Polycystic Ovary Syndrome (PCOS) is one of the most common — and most treatable — causes of infertility. Here's how Dr. Kavya approaches PCOS-related fertility care.
Polycystic Ovary Syndrome (PCOS) is a common hormonal condition affecting how the ovaries function. It is characterised by irregular or absent ovulation, higher-than-typical levels of androgens (male hormones), and often the presence of multiple small follicles on the ovaries seen on ultrasound. PCOS affects a significant proportion of women of reproductive age and is one of the leading, but most manageable, causes of infertility.
Diagnosis is generally based on the Rotterdam criteria, requiring at least two of the following three findings, after other conditions have been ruled out: irregular or absent ovulation, clinical or biochemical signs of excess androgens, and polycystic-appearing ovaries on ultrasound. Diagnostic workup typically includes a hormone panel (LH, FSH, testosterone, AMH, TSH, prolactin), a fasting insulin/glucose assessment, and a pelvic ultrasound.
The core fertility challenge in PCOS is anovulation — the ovaries do not reliably release a mature egg each month — which makes the timing of conception unpredictable or impossible without treatment. Insulin resistance, common in PCOS, can further disrupt hormonal balance and ovulation. Importantly, PCOS affects ovulation, not egg quantity — most women with PCOS actually have a healthy, sometimes even higher, ovarian reserve, which is encouraging for treatment.
Dietary changes, regular physical activity, and weight management are foundational — improving insulin sensitivity often restores ovulation on its own.
Oral medications are typically used first to stimulate ovulation, with response tracked via ultrasound; injectable gonadotropins are used if oral options aren't effective.
For women with significant insulin resistance, metabolic management can directly improve ovulatory function.
If ovulation induction alone doesn't lead to pregnancy, or other factors are present, IUI or IVF may be recommended as the next step.
For tailored, medically supervised guidance on weight management and nutrition during fertility treatment, this should always be discussed directly with your care team rather than followed generically — individual needs vary widely with PCOS.
Yes — many women with PCOS conceive naturally, especially with lifestyle changes that improve ovulation. Others need ovulation induction or further fertility treatment, depending on severity.
Lifestyle modification (weight and insulin management) combined with oral ovulation-induction medication is typically the first-line approach, with injectable options or IUI/IVF considered if needed.
For women with PCOS who are overweight, even a modest 5–10% reduction in body weight can meaningfully improve ovulation and the chances of natural or assisted conception.
PCOS is typically diagnosed using a combination of irregular or absent periods, signs of excess androgen (such as acne or excess hair growth), and ultrasound findings of polycystic ovaries, after ruling out other conditions.
Women with PCOS often respond well to ovarian stimulation due to a higher antral follicle count, though they need careful protocol selection to reduce the risk of ovarian hyperstimulation syndrome (OHSS).