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Does PCOS Affect Fertility?
Does PCOS Affect Fertility? Understanding the Link in Simple Terms
Polycystic Ovary Syndrome (PCOS) is one of the most common hormone-related conditions that affects how a woman’s ovaries work, especially before menopause. While about 20% of women have polycystic ovaries (which means small cysts on the ovaries), many don’t experience any symptoms. But around 5–10% of women have actual PCOS, with clear signs and symptoms—and this number seems to be increasing.
What is PCOS?
According to the American Society for Reproductive Medicine, PCOS is diagnosed when a woman has at least two of these signs:
- Not ovulating regularly (you might notice missed periods).
- High levels of male hormones (androgens).
- Multiple small cysts on the ovaries (more than 10 follicles instead of the usual 5–6).
Your hormones play a big role in your menstrual cycle and fertility. In PCOS, two hormones made in the brain—LH (luteinising hormone) and FSH (follicle-stimulating hormone)—are out of balance. This affects how your egg follicles grow. Instead of maturing and releasing an egg, these follicles stay small and form a cluster, leading to polycystic ovaries.
What Causes PCOS?
PCOS is thought to be linked to hormone imbalances and can run in families. You may be more likely to get PCOS if:
- A female relative has PCOS.
- A family member has type 2 diabetes.
- Your dad went bald early in life.
Being overweight can also increase the chances of developing PCOS, especially if you're already genetically prone to it.
Symptoms of PCOS
PCOS symptoms can be different for every woman and may change over time. The most common ones include:
- Weight gain, mainly around the stomach.
- Unwanted facial or body hair (hirsutism).
- Thinning hair or male-pattern baldness.
- Oily skin or acne.
- Irregular or missed periods, which can lead to fertility issues.
The Role of Insulin
With PCOS, it’s not just your reproductive hormones that are out of sync—insulin plays a big part too. Many women with PCOS are insulin resistant, which makes it easier to gain weight and harder to lose it. Insulin resistance happens when your muscles stop responding properly to insulin, so your body has to make more of it.
Insulin helps your cells absorb sugar from your blood. After you eat, your body produces more insulin to store sugar for energy. But when you're insulin resistant, your body pumps out even more insulin than needed. This can lead to low blood sugar, food cravings, and weight gain—a cycle that can lead to type 2 diabetes if it continues long-term.
Insulin resistance affects other hormones too. Higher insulin levels can:
- Increase fat storage and weight gain.
- Raise testosterone levels, disrupting the hormones that help eggs develop and release.
- Cause acne and unwanted hair growth due to excess testosterone.
What About the Cysts?
Those small "cysts" seen in PCOS are actually underdeveloped follicles that didn’t release an egg. They're a symptom, not the root cause, of PCOS. They’re different from regular ovarian cysts, which are usually bigger.
Interestingly, when women with PCOS improve their diet or use medication, these small cysts often reduce in number and size—just like other symptoms. That’s because PCOS is really a metabolic condition that causes hormone issues, including high testosterone and insulin resistance, which all affect ovulation. So when asking does PCOS affect fertility, it's these hormone imbalances—not the cysts themselves—that make getting pregnant harder.
Does PCOS Affect Fertility?
The good news is that having PCOS doesn’t mean you’re infertile. In fact, around 70% of women with PCOS get pregnant naturally. If your periods are irregular or you’re not ovulating regularly, you may have what’s called "subfertility." This just means that getting pregnant might take longer—but it’s absolutely possible.
The key is encouraging your body to ovulate. There are often lots of eggs waiting to develop, but the hormonal imbalance holds them back. If you can bring your hormones back into balance, your chances of ovulation—and pregnancy—increase. That’s where lifestyle changes and fertility-boosting plans can really help.
Pregnancy and PCOS
Even after getting pregnant, your hormones still matter. Problems like weight issues, poor diet, and high stress can raise the risk of miscarriage or pre-term birth. The good news? You can control many of these factors.
For example:
- Eating the right foods and taking supplements can help balance your hormones.
- Managing stress supports better hormonal health.
- Keeping your weight in check improves your chances of a healthy pregnancy.
As Dr. Robert Franklin from Baylor College of Medicine explains, helping women understand how their weight affects their hormones and fertility is key.
That said, even couples without PCOS are often told to try for a year before getting medical help. And don't forget—fertility isn’t just about women. Male fertility has been declining too, possibly due to pollution and chemicals that affect hormones.
So if you're wondering does PCOS affect fertility, the answer is yes, but it's not the end of the road. There's a lot you can do to improve your chances of conceiving and having a healthy pregnancy.
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