How Do Polycystic Ovaries Affect Pregnancies?

PCOS has become very common; up to 15% of women of reproductive age have it. Despite how widespread it is, the condition remains deeply misunderstood, often leaving women stressed about irregular periods, insulin resistance, and overwhelming anxiety about their future. 

If you’ve been scrolling through forums wondering can PCOS affect pregnancy, here’s the hope: PCOS affects pregnancy, but doesn’t make it impossible!

While it is the leading cause of anovulatory infertility (where ovulation is irregular or absent), it is a treatable hurdle, not a permanent one. In fact, most women can conceive naturally or with minor medical support once their PCOS symptoms are managed. 

Whether you are just starting your journey or have been trying for a while, understanding the connection between your hormones and your fertility is the first step toward taking control.

What Are The Odds of Conceiving with PCOS?

The statistics are actually quite hopeful when examined in the long term.

• The Hurdle: Approximately 70% to 80% of women with PCOS struggle with fertility initially. This is primarily because they don't ovulate (release an egg) on a predictable schedule.

• The Equaliser: With simple medical interventions like ovulation induction pills, the chances of pregnancy with PCOS can jump to 20-30% per cycle. This is nearly identical to the conception rate of couples without PCOS!

• The Long Run: Lifetime studies show that women with PCOS eventually have roughly the same number of children as those without it. Your path might be different, but the destination is very much reachable.

How Does PCOS Affect Pregnancy Chances?

To improve your odds, you need to understand how can PCOS affect pregnancy at the biological level:

1. The Ovulation Gap: High levels of androgens (like testosterone) or insulin can prevent an egg from maturing or being released. If there is no egg (anovulation), fertilisation cannot happen.

2. Egg Quality: The hormonal environment within the ovaries can sometimes affect egg quality, making it slightly more challenging for an embryo to successfully implant.

3. The Uterine Environment: Irregular cycles mean the uterine lining may not always be at the optimal thickness for an embryo to "stick" when ovulation does occur.

Does PCOS Affect Pregnancy Once You Conceive? 

Once you see that positive test, the focus shifts. While many PCOS pregnancies are perfectly healthy, there is a known PCOS effect on pregnancy that requires proactive monitoring by your doctor:

• Miscarriage Risk: The risk of early pregnancy loss can be up to three times higher in women with PCOS, often due to hormonal imbalances.

• Gestational Diabetes: Because PCOS is closely linked to insulin resistance, your body may struggle to manage blood sugar during pregnancy.

• Preeclampsia: There is a slightly higher risk of developing high blood pressure.

These are risks, not certainties. The moment you see early signs of pregnancy, please consult a gynaecologist for early prenatal care.

How to Improve Your Chances of Pregnancy 

You don’t have to just "wait and see." You can actively improve your fertility starting today:

1. Manage Insulin

High insulin pauses ovulation. A low-glycemic diet (more protein, less sugar) or medications like Metformin can help restart your natural cycle.

However, don’t self-medicate or follow any random remedies. Talk to a gynaecologist, get a customised dietary plan according to your health history and lifestyle for effective results.

2. Weight Management

If you are overweight, losing just 5% to 10% of your body weight can restore regular ovulation in up to 80% of women. This is often the single most effective way to improve your chances of pregnancy with PCOS.

3. Ovulation Induction

If lifestyle isn't enough, doctors use medication to "force" the ovary to release an egg. Letrozole or Clomid are simple pills taken for 5 days at the start of your cycle. They are highly effective for PCOS patients.

4. IVF (In-Vitro Fertilisation)

This is the last resort, but here is a secret: PCOS patients often do very well with IVF because they have a high number of eggs available to be collected.

If other methods fail, PCOS patients actually tend to do very well with IVF because they typically have a high "ovarian reserve" (a large number of eggs available).

Conclusion

So, does PCOS affect pregnancy? Yes, it adds a few hurdles. But are those hurdles insurmountable?

Not at all. 

Your ovaries might be stubborn, but modern medicine is smarter. Whether it’s through lifestyle shifts, a simple pill, or just timing your cycle correctly, the odds of a healthy pregnancy are actually in your favour.

While it's important to recognise that PCOS can cause infertility if left unmanaged, knowing the symptoms and treatment options early on helps you to take charge of your fertility journey. Stop guessing and start planning.

Consult a gynaecologist at Pinky Promise today. We can help you analyse your ovulation patterns and create a personalised roadmap to help you reach your goal.

Frequently Asked Questions (FAQs)

Q: Can I get pregnant naturally with PCOS?

Yes. Many women with PCOS have "accidental" pregnancies because they ovulate occasionally and catch the egg at the right time. If your periods are somewhat regular, natural conception is very possible.

Q: Does PCOS affect pregnancy tests?

Generally, no. PCOS does not cause false positives. However, if you are using Ovulation Predictor Kits (OPKs), PCOS can sometimes give false positives because your LH hormone levels are naturally high.

Q: At what age does PCOS fertility drop?

Like all women, fertility declines after age 35. However, some studies suggest women with PCOS might actually have a longer fertility window because their ovarian reserve (egg count) doesn't diminish as quickly as that of women without PCOS.

Q. Is PCOS a high-risk pregnancy? 

Yes, it is often classified as high-risk because of increased chances of gestational diabetes and preeclampsia. However, with consistent prenatal monitoring and lifestyle management, most risks are highly controllable.

Q. Can I still have a healthy pregnancy with PCOS? 

Absolutely. While you may need extra check-ups for blood sugar and blood pressure, the majority of women with PCOS go on to have completely healthy, full-term pregnancies.

Q. Will my baby be healthy if I have PCOS? 

Yes. While there is a slightly higher risk of premature birth or larger birth weight, proactive medical care ensures your baby develops safely and stays healthy throughout the journey.