Women’s Health followed women born 1973–78 over 25 years to compare fertility outcomes in women with and without PCOS. Women with PCOS had fewer children, were more often nulliparous, and had their first and second childbirths at later ages compared to women without PCOS. Advanced maternal age (≥35 years) at first childbirth was more common in women with PCOS and was further associated with increased pregnancy complications, such as gestational diabetes. Importantly, a late diagnosis of PCOS nearly doubled the odds of advanced maternal age at first childbirth, emphasizing the need for earlier identification and reproductive planning in PCOS patients.
Key Points
PCOS Prevalence: About 9.9% of women reported a PCOS diagnosis by age 43–48 in this cohort.
Fertility and Parity:Â Women with PCOS had fewer children (mean 1.7 vs. 1.9) and higher nulliparity (23% vs. 18%) despite similar desires for family size.
Age at Childbirth:Â Women with PCOS gave birth later for first (29.5 vs. 28.8 years) and second children (32.1 vs. 31.1 years) and had longer intervals between pregnancies.
Advanced Maternal Age: Women with PCOS had higher odds of giving birth at age ≥35 (adjusted OR 1.34), which is linked to increased gestational diabetes risk (adjusted OR 3.90).
Influence of PCOS Diagnosis Timing:Â Late PCOS diagnosis (>30 years) doubled the odds of advanced maternal age at first childbirth, highlighting the fertility benefits of earlier diagnosis.
Infertility Treatments:Â Women with PCOS underwent significantly more IVF and ovulation induction treatments.
Clinical Implications: Early PCOS diagnosis and timely reproductive counseling are crucial to mitigate risks and manage infertility effectively.
"Women with PCOS face higher infertility and delayed childbirth; earlier diagnosis can reduce advanced maternal age-related risks."
