Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine system disorders, affecting one in ten women of reproductive age — as many as five million women in the US.
In a normal monthly cycle, follicles (immature eggs) develop and one egg is released into the fallopian tube during ovulation. In women with PCOS, the hormones needed for an egg to fully mature are not present, preventing ovulation from occurring and causing cysts to form on the ovaries.
What are the symptoms of PCOS?
Common symptoms include:
- Irregular or no menstrual periods
- Acne
- Obesity/weight gain/inability to lose weight
- Breathing problems while sleeping
- Depression
- Oily skin
- Infertility
- Skin discolorations
- High cholesterol levels
- Elevated blood pressure
- Excess or abnormal hair growth
- Pain in the lower abdomen and pelvis
- Multiple ovarian cysts
- Skin tags
Some women experience only a few symptoms, while others may have several.
Related: Fungal Infections
How does PCOS affect fertility?
Not all women with PCOS have difficulty becoming pregnant. For those who do, infrequent ovulation is a common cause. Ovulation — required to achieve pregnancy — can be induced through medication.
How is PCOS diagnosed?
There is no specific test to definitively diagnose PCOS, which is why it is commonly misdiagnosed. In addition to evaluating symptoms, a doctor may:
- Perform blood tests to assess hormone levels
- Use an ultrasound to check for ovarian cysts
Diagnosis also involves ruling out other conditions such as adrenal diseases.
Are some ethnicities more prone to PCOS?
PCOS is found among all ethnicities. However, it is more common in Hispanic women (13–14%) compared to Caucasian women (5%).
Other medical conditions such as sleep apnea, cardiovascular disease, diabetes, and issues with insulin resistance or metabolism can also increase PCOS risk.
If I have PCOS, should I see a fertility doctor before trying to conceive?
Yes. If you're not ovulating regularly, it's best to consult a specialist. With the right medication and lifestyle changes, ovulation can be induced, increasing chances of conception.
What can I do on my own to lessen PCOS symptoms?
Lifestyle changes — diet, exercise, and weight management — can significantly reduce symptoms and improve fertility.
Tips include:
- Stay active (30 minutes, 3 times a week)
- Drink plenty of water
- Avoid sugary drinks
- Choose whole grains
- Use unsaturated vegetable oils (e.g., walnuts, avocado)
- Prefer berries over sweets
- Eat greens rich in folate (e.g., spinach)
- Include ½ cup of beans daily
- Drink whole milk (not skim milk)
- Focus on low-carb and "good" carb choices
A 5–10% weight loss can significantly improve pregnancy rates if your BMI is over 30.
How is ovulation stimulated?
Ovulation is often stimulated using oral medications such as:
- Clomiphene Citrate
- Letrozole
Typically taken once a day for five days, these medications may be paired with intrauterine insemination (IUI) to boost pregnancy chances.
If unsuccessful, injectable hormones like FSH or in vitro fertilization (IVF) may be recommended.
Will my chances of multiples go up because of the medication?
Yes. Ovulation medication can lead to multiple eggs being released, increasing the chance of twins or more.
It’s best to work with a fertility specialist to monitor your cycle and manage the risks. IVF with single embryo transfer is a safe option to avoid multiples.
What is a common fertility treatment protocol for a PCOS woman?
- Start with lifestyle changes to reduce symptoms
- Induce ovulation with medication
- Try up to three IUI cycles
- If unsuccessful, proceed with IVF, which offers higher success rates
