PCOS and Fertility

🌼 Understanding PCOS and Its Impact on Fertility

Polycystic Ovary Syndrome, or PCOS, is one of the most common hormonal conditions affecting people of reproductive age—and it’s also one of the leading causes of infertility. The good news? With the right care and support, many people with PCOS go on to have healthy pregnancies.

1. What Is PCOS?

PCOS stands for Polycystic Ovary Syndrome. Despite the name, it doesn’t always mean you have cysts on your ovaries. Instead, PCOS is a hormonal imbalance that affects how the ovaries function.

It’s typically diagnosed when at least two of the following three signs are present:

1. Irregular or absent ovulation (causing missed or unpredictable periods)

2. High levels of androgens (male-type hormones like testosterone)

3. Polycystic-appearing ovaries on ultrasound (many small follicles that haven’t fully matured)

Because hormones play a big role in ovulation, PCOS can make it harder to release eggs regularly, leading to challenges with fertility.

2. What Are the Symptoms?

Symptoms can vary widely, but common signs include:

• Irregular or missed menstrual cycles

• Acne or oily skin

• Unwanted hair growth on the face, chest, or abdomen

• Hair thinning on the scalp

• Weight gain or trouble losing weight

• Difficulty getting pregnant

Some people also experience fatigue, cravings, or mood changes due to insulin resistance—another common feature of PCOS.

3. How PCOS Affects Fertility

PCOS can interfere with regular ovulation, which is necessary for conception. The hormonal imbalance—especially higher levels of LH (luteinizing hormone) and androgens—can prevent follicles from maturing and releasing eggs.

Even when ovulation happens, the hormonal environment may not support proper egg development or implantation, making conception more difficult without treatment.

4. How PCOS Is Diagnosed

There’s no single test for PCOS. Diagnosis usually combines blood tests, ultrasound, and a review of symptoms and menstrual history.

Common evaluations include:

• Ultrasound: Checks for multiple small follicles in the ovaries.

• Blood tests: Measure hormone levels that affect ovulation and metabolism.

• Metabolic screening: Tests for insulin resistance or blood sugar imbalance, which often accompany PCOS.

  
  

🧪 Test Values Explained: Understanding Your PCOS Hormone Profile

Test	What It Measures	Typical Findings in PCOS	Typical Range
LH (Luteinizing Hormone)	Signals ovulation	Often elevated	Normal LH:FSH ratio ≈ 1:1; in PCOS it may be 2:1 or 3:1
FSH (Follicle-Stimulating Hormone)	Stimulates egg growth	Normal or low	3–10 mIU/mL
Total Testosterone	Androgen hormone	Elevated	<50 ng/dL
Free Testosterone	Active androgen level	Elevated	<3.0 pg/mL
AMH (Anti-Müllerian Hormone)	Egg reserve / follicle number	High (many small follicles)	Often >4.0 ng/mL
Insulin & Glucose	Metabolic balance	High insulin or insulin resistance common	Fasting insulin <10 µIU/mL; glucose <100 mg/dL

➡️ A pattern of higher LH, testosterone, and AMH—with irregular periods—often points toward PCOS, but your doctor will interpret these results in the context of your full health picture.

5. What Can Be Done to Help

While PCOS can’t be “cured,” there are many effective ways to manage symptoms and improve fertility:

💊 Lifestyle and Medical Approaches

• Balanced nutrition and regular movement: Even small weight changes can help restore ovulation.

• Metformin: Improves insulin sensitivity and helps regulate cycles.

• Hormonal birth control: Regulates periods and balances hormones for those not trying to conceive.

  
  

🌱 Fertility Treatments

• Ovulation induction: Medications like letrozole (Femara) or clomiphene citrate (Clomid) help trigger egg release.

• In vitro fertilization (IVF): A great option for those who don’t ovulate regularly or need a more controlled process.

• Egg freezing: For those not ready to conceive yet but want to preserve fertility.

  
  

6. What to Expect During Treatment

People with PCOS often respond differently to fertility medications, so careful monitoring is key. Your care team may adjust medication doses, track hormone levels, and perform regular ultrasounds to support safe and successful treatment.

Working with a clinic experienced in PCOS fertility care ensures you get a personalized plan that balances both hormone health and emotional well-being.

💗 The Takeaway:

PCOS is one of the most common—and most treatable—causes of infertility. With early testing, personalized care, and a holistic approach that supports both body and mind, many people with PCOS go on to have healthy pregnancies.

If you think you may have PCOS or are struggling to conceive, reach out to a fertility specialist. The first step toward clarity and hope is understanding your hormones.