How PCOS Affects Fertility and Ways to Manage It

If you've been struggling with irregular cycles, unexpected weight gain, or difficulty getting pregnant, PCOS may be a factor — but with the right knowledge and support, it can be effectively managed.
In this blog, we’ll break down what PCOS is, how it affects ovulation and fertility, what symptoms to watch for, and what you can do — both naturally and medically — to improve your chances of conception. Whet
What Is PCOS & How It Affects Fertility
What Is PCOS (Polycystic Ovary Syndrome)?
PCOS is typically characterized by three main features:
- Elevated androgen levels: These are often referred to as “male hormones,” and in excess, they can cause symptoms like acne, facial hair growth, and hair thinning.
- Irregular or absent ovulation: Women with PCOS may not release an egg (ovulate) regularly, making menstrual cycles unpredictable or absent altogether.
- Polycystic ovaries: On ultrasound, the ovaries may appear enlarged with many small fluid-filled sacs (follicles) that fail to mature and release an egg.
How PCOS Impacts Ovulation and Fertility
Here’s how PCOS affects fertility:
- Irregular or absent ovulation- Without regular ovulation, there’s no egg released for fertilization. This makes it difficult for women with PCOS to conceive naturally.
- Hormonal imbalance- PCOS disrupts the balance between key reproductive hormones (LH, FSH, estrogen, progesterone), leading to poor follicle development and failed ovulation.
- Insulin resistance- Many women with PCOS also have insulin resistance, where the body doesn’t respond properly to insulin. This can cause the ovaries to produce even more androgens, worsening hormonal imbalances and further disrupting ovulation.
- Unpredictable cycles- Women with PCOS may experience long menstrual cycles, skipped periods, or no periods at all, making it harder to track ovulation and plan pregnancy.
Recognizing the Symptoms & Getting Diagnosed
Common Symptoms of PCOS
PCOS affects many aspects of a woman’s health — from her menstrual cycle to her skin and weight. Here are the most common symptoms women with PCOS may experience:
- Irregular periods: Infrequent, heavy, or skipped periods are common due to disrupted ovulation.
- Acne & oily skin: Elevated androgen levels can trigger breakouts, especially along the jawline and cheeks.
- Weight gain: Many women with PCOS gain weight easily, particularly around the abdomen.
- Hair growth: Known as hirsutism, excess hair appears on the face, chin, chest, or abdomen.
- Thinning scalp hair: Hair may become thinner or fall out, resembling male pattern baldness.
- Infertility: Caused by irregular or absent ovulation, which makes conception difficult.
How PCOS Is Diagnosed
Common methods used to diagnose PCOS include:
Pelvic Ultrasound: A transvaginal ultrasound is used to examine the ovaries for the presence of multiple small follicles or cysts, as well as to assess ovarian size and endometrial thickness.
Hormonal Blood Tests: These tests check for imbalances in hormones such as:
- LH (Luteinizing Hormone) & FSH (Follicle-Stimulating Hormone)
- Testosterone (androgens)
- Insulin levels (to detect resistance)
- AMH (Anti-Müllerian Hormone) — often elevated in PCOS
- Thyroid hormones and prolactin to rule out other causes of irregular cycles
How to Manage PCOS & Improve Fertility Naturally
Let’s explore simple, natural ways to take control of PCOS and enhance fertility.
Diet Changes That Help With PCOS
Your diet plays a major role in balancing hormones, reducing insulin resistance, and supporting ovulation.
Focus on:
- Low glycemic index (GI) foods to stabilise blood sugar levels
- High-fibre vegetables like spinach, kale, and broccoli
- Berries, nuts, seeds, legumes, and lean proteins (e.g., chicken, tofu, eggs)
- Healthy fats like avocado and olive oil
- Refined carbs like white bread, pasta, and pastries
- Sugary snacks and drinks
- Processed foods high in unhealthy fats
- Excess dairy, which may aggravate acne and insulin levels in some women
Exercise & Weight Management
Even modest weight loss can have a significant impact on hormone regulation and ovulation in women with PCOS.
- Just 5–10% weight loss can improve insulin sensitivity and restart ovulation.
- Exercise helps reduce inflammation and manage stress, which impacts fertility.
- Walking or brisk walking (30 minutes daily)
- Strength training (2–3 times/week)
- Yoga or Pilates for stress relief and hormone balance
- HIIT (High-Intensity Interval Training) — effective in short bursts
Supplements That Support PCOS & Fertility
Recommended options include:
- Inositol (myo- and d-chiro) – Helps regulate insulin, restore ovulation, and improve egg quality
- Vitamin D – Commonly low in PCOS; supports fertility and hormone regulation
- Omega-3 fatty acids – Fight inflammation and support reproductive hormone balance
- Zinc & Magnesium – Important for egg development and metabolism
- Chromium – Helps control blood sugar levels and improve insulin sensitivity
Medical Treatments & Fertility Options for PCOS
Let’s break down the most common medical and fertility interventions for PCOS:
Medications That Help with Ovulation
If you're not ovulating regularly, certain medications can gently stimulate your ovaries to release eggs, increasing your chances of conception. Commonly used medications:
- Clomiphene citrate (Clomid) or Letrozole
First-line oral medications that trigger ovulation by acting on your brain's hormone signals. Letrozole is often preferred in women with PCOS for its higher success rates. - Metformin
Originally a diabetes medication, Metformin helps improve insulin resistance, regulate cycles, and sometimes restore spontaneous ovulation. - Gonadotropins
Injectable hormone treatments are used when oral medications don’t work or on patients undergoing IVF. These require close monitoring via ultrasound to avoid overstimulation. - Birth control pills (if not trying to conceive)
Help regulate periods, lower androgen levels, and control symptoms like acne and excess hair growth.
Fertility Treatments for Women With PCOS
Common fertility options include:
- Intrauterine Insemination (IUI): Involves placing sperm directly into the uterus around ovulation. Often combined with ovulation-inducing medication for better timing.
- In Vitro Fertilization (IVF): Offers higher success rates, especially when other methods fail. Eggs are retrieved from your ovaries, fertilized with sperm in the lab, and a healthy embryo is transferred to the uterus. IVF can be especially helpful for PCOS patients with multiple eggs or poor cycle regulation.
- Ovarian Drilling (rare and usually a last resort):
PCOS may be a lifelong condition, but it doesn’t have to stand in the way of your fertility goals. With the right diagnosis, personalized treatment, and ongoing support, many women with PCOS go on to conceive and lead healthier, hormone-balanced lives. Isha Women’s Hospital, under the expert guidance of Dr Chinmay Pataki, one of the best fertility specialists for women, combines cutting-edge fertility treatments with holistic support and offers compassionate care tailored to every woman's unique journey.
Whether you're struggling with irregular cycles, difficulty conceiving, or simply want clarity about your reproductive health — we're here to help you every step of the way.
Book your consultation today at Isha Women Hospital and take the first step toward understanding your cycle, managing PCOS, and embracing a healthier, more fertile future.
Frequently Asked Questions (FAQs)
Ans - Yes—many women do with lifestyle changes and tracking ovulation.
2. How does weight affect PCOS fertility?
Ans - Excess weight can worsen insulin resistance and hormonal imbalance.
3. What is the best diet for PCOS and fertility?
Ans - A low-carb, anti-inflammatory diet with healthy fats and lean protein.
4. How long does it take to get pregnant with PCOS?
Ans - Varies—some conceive in months, others may need medical help or IVF.
5. Is IVF successful for women with PCOS?
Ans - Yes—IVF success rates are often high for PCOS patients when ovulation is controlled.