PCOS and Infertility- What to Know in 2025

Polycystic ovary syndrome (PCOS), is one of the most common causes of ovulatory disorders, accounting for up to 85% of diagnoses. PCOS not only impacts reproductive health but can also affect long-term wellness. In this updated post, we’ll explore what PCOS is, how it can influence fertility, and the latest insights into treatment and management.

PCOS is a hormone disorder that affects an estimated 5–10% of women of reproductive age. Like all syndromes, it is defined as a group of symptoms that occur together. Not everyone with PCOS experiences the same issues, but a diagnosis typically requires at least two of the following three criteria:

Because symptoms vary, some individuals may not realize they have PCOS until they seek care for infertility or irregular periods.

Hormonal imbalance associated with PCOS can interfere with ovulation, making it harder to conceive. This imbalance can cause:

These factors may lead to irregular or missed periods, one of the most common signs of disrupted ovulation.

Diagnosis is usually made through a combination of:

Some of the risks are related to a woman not ovulating regularly. When ovulation doesn’t happen, it interrupts the usual hormone cycle and causes the lining of the uterus to be exposed to constant levels of estrogen. This can encourage the lining to become too thick and cause abnormal bleeding. It also may lead to uterine cancer or pre-cancerous changes. This lack of regular ovulation can also make it difficult to get pregnant. Metabolic syndrome is common in women with PCOS. Symptoms include extra weight around the middle, high cholesterol, high blood pressure, and insulin resistance/diabetes. Each of these symptoms raises the risk of heart disease. Obesity is common in women with PCOS.

One way to treat infertility is to cause ovulation using medicine. Clomiphene citrate is taken by mouth and is usually tried first. Letrozole is another oral medicine that is sometimes used and can be particularly helpful with patients with PCOS. If this is unsuccessful, injected fertility medicines called gonadotropins may be given to stimulate the growth of an egg. Women with PCOS must be watched very carefully when these medicines are used to make sure that they are not responding too much. If a woman is overweight, losing weight can help improve ovulation patterns and fertility.

Insulin-sensitizing medicines such as metformin can help the body use insulin more effectively to improve ovulation. This may also lower the risk of developing diabetes or metabolic syndrome. Aromatase inhibitors, such as letrozole, are sometimes used in women with PCOS who desire fertility. In vitro fertilization (IVF) may help women with PCOS get pregnant if other treatments do not work. Treatment should be tailored to each woman’s needs, symptoms, and particular situation and may change over time. Talk with your healthcare provider to find out the best approach for you.

PCOS is a condition that involves a hormonal imbalance that can interfere with ovulation. Some people with PCOS have difficulty getting pregnant. There are effective treatments, though. With medical intervention, many people with fertility problems due to PCOS are able to conceive. It’s also important to note that PCOS doesn’t mean you can never get pregnant.

Source:
https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/polycysticovary-syndrome-pcos