POLYCYSTIC OVARIAN SYNDROME (PCOS), Nathan Fox, MD (Digital)

By on January 12, 2017

Polycystic ovarian syndrome (PCOS) is a common cause of infertility in the United States. This syndrome affects 5 to 10 percent of all women of reproductive age. PCOS is characterized by oligomenorrhea (irregular periods), hyperandrogenism (high levels of testosterone and other hormones), chronic anovulation, and insulin resistance.

Pregnancy Loss and Polycystic Ovarian Syndrome

Early pregnancy loss is a prominent pregnancy complication associated with PCOS. Research has estimated that 30 to 50 percent of pregnancies in patients with PCOS miscarry within the first trimester.

One postulated etiology for these early pregnancy losses is that hyperinsulinemia may impair endometrial function and successful implantation, vital parts of a successful pregnancy. Insulin, like growth factor binding protein 1 (IGFBP-1) is a secretory endometrial product thought to be involved in implantation and pregnancy maintenance. IGFBP-1 is a protein that facilitates the adhesion processes at the feto-maternal interface and serum IGFBP-1 concentrations are decreased in PCOS patients.

Other Increased Pregnancy Risks of PCOS

While it is established that women with PCOS are at an increased risk for infertility, these patients also appear to be at an increased risk for other pregnancy complications, such as gestational diabetes and gestational hypertension. Women with PCOS have been shown to have an 8 to 38 percent risk of developing gestational diabetes. This association is stronger in obese women with PCOS as opposed to women of normal weight.

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