We spoke to Dr Nandita Palshetkar, Scientific Director & Head of the Bloom IVF Unit at Lilavati Hospital, Mumbai, and Medical Director of Bloom IVF Centres, for expert insight on this condition.
Causes of Cushings Syndrome
Cushing's syndrome develops when the body is exposed to high cortisol for a long period.Common causes include:
- A pituitary tumour (Cushing's disease)
- An adrenal gland tumour
- A tumour elsewhere in the body that produces adrenocorticotropic hormone (ACTH)
- Long-term use of steroid medicines
How Cushings Syndrome Affects Fertility and Ovulation
Excess cortisol suppresses gonadotropin-releasing hormone, which in turn lowers luteinising hormone (LH) and follicle-stimulating hormone (FSH), restricting ovulation. The adrenal glands may also make extra androgens, which add to the disruption. Most women with active Cushing's syndrome develop:- Irregular or absent periods
- Reduced or absent ovulation
- Lower fertility
- Increased androgen levels in some cases
Cushing's Syndrome Symptoms Often Mistaken for PCOS or Pregnancy
Cushing's syndrome overlaps with PCOS and with pregnancy changes. Symptoms include:- Weight gain on the face, neck, and abdomen, with thin arms and legs
- Wide purple stretch marks
- Irregular or absent periods
- Acne and excess facial or body hair
- Easy bruising and thin skin
- Muscle weakness, especially in the thighs and shoulders
- High blood pressure and high blood sugar
- Bone pain or fractures
- Low mood and poor sleep
Excess cortisol can interfere with ovulation and fertility, and hence if a woman with active Cushing's syndrome is considering pregnancy, the priority should be to diagnose and control the underlying condition.
Risks of Cushing's Syndrome in Pregnancy
Pregnancy with active Cushing’s syndrome requires close monitoring because excess cortisol can affect several organs and pregnancy-related systems.For the mother:
- High blood pressure and pre-eclampsia
- Gestational diabetes
- Heart failure
- Bone fractures
- Blood clots
- Infections and slow wound healing
- Miscarriage
- Preterm birth
- Low birth weight
- Slow growth in the womb
- Stillbirth
Cushing's Syndrome Treatment During Pregnancy
Treatment to control excess cortisol is generally preferred before attempting pregnancy. European guidance recommends avoiding pregnancy while Cushing’s syndrome remains active because of the increased maternal and foetal risks.Treatment depends on the cause, severity, and stage of pregnancy.
- Surgery: Removal of the adrenal or pituitary tumour, usually in the second trimester, when surgical risk is lower.
- Medicine: Metyrapone is the most commonly used drug. Ketoconazole is generally avoided, and mifepristone is contraindicated because it can end a pregnancy.
- Supportive care: Control blood pressure and blood sugar, schedule regular growth scans, and deliver at a high-risk pregnancy centre.
Getting Pregnant After Cushing's Syndrome Treatment
Periods and ovulation often return after cortisol levels normalise. After surgery, the body may need hydrocortisone replacement until the adrenal glands recover.Doctors generally advise conceiving once hormone levels are stable and blood pressure, blood sugar, and bone health are optimised.
If periods do not return, ovulation induction or IVF may be considered. Cushing's disease can recur, so follow-up tests continue after treatment.
Cushing's Syndrome in India: Steroid Misuse and Delayed Diagnosis
Long-term steroid use is a frequent cause of Cushing's syndrome. Common sources include:- Oral steroids bought without a prescription
- Unlabelled herbal or "joint pain" powders that contain steroids
- Strong steroid skin creams used for long periods
Pregnancy with Cushing's syndrome is possible, but the safest outcomes follow early diagnosis, treatment, and specialist-led care.
You’re not alone in your journey when trying to conceive. Join our supportive community to connect with others, share experiences, and find encouragement every step of the way.
FAQs on Can You Get Pregnant with Cushing's Syndrome?
- Can Cushing's syndrome cause infertility?
Yes. High cortisol can stop ovulation and disrupt periods. Fertility often improves after treatment. - Is it safe to have a baby with Cushing's syndrome?
Pregnancy carries higher risks for mother and baby. Planning pregnancy after treatment, or with specialist monitoring, lowers these risks. - How long after Cushing's treatment can you conceive?
The time varies. Periods may return within months, but doctors usually advise waiting until hormone levels are stable.
