Miscarriage & PCOS
The General Effects Of Hormonal Imbalances and PCOS
Between five and ten percent of women of childbearing age suffer with polycystic ovarian syndrome (PCOS), which is characterized by multiple hormonal imbalances. One such imbalance causes excessive amounts of male hormones (androgens), particularly testosterone, to be present in the body. The result of this overload of testosterone is irregular menstrual cycles, anovulation (absence of ovulation), acne, excess facial hair, weight problems, type 2 Diabetes, insulin resistance and infertility. All of these conditions are not only frustrating, but also very disheartening to a woman with PCOS who wants to have a baby.
When a PCOS sufferer does manage to conceive, usually through the use of fertility drugs and IVF, the often very bumpy journey is only just beginning. Since PCOS has an underlying aspect of insulin resistance, even after conceiving the risk of complications is very high. Such problems as preeclampsia, gestational diabetes, macrosomia (very large birth weight of the baby), and clotting factors all endanger both mother and baby.
Miscarriage And Insulin Resistance
The miscarriage rate among PCOS pregnancies is between 45 and 50 percent as compared to the national average of 15 to 25 percent in the general population. It can very difficult to diagnose the exact cause of the miscarriage and many such events go unexplained, although those women with PCOS caused by insulin resistance have a higher risk than those without the condition. The effect of high levels of insulin may cause increased blood clotting in the uterus which, in turn, leads to insufficiency of the placenta. The failure of the placenta to properly nourish the baby and remove toxic waste from the environment results in miscarriage.
Possible Causes Beyond Insulin Resistance
Insulin resistance is not the only hormonal link between PCOS and miscarriage. Some studies have found links between miscarriage and high levels of Luteinizing Hormone (LH). LH is a glycoprotein hormone that stimulates ovulation and some women with PCOS have a higher level of LH during the first half of their cycle. This signals the egg to prematurely disconnect from the supporting cells and the egg then stops maturing. This interruption in the maturation process of the egg may result in abnormal chromosomes which, in turn, increase the probability of miscarriage.
Research completed at the Virginia Commonwealth University Medical Center discovered that pregnant women with PCOS lacked high enough concentrations of two vital proteins that are found in the uterine lining: glycodelin and IGF binding protein. Both of these proteins may play a significant role in the implantation of the embryo in the uterus since their secretion occurs during pregnancy and affects the endometrium.
Don't Lose Hope
PCOS is not easy to live with and has to potential to alter a woman's life. While it is impossible to give infallible answers to the problem, there are some things a woman with PCOS can do to improve her health and reduce the risk of miscarriage. Simple dietary changes, the inclusion of a regular exercise program, reducing stress and seeking medical help in order to stabilize insulin and glucose levels are all practical steps which may increase the possibilities of a successful pregnancy and birth.