PCOS & Infertility: Breaking Down the Barriers

Have you ever thought about the lesser-known causes of infertility? Polycystic Ovary Syndrome (PCOS) is one of the leading causes of infertility in women, primarily because it disrupts normal ovulation. Women with PCOS often experience irregular or absent menstrual cycles, which means eggs are not released consistently for fertilisation.

A PMC study suggests insulin resistance, a common feature of PCOS, can worsen hormonal imbalance and contribute to fertility problems. In some cases, the ovaries may develop multiple small cysts, which further impact the release of eggs. Beyond ovulation, PCOS can also affect the quality of eggs and the uterine environment, making it harder for pregnancy to occur naturally.

While PCOS can be challenging, it’s important to remember that many women with the condition are still able to conceive, especially with proper diagnosis, treatment, and supportive lifestyle changes. In an exclusive conversation with Onlymyhealth, Dr Preetinder Kaur Bedi, Senior Consultant- Obstetrics & Gynecology at Apollo Cradle & Children’s Hospital, Motinagar, Delhi shared significant information about PCOS and fertility link.

Diagnosing Infertility In Women With PCOS

Diagnosing infertility in women with PCOS involves a thorough and thoughtful approach.
The first step is usually a detailed medical history, where the doctor asks about menstrual cycles, weight changes, symptoms such as excessive hair growth or acne, and any difficulties conceiving.

Blood tests are often recommended to check hormone levels, including reproductive hormones, thyroid function, and blood sugar or insulin levels, as insulin resistance is common in PCOS.
Ultrasound imaging of the ovaries is another important tool, as it can reveal the presence of multiple small follicles typical of PCOS.

Alongside these investigations, doctors also assess other potential causes of infertility, such as blocked fallopian tubes or male factor infertility, to ensure no contributing factor is overlooked. By combining these findings, doctors can provide a clear picture of whether PCOS is the primary factor and create a tailored plan to address fertility challenges.

Also Read: Diagnosed With PCOS After Moving To Canada: Here’s How 22-Year-Old Bhavya Gulati Took Control and Reversed It

Available Treatment Options To Improve Fertility Outcomes In PCOS Patients

As per Dr Bedi, “There are several effective treatment options available for women with PCOS who are trying to conceive, and the choice depends on individual needs and medical history.”
For many, the first step includes lifestyle modifications like healthy diet, exercise, and weight management, which can restore more regular ovulation.

• In some cases, gonadotropin injections may be recommended if oral medications are not successful.
• For women who don’t respond to these options, assisted reproductive technologies like in vitro fertilization (IVF) can provide a path to pregnancy.
• If insulin resistance is a concern, medications like metformin may also be used to improve hormonal balance and ovulation.
• Surgical options, such as ovarian drilling, are rarely needed but may be considered in specific cases.

With a personalized approach, many women with symptoms of PCOS are able to successfully conceive, and doctors work closely with patients to choose the safest and most effective option.

Can lifestyle modifications such as diet, exercise, and weight management significantly improve fertility in women with PCOS?

“Yes, lifestyle modifications can have a powerful impact on fertility for women with PCOS,” answers Dr Bedi.

• Even a modest weight loss of 5–10% can help restore regular menstrual cycles and improve the chances of ovulation, a PubMed Central study finds.
• A balanced diet rich in whole grains, lean proteins, fruits, and vegetables supports hormonal health and can help manage insulin resistance, which is often linked to PCOS.
• Similarly, exercise, both aerobic and strength-based, not only aids weight management but also improves insulin sensitivity, reduces stress, and balances hormone levels.
• These changes can make ovulation more predictable, enhancing fertility naturally. Beyond physical health, lifestyle adjustments often help women feel more in control of their condition, improving emotional well-being too.

Also Read: Can PCOS Put Women At Risk Of Cardiovascular Disease? Here's What We Know

PCOS And Fertility Treatments: What Are Their Success Rates?

According to Dr Bedi, “Fertility treatments for women with PCOS such as ovulation induction and IVF are highly effective options for women with PCOS. Ovulation induction involves using medications like letrozole or clomiphene citrate to stimulate the ovaries to release eggs. This helps create a predictable window for fertilization, either through natural conception or assisted techniques like intrauterine insemination (IUI).”

Success rates with ovulation induction are encouraging, particularly in younger women and those who respond well to the medications. For women who don’t conceive with these methods, IVF (in vitro fertilization) may be recommended.

In IVF, eggs are retrieved from the ovaries, fertilized with sperm in a laboratory, and the resulting embryos are transferred into the uterus. IVF success rates in PCOS patients are generally comparable to or slightly better than women with other fertility issues, especially when careful monitoring reduces risks such as ovarian hyperstimulation.

Both treatments offer hope, and doctors help patients choose the right path based on age, overall health, and specific fertility goals.

Emotional Or Psychological Challenges Faced By Women With PCOS-Related Infertility

Women with PCOS-related infertility often face significant emotional and psychological challenges. The unpredictability of their cycles and repeated difficulties in conceiving can cause stress, frustration, and feelings of inadequacy. Many women also struggle with body image concerns due to weight gain, acne, or excessive hair growth associated with PCOS, which can further impact self-esteem.

Also Read: Mental Health In Fertility: Expert Explains The Role Of Counsellors In IVF

The emotional toll may include anxiety, depression, or strained relationships with partners and family members.

“As doctors, it is essential to recognize these challenges and create a safe, compassionate space for women to share their concerns. Counseling and support groups can be recommended to help women feel less isolated in their journey. Emotional support, combined with clear communication about treatment options and realistic expectations, can empower women to make informed choices without added pressure. By addressing both physical and emotional health, doctors can provide truly holistic care for women navigating infertility with PCOS,” shares Dr Bedi.

Importance Of Personalised, Compassionate Care In Managing PCOS-Related Infertility

Personalised care is crucial when managing PCOS-related infertility because every woman’s experience is unique. No two patients present with the exact same symptoms, challenges, or treatment responses, so a one-size-fits-all approach rarely works.

Dr Bedi quotes, “Compassionate care begins with truly listening, understanding a woman’s concerns, her emotional state, and her hopes for motherhood. It means tailoring treatment plans that not only address medical needs but also respect personal preferences, lifestyle, and cultural values.”

In practice, this may involve combining medical treatments with guidance on lifestyle changes, offering emotional support through counseling, and maintaining open communication at every step. Compassion also means being sensitive to the emotional burden of infertility and reassuring women that they are not alone in their journey.

Final Word

By integrating empathy with evidence-based medicine, doctors can build trust and partnership with their patients, ultimately improving both fertility outcomes and the overall experience of care.