PCOS is the most common hormonal cause of infertility — and one of the most treatable. Understanding it is the first step to getting pregnant.
Polycystic Ovary Syndrome (PCOS) affects roughly 1 in 10 women of reproductive age. It is diagnosed when at least two of three features are present: irregular cycles, signs of excess androgens, and polycystic-looking ovaries on ultrasound.
How PCOS Affects Fertility
PCOS disrupts the hormonal signals that trigger ovulation. Without regular ovulation, conception is unpredictable. Many women with PCOS conceive naturally; others need help restoring ovulation with lifestyle changes, medication or assisted reproduction.
First-Line Treatment: Lifestyle
A loss of even 5–10% of body weight can restore regular cycles in many women. A low-glycaemic diet, 150 minutes of moderate exercise a week, and stress management are foundational — and often surprisingly effective.
Medical Treatment
Letrozole is now the first-line ovulation induction medicine for PCOS, having largely replaced clomiphene. Metformin may be added if insulin resistance is present. If oral medication does not lead to ovulation or pregnancy, gonadotropin injections or IVF are the next steps.
Long-Term Care
PCOS care extends beyond fertility — it also lowers long-term risk of type 2 diabetes, endometrial issues and cardiovascular disease. Annual screening and a sustainable lifestyle plan are worth the investment, whether or not you are trying to conceive.
PCOS is a manageable condition, not a barrier to motherhood. With the right plan, the vast majority of women with PCOS go on to have healthy pregnancies.
Have questions about your own journey?
A relaxed first conversation with Dr. Maheshwari can give you clarity, options and a plan tailored to you.
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