Does PCOS Affect Fertility? What Can I Do About It?

"Why is it so difficult to conceive when I am doing everything right?"

Are you someone who has been asking this silently, searching for answers related to reproductive health, hoping for clarity and wondering what's missing? We hear you.

In India, conversations around fertility often remain hushed because of stigma and social pressure. Yet, the emotional toll is real and deeply personal. So many women, despite eating well, staying active, and doing "all the right things," find themselves dealing with irregular periods, unexplained weight changes, acne, or mood swings.

Usually, these signs are normalised as lifestyle changes. But there could be an underlying condition that just doesn't affect your skin or cycle, but your ability to conceive. That is PCOS. In this article, we will talk about what PCOS is, how it affects fertility, and what you can do to support your body naturally and mindfully.

What is PCOS and What Causes It?

Polycystic Ovary Syndrome (PCOS) is a hormonal condition that impacts how the ovaries function. According to WHO, PCOS affects nearly 6 to 13% of women of childbearing age (between the ages of 20 and 35).

In PCOS, the body produces more androgens (male hormones) than usual. This can lead to a range of symptoms that may differ for every woman. Some may notice changes in their periods, others in their skin, hair, or weight. And sometimes, it quietly affects fertility without many outward signs.

The exact cause of PCOS is unclear, but the following are a few factors that lead to it:

Genetics: PCOS often runs in families. If your mother or sister has it, your chances may be higher.
Insulin Resistance: This is when the body's cells do not respond properly to insulin, a hormone that helps manage blood sugar. To compensate, the body produces even more insulin. This can lead to higher insulin levels, which may trigger the ovaries to produce more androgens.
Inflammation: Low-grade, chronic inflammation in the body can increase androgen production and affect ovarian health.
Lifestyle: Lack of physical activity, poor sleep, unhealthy eating habits, or high stress levels may also affect how the body responds to hormonal changes.

How Does PCOS Affect Fertility?

A woman's reproductive cycle is divided into 4 phases: menstruation, follicular, ovulation, and luteal. During ovulation, the ovaries release an egg. However, this process is disturbed in women with PCOS. The high levels of androgens in the body can prevent eggs from developing properly. This can prevent ovulation or result in irregular ovulation, making it difficult to predict when or if ovulation will occur. Without regular ovulation, conception becomes a lot more challenging.

Apart from this, insulin resistance can further complicate fertility. High insulin levels can interfere with the normal functioning of the ovaries. This makes it even more difficult for them to release a mature egg. This is why managing insulin resistance is often an essential part of fertility treatment for women with PCOS.

How is PCOS Diagnosed?

For many women, PCOS remains undiagnosed until they start trying to conceive. By then, they may have already experienced irregular periods, skin changes, or weight fluctuations, which are all common signs of the condition. But most people overlook these signs and avoid getting a diagnosis.

If you suspect you might have PCOS, it's important to see a gynaecologist. The diagnosis typically involves a combination of the following:

Medical History: A gynaecologist will ask about your menstrual cycle, any skin changes (like acne or excess hair), and weight changes.
Physical Exam: Your doctor might check for signs like excessive hair growth or thinning hair.
Blood Tests: These help measure hormone levels, including androgens, to see if they are higher than normal.
Ultrasound: A pelvic ultrasound can show if there are multiple small follicles in your ovaries, which indicates PCOS.

Did You Know?

Despite its name, you don't actually need to have cysts to be diagnosed with PCOS. The term refers to small fluid-filled sacs, known as immature follicles, that may appear on an ultrasound. These aren't harmful in themselves, but they indicate an underlying hormonal imbalance. These follicles can prevent eggs from fully developing, leading to missed or irregular ovulation cycles. So, while having cysts is a common feature of PCOS, it's not essential for diagnosis and not all women with PCOS will have cysts.

How Can I Improve Fertility with PCOS?

Medical supervision is a non-negotiable to conceive with PCOS. However, the following are a few PCOS fertility tips to support your body and hormones naturally:

Embrace movement that feels good: You don't need to spend hours at the gym. Indulge in simple forms of exercise like walking, yoga, or dancing that keep you active and consistent and also regulate insulin levels.
Eat to nourish, not restrict: Eating to balance your hormones doesn’t mean following a rigid diet. Try to include fibre-rich vegetables, whole grains, good fats, and proteins in your meals. Cutting back on refined carbs and sugar can also help with insulin resistance and reduce inflammation.
Prioritise sleep and rest: Your body needs rest to regulate hormones. Poor sleep can increase insulin sensitivity and stress levels, which are symptoms of PCOS. Aim for 7–8 hours of quality sleep. Also, find small ways to manage stress by deep breathing, journaling, or time outdoors can help.
Sip on plant-powered support: Consider incorporating gentle, hormone-balancing options like The Basics Woman’s Hormone Balancing Brew. It contains 11 Ayurvedic herbs, including spearmint, ashwagandha, ashoka, shatavari, lodhra, peppermint, and more. It’s specially formulated to support cycle regularity and reduce inflammation—two key things when working on fertility with PCOS.
Speak to a Gynaecologist you trust: If you are trying to conceive and things are not falling into place, it’s okay to seek help. Early guidance can save you a lot of confusion. A gynaecologist can assess how PCOS is affecting your fertility and recommend the right steps, like tracking ovulation more effectively or understanding your hormone levels better.

FAQs

Can I get pregnant naturally with PCOS?
Yes, many women with PCOS conceive naturally with healthy lifestyle changes and cycle tracking. While it might take longer, it’s definitely possible.
Does PCOS mean I’m infertile?
Not at all. PCOS can affect ovulation, which may delay conception, but it doesn’t mean you're infertile. With the right support, your chances can improve significantly.
Should I wait before seeing a doctor for fertility concerns?
If you have been trying to conceive for over 6–12 months, or if your cycles are irregular, it’s a good idea to consult a gynaecologist sooner rather than later.