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Pregnant women with PCOS should be followed for the development of gestational diabetes and hypertension since insulin resistance and/or increased glucose intolerance place a woman at higher risk for pregnancy complications.

It is important for the pregnant woman with PCOS to eat a healthy, balanced diet so that the mother and baby receive all important nutrients. A specialized diet should never be undertaken (e.g. low carbohydrate) without consultation with a doctor. A nutritionist can also be helpful in terms of relevant guidance for healthy diet during pregnancy.

There is little agreement regarding treatment with metformin during pregnancy. Some doctors will not prescribe it if a woman is trying to conceive while others may discontinue it only at various stages of pregnancy. There is increasing evidence that metformin may reduce the risk of miscarriage and gestational diabetes.

Although it is known that healthy babies have been born to mothers taking metformin during pregnancy, studies are lacking to clearly assess the long term risks of metformin on the newborn infant. The US Food and Drug Administration has classified metformin as a Pregnancy Category B medication, meaning that it is unlikely to harm the fetus.

The glitazones, Avandia (rosiglitazone) and Actos (pioglitazone) are categorized as Pregnancy Category C which means that it is not known if this class of drugs may harm the fetus.

Most medications pass through mother's milk, and therefore, when a woman is breast-feeding, she must discuss continuation of any medication with her health care provider. Some physicians either reduce or discontinue insulin-sensitizing medication when a woman is breast-feeding.

It is interesting to note that following pregnancy, some women with PCOS develop regular menses and find it easier to subsequently conceive.