Can PCOS Cause Infertility? Symptoms, Treatment & Risk
Written By Shaheen
Medically Reviewed By Dr. Yash Bahuguna, MBBS, MS, DNB, Medical Registration No. 110281
Last Updated: 24th Feb
Read Time: 5 Min
While Polycystic Ovary Syndrome is a leading cause of infertility, it is not a diagnosis of sterility. In fact, it is considered one of the most treatable fertility challenges. Women with PCOS successfully conceive with the right clinical support and lifestyle adjustments.
Globally, PCOS affects 10% to 13% of women, making it a well-researched area of reproductive medicine. While the journey may require more intentionality, the path to parenthood remains wide open for the vast majority.
How Exactly Does PCOS Affect Fertility?
To get pregnant, a specific chain of events needs to happen.
Your hormones tell your ovaries to grow an egg.
The egg is released into the fallopian tube (Ovulation).
Sperm meets the egg.
So, can PCOS cause infertility? Yes, because it breaks this chain at step 2.
In women with Polycystic Ovary Syndrome (PCOS), hormonal imbalances (usually high Androgens or Insulin) disrupt the signal that tells the ovary to release the egg. Instead of bursting forth, the egg often stays stuck in the ovary, forming a tiny cyst.
If you don't ovulate, there is no egg for the sperm to fertilise. This is called Anovulation, and it is the main reason PCOS leads to infertility in untreated cases.
What Are the Signs That PCOS Is Affecting Your Fertility?
Not every woman with PCOS has fertility issues. Some ovulate occasionally, while others don't ovulate at all. To determine if PCOS and infertility are intersecting for you, look for these key indicators:
Irregular Periods: If your cycle is shorter than 21 days or longer than 35 days, you likely aren't ovulating regularly.
No Periods (Amenorrhea): If you go months without a bleed, you almost certainly aren't releasing eggs.
No Egg White Vaginal Discharge: Around mid-cycle, you should see clear, stretchy discharge. If you never see this, ovulation might be missing.
Note: Even if you get a period, you might not be ovulating (this is called an anovulatory cycle). If you have been trying to conceive for 6 months without success, don't wait. Consult a gynaecologist to know the reason and how to get pregnant naturally or with some treatment.
How Can I Treat PCOS for Fertility at Home?
This is where the hope comes in. Now that we know why does PCOS cause infertility (lack of ovulation), we have very effective ways to treat PCOS at home!
1. Lifestyle Changes (The First Step)
If you are overweight, losing just 5% to 10% of your body weight can be enough to restart ovulation naturally. Exercise and a low-glycemic diet help lower insulin levels, which allows your ovaries to function better.
2. Ovulation Induction Medication
If lifestyle changes aren't enough, doctors use medicine to nudge your ovaries.
Letrozole or Clomid: These are pills that trick your brain into producing more stimulating hormones, forcing the ovary to release an egg.
Metformin: Often prescribed to help with insulin resistance, which can indirectly help restart ovulation.
3. Assisted Reproductive Technology (ART)
If pills don't work, we have stronger options.
IUI (Intrauterine Insemination): Placing sperm directly inside the uterus when you ovulate.
IVF (In-Vitro Fertilisation): Taking the egg out, fertilising it in a lab, and putting it back. PCOS patients often have lots of eggs, which can actually be an advantage in IVF.
5 Facts About Managing PCOS
Many people think PCOS is just about irregular periods or difficulty losing weight, but the condition is much more complex. Understanding these lesser-known aspects can help you take better control of your health journey.
Facts About PCOS | Why It Happens | Actionable Steps for You |
It’s a Metabolic Issue, Not Just a Weight Issue | PCOS often involves insulin resistance, which changes how your body processes energy. This can make weight loss feel uphill because your hormones, not just your calories, are out of sync. | Don't focus on drastic changes. Studies show that even a modest 5-10% reduction in body weight can "reset" your system and help restart regular ovulation. |
Movement is Medicine for Your Cycle | Exercise does more than burn calories; it improves how your cells respond to insulin. This hormonal shift can actually help trigger a more regular menstrual cycle. | Aim for a "hybrid" approach. Combine 150 minutes of moderate cardio with weekly strength training to maximise your metabolic health and mood. |
Food Choice Over Calories | What you eat matters more than how much. High-sugar foods cause insulin spikes that worsen PCOS, while anti-inflammatory foods help stabilise the system. | Prioritise the "Low-GI" (Glycemic Index) approach. Think Mediterranean: lean proteins, healthy fats, and whole grains that keep your blood sugar steady. |
The Stress-Symptom Loop | High cortisol (the stress hormone) can directly interfere with your reproductive hormones, making PCOS symptoms like acne or hair growth more severe. | Make "nervous system regulation" part of your treatment. Small habits like daily mindfulness, yoga, or deep breathing can help keep your hormones in balance. |
Sleep is a Hormonal Anchor | Lack of sleep isn't just tiring; it actively worsens insulin resistance and can lead to increased cravings and weight gain, creating a cycle that’s hard to break. | Protect your "Sleep Hygiene." Try to get 7–8 hours of quality rest to help your body regulate insulin and keep your hunger hormones in check. |
If you’re working hard and still not seeing any results, maybe your body needs a plan customised to your lifestyle. For that, consult a gynaecologist, follow their plan, and you will definitely see remarkable improvements as you sincerely follow their instructions.
Are There Any Pregnancy Risks with PCOS?
While the answer to "can PCOS affect fertility?" is yes, it can also affect the pregnancy itself once you’ve successfully conceived.
Because of the hormonal and metabolic nature of the condition, women with PCOS may face a higher risk for:
Miscarriage: Hormonal imbalances or insulin issues in the early stages can sometimes lead to complications; it is important to be aware of the symptoms of miscarriage and stay in touch with your doctor.
Gestational Diabetes: A form of high blood sugar that develops during pregnancy, stemming from existing insulin resistance.
Preeclampsia: A condition characterised by high blood pressure that requires careful monitoring.
This sounds scary, but it just means your pregnancy will be monitored closely. With proper care, these risks are manageable. So, once you conceive, regularly talk to a gynecologist to discuss precautions and a tailored care plan. Your proactive health management ensures a safer pregnancy.
Conclusion
So, does PCOS cause infertility? It certainly makes the road bumpier, but it doesn't close the road completely.
Your ovaries might be a little stubborn, but they aren't broken. With the right combination of lifestyle tweaks and medical support, your dream of becoming a mother is very much achievable.
Instead of spending months worrying about your cycle, it’s best to get professional clarity. Chat with a gynecologist at Pinky Promise today. We can help you understand your ovulation patterns and start the right treatment to help you conceive.
Frequently Asked Questions (FAQs)
Q: Can I get pregnant naturally with PCOS?
Yes, absolutely. Many women with PCOS ovulate intermittently and get pregnant without any medical help. However, it might take longer than average because you have fewer "fertile windows" per year than someone with a regular cycle.
Q: Does having PCOS mean I am infertile forever?
No. PCOS is a treatable condition. It is a cause of sub-fertility (delayed conception), not usually permanent sterility. Most women with PCOS will be able to have children, either naturally or with medication.
Q: How do I know if I am ovulating?
You can use Ovulation Prediction Kits (OPKs) (though these can sometimes give false positives in PCOS), track your Basal Body Temperature (BBT), or visit a doctor for a Follicular Study (ultrasound) to see the egg growing in real-time.
Q: Does removing ovarian cysts cure infertility?
Not necessarily. The cysts in PCOS are actually tiny, immature follicles, not harmful cysts that need removing. Surgery (Ovarian Drilling) is rarely done nowadays and only as a last resort if medication fails.
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