PCOS Miscarriage Rate: What Are the Risks Factors?

How to Decrease the Odds of a Misscariage for Women With PCOS

A pregnant woman experiencing pain.
A pregnant woman experiencing pain. IAN HOOTON/SPL/Getty Images

Many women wonder whether their polycystic ovary syndrome (PCOS) diagnosis means that they have a higher miscarriage rate. Unfortunately an October 2010 study published in the Journal of Fertility and Sterility confirmed that if you have PCOS, you are at a greater risk for having a miscarriage.

Prior to the study, the rate of miscarriage for women with PCOS was reported to be as high as 30% to 50%, but the study concluded that the rate was probably higher, as women with PCOS were two times more likely to have a miscarriage after undergoing assisted reproductive therapy such as in-vitro fertilization (IVF) or Intrauterine insemination (IUI).

In a 2009 paper published in the same journal, researchers concluded that PCOS was present in approximately 40% to 80% of women with recurrent miscarriages.

Factors That May Increase Miscarriage Risk

Factors that may be contributing to increased miscarriage rates in women with PCOS include:

  • Insulin resistance or elevated insulin levels
  • Higher Lutenizing Hormone (LH) levels which can be increased by elevated insulin.
  • Elevated testosterone levels
  • Obesity
  • Infertility treatments are also factors that may be involved
  • Genetic abnormality

Can I Do Anything to Prevent a Miscarriage If I Have PCOS?

Most likely, no. If the loss is due to a genetic abnormality, once the pregnancy has been established, nothing can be done to prevent a miscarriage. Sometimes a physician will place a patient who has a threatened pregnancy loss 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.

Many of the altered hormone levels and PCOS related factors listed above are greatly affected by diet and lifestyle and may be improved through 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.

Is Taking Metformin While Pregnant Dangerous?

In a study where 3 different groups of women with PCOS were given metformin, all rates of miscarriage decreased while on the drug. The groups that stopped at 8 weeks and 12 weeks had a statistically significant lower miscarriage rates, while the group that stopped taking metformin in the first few weeks of finding out they were pregnant did not have a statistically significant drop in miscarriage rates.

While of course it is always best to follow your physician’s orders, it is generally thought that maintaining your metformin regimen may reduce your miscarriage risk. When pregnant, you should have a discussion with your doctor regarding the pros and cons of continuing your medication.

If I Have a Miscarriage, Can I Still Have a Healthy Pregnancy Later?

Absolutely.

Many women with recurrent miscarriages go on to have normal, healthy pregnancies. Developing a strong relationship with your doctor is the first step in learning more about how to best treat your condition so that a healthy, viable pregnancy is in your future.

Sources:

Thatcher, Samuel S. "PCOS: The Hidden Epidemic." Indianapolis: Perspectives Press, 2000.

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.

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