University of Oulu

Bahri Khomami, M., Teede, H. J., Joham, A. E., Moran, L. J., Piltonen, T. T., & Boyle, J. A. (2022). Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion. Clinical Endocrinology, 97(2), 227–236.

Clinical management of pregnancy in women with polycystic ovary syndrome : an expert opinion

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Author: Khomami, Mahnaz Bahri1; Teede, Helena J.1,2; Joham, Anju E.1,2;
Organizations: 1Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Level 1, 43-51 Kanooka Grove, Australia
2Monash Health, Melbourne, Australia
3Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2022-11-02


Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS. The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health. PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy-related risk profile should ideally be assessed for modifiable risk factors (e.g., lifestyle and weight management) at preconception in women with PCOS. Hyperglycaemia should be screened using a 75-g oral glucose tolerance test at preconception or within the first 20 weeks of pregnancy if it has not been performed at preconception and should be repeated at 24–28 weeks of pregnancy. In the absence of evidence of benefit for strategies specific to women with PCOS, the international evidence-based guidelines for the assessment and management of PCOS recommend screening, optimizing, and monitoring risk profile in women with PCOS (at preconception, during and postpregnancy) consistent with the recommendations for the general population. Recommended factors include blood glucose, weight, blood pressure, smoking, alcohol, diet, exercise, sleep and mental health, emotional, and sexual health among women with PCOS. The guidelines recommend Metformin in addition to lifestyle for assisting with weight management and improving cardiometabolic risk factors, particularly in those with overweight or obesity. Letrozole is considered the first-line pharmacological treatment for anovulatory infertility in PCOS. Individualized approach should be considered in the management of pregnancy in PCOS.

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Series: Clinical endocrinology
ISSN: 0300-0664
ISSN-E: 1365-2265
ISSN-L: 0300-0664
Volume: 97
Issue: 2
Pages: 227 - 236
DOI: 10.1111/cen.14723
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3123 Gynaecology and paediatrics
Funding: This manuscript did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. MBK was funded by the Australian government's Medical Research Future Fund (MRFF), which supports health and medical research and innovation to improve the health andwell-being of Australians. HT was funded by a fellowship from the National Health and Medical Research Council (NHMRC)/MRFF. AJ was funded by a fellowship from the The Centre for Research Excellence in Women's Health in Reproductive Life (CRE WHiRL). LM was funded bya fellowship from the National Heart Foundation (NHF). TP was funded by Academy of Finland (Grant Numbers: 315921, 321763), Novo Nordisk Foundation and Juselius Foundation. Open access publishing facilitated by Monash University, as part of the Wiley - Monash University agreement via the Council of Australian University Librarians.
Academy of Finland Grant Number: 315921
Detailed Information: 315921 (Academy of Finland Funding decision)
321763 (Academy of Finland Funding decision)
Copyright information: © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.