Overview
The good news is that PCOS is very treatable. Most women with PCOS conceive with simpler treatment such as ovulation induction, and IVF is needed only when other options have not worked or there are other fertility factors.
What is PCOS?
PCOS is usually diagnosed when a woman has at least two of these three features:
- Irregular or absent periods, because ovulation is irregular
- Signs of high male hormones, such as acne, excess hair or raised testosterone in a blood test
- Many small follicles in the ovaries on ultrasound (the "polycystic" appearance)
Other causes of irregular periods, such as thyroid problems or high prolactin, are ruled out first. PCOS is often linked with insulin resistance and weight gain, but many women with PCOS are slim.
How PCOS affects fertility
Without regular ovulation there is no egg to fertilise in many cycles, and it is hard to know the fertile days. PCOS can also bring a higher risk of miscarriage and pregnancy diabetes, which is why good control before and during pregnancy matters.
Treatment options for PCOS
- Lifestyle changes
For women who are overweight, losing even 5 to 10 percent of body weight can bring back regular ovulation and improve the response to treatment. - Ovulation induction with tablets
Letrozole is now the usual first choice to help the ovaries release an egg. Follicle-tracking scans show when ovulation is near, so you can time intercourse. - Metformin
Sometimes added for women with insulin resistance or raised blood sugar. - Injections and IUI
If tablets do not work, low-dose hormone injections with close monitoring, sometimes combined with IUI. - Laparoscopic ovarian drilling
A keyhole procedure that can restore ovulation in selected women who do not respond to medicines. - IVF
When other treatments fail or there are other factors such as blocked tubes or male infertility. Women with PCOS produce many eggs, so we use protocols that lower the risk of ovarian hyperstimulation syndrome (OHSS), often freezing embryos and transferring them in a later cycle.
What to expect at Ishwa IVF
- Confirmation of the diagnosis with blood tests and ultrasound
- A plan that starts with the simplest effective step
- Follicle monitoring scans so treatment is timed and safe
- Advice on weight, diet and blood sugar, before and during pregnancy
Questions about PCOS and infertility
Can I get pregnant naturally with PCOS?
Many women with PCOS do, especially when periods become more regular with weight loss or treatment. If you have been trying for 12 months, or 6 months if you are over 35 or your periods are very irregular, it is worth seeing a fertility specialist.
Do all women with PCOS need IVF?
No. Most women with PCOS conceive with ovulation induction, sometimes with IUI. IVF is used when simpler treatment has not worked or there are other fertility problems.
Is PCOD the same as PCOS?
The terms are often used for the same condition in India. Doctors use the name PCOS and diagnose it from your periods, hormone levels and ultrasound.
Does weight loss really help PCOS fertility?
For women who are overweight, losing 5 to 10 percent of body weight can restore ovulation and improve the chance of pregnancy with or without treatment.
Is IVF riskier for women with PCOS?
Women with PCOS have a higher risk of ovarian hyperstimulation syndrome (OHSS). We reduce this with gentle stimulation protocols, careful monitoring and, often, by freezing embryos for a later transfer.
