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Sunday, February 7, 2016

PCOS Leads To Risks In Pregnancy: Planning Needed: Weight Loss Improves Concerption Rates and Pregnancy Health


The doctors Stein and Leventhatal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome, PCOS or Polycystic Ovarian Syndrome. It begins in teen years, at which time it may mean some acne and  occasional irregular cycles. most likely it resolves with menopause and the quieting of the ovarian hormones. Obesity is an integral component of the condition for many women and it's thought to be the result of insulin resistance due to PCOS but modifiable by therapy. The most common issue with getting pregnant is chronic anovulation which leads to patients not getting pregnant. Now it has been shown in a publication by Doherty in the journal of OBSTETRICS AND GYNECOLOGY that women with PCOS have increased risks of preeclampsia, gestational diabetes, preterm delivery, and cesarean delivery. Generally it is thought that the overall metabolism disorder leads to changes in the placenta and in term changes in the vascular system of the developing fetus in pregnancy.Sadly there has also been increased rates of any congenital birth defect, and increased rates of hospitalization for the child that persists into adolescence. It's important to try to normalize weight and the hormonal effects of PCOS prior to pregnancy. The Treatment of PCOS Women study done by Legro and coworkers has shown that 4 months of treatment with weight loss medications, oral contraceptives, and using lifestyle factors to alter eating increases the pregnancy rate from about 10-25% all the way up to 45-60%.  Attempts to control both the metabolism: good sugar control and normalize insulin levels, the weight, and the levels of blood inflammation should help to off set those effects. See your gyno to discuss how you can plan your pregnancy for the best health.

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