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Anyone who lives with PCOS knows that it can impact everything from your mood to your diet. If you’re trying to conceive, it’s natural to also worry about whether PCOS will affect this aspect of your life in unwanted ways.
There is research available that points to connections between PCOS and difficulty conceiving. Still, there are also tools, resources, and tests that can help you better manage the risk of miscarriage or other unwanted pregnancy conditions.
According to Dr. Dorothy Bestoyong, an OB/GYN based in Orlando, Florida, one of the first things you should do before getting pregnant is to set up a doctor’s appointment that centers on preconception counseling. This will set aside a time and place to ask for a general health screening that can rule out existing conditions like insulin resistance, diabetes, or hypertension, which PCOS could sometimes trigger and which can complicate a pregnancy if present.
Is there a connection between PCOS and miscarriage?
If you live with PCOS, it’s normal to want to understand your risk for miscarriage during pregnancy. The National Institute of Child Health and Human Development notes that “women with PCOS are three times as likely to miscarry in the early months of pregnancy as are women without PCOS.”
According to the Office on Women’s Health, PCOS can make it harder to get pregnant while also increasing your risk for certain conditions if you do get pregnant.
Fortunately, as the Office on Women’s Health notes, PCOS is one of the most common and treatable causes of infertility if diagnosed before trying to conceive. For instance, with enough understanding of your condition, you may be able to work with your care team to find pathways toward ovulation. Often, women with PCOS struggle to conceive because they are not ovulating regularly.
How can you lower your risk of miscarriage if you have PCOS?
As Dr. Bestoyong explains, a good first step is identifying any potential conditions that may increase your risk of miscarriage. Zeroing in and treating preexisting conditions — like insulin resistance, diabetes, high blood pressure, or unhealthy cholesterol — can, by default, lessen the risk of any complications during pregnancy.
The Office on Women’s Health adds that reaching a healthy weight, healthy blood sugar levels, and even adding folic acid to your supplement regimen can also make a difference in lowering your risk for pregnancy complications.
Can miscarriages happen even if you’re managing your PCOS?
According to March of Dimes, anywhere from 10 to 30% of pregnancies end in miscarriages. A majority of miscarriages occur in early pregnancy (before 20 weeks), and some even happen before someone knows they are pregnant.
While women who live with PCOS are more likely to experience a miscarriage than other women, all women are often faced with how complicated and unexplainable a miscarriage can be.
In trying to understand the connection between PCOS and miscarriage better, Dr. Bestoyong reemphasizes that the best way to prevent a miscarriage is to catch any preexisting conditions beforehand and also to know what a miscarriage looks and feels like.
“In general, things to look out for in regards to signs of miscarriage: cramping that is persistent, cramping associated with bleeding or spotting,” explains Dr. Bestoyong. “Unfortunately, there are just times when there is no physical sign. But some may have a gut feeling that something doesn’t feel right. Always trust your gut and get checked out.”
Since researchers are still working to understand the connection between PCOS and miscarriage better, it’s important to remember that you can only control what you can control. Getting a full health workup is one tangible step. If you've been trying to get pregnant for over a year without success (6 months if you're over 35), are experiencing irregular periods, or have suffered from multiple pregnancy losses, consulting with a fertility specialist may be the best next path forward.
Vivian Nunez is a writer, content creator, and host of Happy To Be Here podcast. Her award-winning Instagram community has created pathways for speaking on traditionally taboo topics, like mental health and grief. You can find Vivian @vivnunez on Instagram/TikTok and her writing on both Medium and her blog, vivnunez.com.