Polycystic ovary syndrome is a complex, commonest endocrine metabolic condition in the reproductive years of a woman. There is no single attributing factor. It is multifactorial.
Its impact on pregnancy is not elucidated entirely. Women with recurrent pregnancy loss, subfertility, obesity causing concerns are associated with PCOS. Spontaneous miscarriage is seen in almost 40% of patients in early pregnancy. Recurrent pregnancy loss and subfertility could be related due to increased secretion of LH hormone causing concerns with egg maturity and uterine lining receptivity. Pregnancy induced insulin resistance due to other pregnancy hormones puts patients at risk to develop Gestational diabetes, pregnancy induced hypertension.
In women who have been on insulin sensitizers like Metformin before pregnancy to decrease insulin resistance and in obese women , continuing them on Metformin after conception have been associated with less pregnancy losses, hence recommended to continue till 12 weeks of pregnancy. There is no additional risk of abnormalities by continuing Metformin.
Lifestyle modifications including diet and exercise will help women with PCOS contemplating pregnancy reduces the above mentioned risk