PCOS and Miscarriage: Causes and Prevention

Miscarriage is always heartbreaking for people trying to bring life to their world. There may be varied reasons for early pregnancy loss, but PCOS may have a higher rate of causing it, as there are three times more chances that people with PCOS may miscarry compared to people without PCOS. And so individuals with PCOS go through different problems, including pregnancy issues. 

Polycystic Ovarian Syndrome (PCOS) is a syndrome of ovarian dysfunction that affects about 4-18% of women of reproductive age, typically causing hormonal imbalance and impaired fertility. 

PCOS particularly has a massive impact on fertility and can cause problems in conceiving or during pregnancy, which may end in miscarriage. PCOS is a common cause of infertility and increases the risk of miscarriage (the loss of pregnancy during the first 20 weeks) due to hormonal imbalances, provoked by PCOS.

With the right tools and support, you can improve PCOS symptoms. In this article, we will be covering different factors affecting pregnancy and ways to reduce the risk of miscarriage.  

PCOS Symptoms

PCOS is a common hormonal condition that affects metabolic and reproductive health. Also, hormonal imbalance and elevated blood insulin levels are some characteristics of PCOS that usually cause issues in pregnancy.

The symptoms that you would normally experience with PCOS include irregular menstrual cycles, acne, ovulation issues, excessive hair growth on the face and body, and weight gain issues. People with PCOS may also have high cholesterol or gestational diabetes type 2. 

The diagnosis is challenging because it is still not clear what causes PCOS. It may involve several environmental and genetic factors. However, when you consult with your doctor for PCOS, the criteria that you need to meet for diagnosis typically include:

• Irregular ovulation or lack of ovulation (anovulation) –  indicated by irregular menstrual cycles
• Multiple small cysts on ovaries
• Higher androgen levels

If you are experiencing PCOS-related symptoms, it is best to get tested and understand how to proceed. You can screen the levels of AMH in your body with lab tests, like the Panorama Fertility Lab Test (an at-home finger-prick test) because high levels of AMH (anti-mullerian hormone) are usually associated with PCOS and is a key biomarker that tells how many eggs you have. You can also test 4 other biomarkers (Prolactin, fSH, fT4, Free Testosterone) that can give you the full picture of your reproductive health and from the ease of your home, as well.

How PCOS Affects Fertility and Pregnancy​

PCOS is a leading cause of infertility and miscarriage. It is typically accompanied by hormonal imbalance and can affect your reproductive health.

To conceive, your body needs to ovulate to produce progesterone and eventually to get pregnant. Since PCOS causes a lack of ovulation, it may lead to infertility.

Even when you conceive, PCOS pregnancy may have complications, which include:

• Hypertension – high blood pressure
• Gestational diabetes – increased blood sugar that develops during pregnancy
• Pre-eclampsia – a condition which is associated with high blood pressure and high levels of protein in urine
• Miscarriage

Cases like these require proper surveillance and medical attention until the baby is born. And you can totally save your pregnancy!

You can reach out to Mira’s virtual Hormone Health Clinic for Fertility to discuss all your PCOS-related concerns during your path to successful pregnancy. Many of our certified Hormone Health Coaches specialize in PCOS management and will provide you with expert guidance. 

The Link Between PCOS and Miscarriage

PCOS affects the reproductive system, beginning with irregular menstrual cycles or irregular ovulation, which leads to reduced chances of conceiving and higher chances of infertility.  

PCOS is usually a major cause of miscarriage. Women with PCOS are at higher risk of pregnancy loss than women without PCOS. According to research, 30-50% of PCOS women are more likely to have a miscarriage compared with 10-15% of women without PCOS – a rate that is three times higher. 

Factors Affecting Miscarriage in PCOS

There are various factors contributing to increased miscarriage risk in PCOS, which include:

Hormonal Imbalances 

Hormonal imbalances due to PCOS affect the reproductive system the most, such as higher levels of luteinizing hormones and androgens (a male sex hormone that develops and maintains masculine characteristics in reproductive tissues), such as testosterone. 

Higher luteinizing hormone (LH) levels increase the chances of miscarriage. Similarly, increased levels of androgens (hyperandrogenism) also cause early pregnancy loss and are usually considered definitive for the diagnosis of PCOS. 

Why not stay ahead of the game? You can monitor your hormone fluctuations with Mira’s Hormone Monitor, which has AI trained on 13M+ hormone data points, detecting the tiniest hormone fluctuations with 99% accuracy. 

Did you know? 56% of users with PCOS got pregnant within the first year of using Mira. 

*Mira is not designed to monitor, diagnose, or track PCOS.

Insulin Resistance

Another factor that contributes to an increased miscarriage rate in people with PCOS is insulin resistance or increased insulin levels. It can be associated with excess fat tissue, but caused by permanently high blood sugar levels.

Impaired Egg Quality

PCOS can disturb the normal maturation of eggs in the ovaries. Eggs can be fertilized and turned into an embryo. However, hormonal imbalances in PCOS create a hostile environment for egg development; as a result, they are not completely matured or have genetic abnormalities, which impair egg quality that may cause issues in fertilizing and maintaining a pregnancy. 

The positive news is that you can control these factors and manage PCOS to reduce miscarriage risk with a change in diet, healthy lifestyle, and regular exercise. 

Managing PCOS to Reduce Miscarriage Risk 

PCOS can become troublesome if not managed properly. But it can be treated with the help of lifestyle changes and medical guidance, which ultimately help reduce miscarriage risk. If you want to have a healthy pregnancy, here are some practical ways to manage PCOS to lower miscarriage risk. 

Lifestyle Changes

Proper Nutrition

One effective way to manage PCOS is to switch to a balanced diet if you want to steady your hormones, conceive, and have a healthy pregnancy. Adding fresh fruits, beans, nuts, whole wheat, and fresh vegetables to your diet will help manage the condition and reduce the risk of pregnancy loss. 

What should you avoid?

Anything that can cause issues while you are switching to a healthy lifestyle. Consuming food high in fats, such as milk, cheese, meat, and fried food can deteriorate obesity and aggravate PCOS. Also, avoid carbs and sugars to control your weight and hormone levels.  

However, even a balanced diet may not provide all the nutrients you need, and nutrient deficiency can also cause hormonal imbalance and insulin resistance, eventually affecting your pregnancy. You can have essential nutrients with supplements, such as vitamin D, myo and D-chiro-inositol, and folic acid. 

Exercise

Regular exercise can do wonders for PCOS patients as it helps in maintaining a healthy weight and reducing high BMI. Not only that, but exercise also helps reduce stress, balance hormone levels, and lower blood glucose, which works perfectly for a successful pregnancy.

Weight Management 

Since weight gain comes with higher risks of pregnancy complications, gestational diabetes, and miscarriage, maintaining a healthy weight becomes crucial. You can manage weight by regularly exercising, consuming a balanced diet with all the essential nutrients, and keeping track of your hormone fluctuations. 

Medical Treatments 

The most crucial step in managing PCOS is seeking medical advice about all your concerns related to PCOS and pregnancy loss risk. Healthcare providers usually prescribe oral contraceptives, clomiphene, and letrozole. Clomiphene and letrozole are used to stimulate ovulation. 

Metformin’s Role in Reducing Miscarriage Risk 

More often, your doctor may prescribe anti-diabetic medicine, metformin for treating PCOS. Metformin has played a positive role in increasing chances of pregnancies in PCOS women. The use of metformin during pregnancy in people with PCOS has shown beneficial effects on some pregnancy-related complications, including early pregnancy loss and gestational diabetes. 

So, metformin can be used to help increase chances of conception and elevate the successful PCOS pregnancy rate. 

Thyroid Management in Early Pregnancy

​Thyroid hormones are essential for the normal development of your baby’s brain and nervous system. So, thyroid management in early pregnancy is crucial because your baby depends on your supply of thyroid hormone coming through the placenta during the first 3 months of pregnancy.  

Thyroid problems can be challenging to diagnose in pregnancy because of higher levels of thyroid hormones and symptoms common in pregnancy and thyroid disorders. With the Panorama Lab Test, you can screen thyroid hormones to help you manage thyroid hormone levels before pregnancy because elevated levels can be detrimental to you and your baby as it can cause miscarriage or premature birth to name a few problems. 

Conclusion

It is not impossible to conceive with PCOS. By making significant lifestyle changes and maintaining healthy practices, you can ensure successful attempts to get pregnant and have a healthy pregnancy.

For a smooth pregnancy, you must take good care of yourself and follow your doctor’s advice. If you have a high-risk pregnancy, your doctor may put you on bed rest. 

It is difficult to know what causes miscarriage in PCOS pregnancies, but by being mindful of your choices and habits, you can control PCOS and minimize the risk of miscarriage. Make sure to manage PCOS after pregnancy as well because it can affect psychiatric and cardiac health. 

However, the good news is that you can get pregnant and have a successful pregnancy even after recurrent miscarriages. 

Frequently Asked Questions 

Does PCOS increase the chances of miscarriage?​

Women with PCOS are three times more likely to have a miscarriage than women without PCOS due to hormonal imbalance and insulin resistance. 

Can a miscarriage lead to the development of PCOS?​

If you have not been diagnosed with PCOS and have a miscarriage or recurrent miscarriages, you should get examined for PCOS. A study found that PCOS has been found in around 40-80% of women with multiple miscarriages. 

Why do women with PCOS face higher miscarriage rates by week?​

Women with PCOS also have hormonal imbalances and insulin resistance, which are the leading causes of miscarriage. 

Can I get pregnant with PCOS?

You can get pregnant with PCOS by switching to a balanced diet, a healthy lifestyle, maintaining a moderate weight, and proper supplement intake.