Still others may need to have surgery on the ovaries when other treatments have been unsuccessful.

What Risks Does PCOS Pose for a Pregnancy?

Women who have PCOS may have a higher rate of complications during pregnancy. Some of these complications include:
Research has also shown that babies born to women with PCOS have a higher risk of being in a neonatal intensive care unit or dying before, during, or shortly after birth. However, these risks are higher with twins or multiple babies.
Studies are currently being done to determine whether the diabetes medicine metformin can help prevent or at least reduce the risk of having these types of problems while pregnant. The FDA classifies metformin as a pregnancy Category B drug, which means it does not appear to cause major birth defects or other complications during pregnancy.
However, only a few studies have been done on the safety of using metformin when pregnant. In addition, metformin does pass through breast milk. Therefore, talk to your healthcare provider about the potential risks of using this medicine while breastfeeding.
Last reviewed by: Arthur Schoenstadt, MD
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