By Breea Johnson, MS RD
Women with PCOS (polycystic ovary syndrome) may endure a lot to get pregnant - from utilizing medications to induce ovulation to undergoing IVF – all while experiencing the typical PCOS symptoms. But, does PCOS also impact miscarriage rates? Pregnancy loss rates amongst women with PCOS have been reported to be as high as 30% to 50%, but some research has shown that information to be conflicting. In a recent study, women with PCOS were found to have a 2-fold increase of miscarriage loss after undergoing ART (IVF or IUI) (Chason et al, 2010). While not the 30-50% reported previously, the rate found by Chason et al. is pretty substantial considering the general reproductive population has about an 11% miscarriage rate. PCOS has also been found in approximately 40% to 80% of women with recurrent miscarriages (Palomba et al, 2009).
Insulin levels also seem to play a factor in miscarriage, as studies have shown that Metformin has positive effects on reducing miscarriage rates in women with PCOS. In a study comparing three groups of women with PCOS on Metformin, all rates of miscarriage decreased while on Metformin but the groups that stopped at 8 weeks and 12 weeks had a statistically significant drop in miscarriage rates while the group that stopped immediately after a positive pregnancy diagnosis did not have a statistically significant drop (from roughly 20-40% down to 4-8%). However, a meta-analysis of randomized controlled trials showed that preconception intake of Metformin did not have a beneficial effect on reducing miscarriage rates in women with PCOS (Palomba et al, 2009). The research is still very limited in this area.
Factors in women with PCOS that may be contributing to increased miscarriage rates include higher Lutenizing Hormone (LH) levels which can be increased by elevated insulin. Elevated testosterone levels, obesity, insulin levels and infertility treatments are also factors that may be involved (Palomba et al, 2009). Many of these altered hormone levels seen frequently with PCOS are greatly affected by diet and lifestyle and may be improved through working with a nutritionist. Acupuncture has also been used to minimize the chance of miscarriage. Please call Pulling Down the Moon at (312) 321-0004 or visit our website at www.pullingdownthemoon.com for more information.
Chason et al. A Diagnosis of Polycsytic Ovary Syndrome (PCOS) is associated with an increased likelihood of pregnancy loss with Assisted Reproduction. October 2010.
Palomba et al. Effect of preconceptional metformin on abortion risk in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Fertility Sterility. 2009.