PCOS and Ovulation
PCOS affects 1 in 10 women of reproductive age and is the most common cause of anovulation, where the ovaries don't release an egg regularly. Without regular ovulation, conception is difficult. However, it's important to know: PCOS does not mean infertility. With the right interventions, the majority of women with PCOS can and do conceive.
Lifestyle Interventions First
For women with PCOS and insulin resistance (a common feature), even a 5–10% reduction in body weight can restore ovulation. This isn't about aesthetics, it's about insulin sensitivity. A low-glycaemic diet, regular moderate exercise, and reducing ultra-processed foods can restore ovulatory cycles in some women without any medication.
Ovulation Induction Medications
Letrozole is now the first-line medication for ovulation induction in PCOS (having replaced clomiphene in most guidelines). It works by temporarily lowering oestrogen to stimulate FSH production and follicle development. Metformin is often added for insulin-sensitising benefits. Both are well-studied and well-tolerated in most women.
IVF and PCOS
PCOS paradoxically makes ovarian stimulation for IVF very effective, ovaries with many follicles respond well. However, the risk of ovarian hyperstimulation syndrome (OHSS) is higher, so careful protocol selection is essential. Freeze-all embryo cycles followed by a natural frozen embryo transfer (FET) significantly reduces OHSS risk while maintaining excellent success rates.
Medical Disclaimer
This article is written for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making health decisions.
Dr. Nina Patel
Reproductive Endocrinologist
All TryHerCare articles are written and reviewed by qualified medical professionals. Our content is clinician-reviewed to ensure accuracy and clinical relevance.
