Pregnancy considerations in women with polycystic ovary syndrome

Women with polycystic ovary syndrome (PCOS) are subfecund, and while anovulatory infertility is most likely the primary cause, other factors may contribute. Recent data suggest that women with PCOS are at increased risk for preterm labor, preeclampsia, and gestational diabetes, though the evidence for increased miscarriage rates is less certain. There is no evidence-based schema for achieving pregnancy in women with PCOS, though lifestyle modification, clomiphene citrate, and metformin are the current front line therapies. There are few data to support treatment during pregnancy with metformin in women with PCOS to prevent pregnancy loss or pregnancy complications.