PCOS And Miscarriage
Polycystic ovarian syndrome (PCOS) affects between six to ten percent of American women of childbearing age. The hormonal imbalances that earmark PCOS result in an overabundance of androgens (male hormones), especially testosterone, in the woman's body. The effects of these imbalances range from irregular menstrual periods and anovulation to acne, excessive facial hair and weight problems. The underlying insulin resistance that is predominant in PCOS causes type 2 diabetes, affects fertility and adds complications to conception.
Higher Rate Of Miscarriage For Women With PCOS
Once a woman with PCOS conceives, there is a possibility she may be able to complete the pregnancy without major complications. However, women with PCOS have a higher rate of miscarriage than those who do not suffer with the syndrome. Some studies found that the rate of miscarriage in women with PCOS is as high as 50 percent, compared to the national average of 15 percent.
Miscarriage is defined as the spontaneous ending of a pregnancy before its 24th week. While the cause of miscarriage is usually left unexplained, contributing factors such as genetics, or anatomic or infectious abnormalities are considered. Researchers are studying the impact of hormone abnormalities on women, including insulin resistance, something that is dominant in women with PCOS.
What Is PCOS?
PCOS is a syndrome of hormonal imbalances and women with it have several imbalances, with hormones in one area too high and in another too low. The higher incidence of miscarriage in women with PCOS has been attributed often to elevated insulin levels and researchers have noted that miscarriage is more likely to occur in women with PCOS caused by insulin resistance than in those who do not have the condition.
High insulin levels in pregnant women with PCOS potentially interfere with blood clotting in the uterus, at the interface between the uterine lining and the placenta. This leads to placental deficiency, when the placenta fails to deliver nutrients to the baby and to remove toxic waste matter. The result is miscarriage.
High levels of Luteinizing Hormone (LH), a glycoprotein hormone that stimulates ovulation, have also been linked to miscarriage in women with PCOS. Another contributor may be high levels of male hormones (androgens). Some women with PCOS experience dysfunctional levels of both LH and androgens, linked to insulin resistance.
Key Proteins Are Diminished
Researchers at the Virginia Commonwealth University Medical Center found that there were significantly lower concentrations of glycodelin and IGF binding protein, two key proteins in the uterine lining, in women with PCOS. These proteins are released during pregnancy by the uterine lining and play an important role in the implantation of the embryo and the maintenance of the pregnancy.
While there is no magic bullet for PCOS or insulin resistance, the risk of miscarriage can be reduced by improving the overall diet, increasing exercise, reducing stress, stabilizing insulin and glucose levels, and balancing the hormonal systems.