Polycystic Ovary Syndrome (PCOS)

What is PCOS?

Polycystic ovaries means lots of cysts are appearing on the ovaries. Polycystic Ovary Syndrome (PCOS) affects hormones – women produce higher levels of insulin and testosterone which can lead to one or more symptoms like:

• irregular or no periods
• excess hair growth (usually on the face, stomach or back)
• acne
• weight gain
• mood problems
• fertility issues

The cause of PCOS is unknown; it can be genetic or result from lifestyle and environmental factors.

How is PCOS diagnosed?

PCOS is usually diagnosed using ultrasound, blood tests and a review of medical history.
For a PCOS diagnosis, women need to meet at least 2 of the following criteria:^[1]

• the ovaries are polycystic because 12 or more follicles are visible on one ovary, or one or both ovaries have increased in size
• there are high levels of testosterone (androgens) in the blood, and associated symptoms like excess hair growth or acne
• irregular or no periods (menstrual dysfunction)

If you think you might have PCOS, talk to your GP or a Fertility Doctor about tests they can run.

What is the difference between PCO and PCOS?

PCO refers to having polycystic ovaries that can be identified via ultrasound.

PCOS is a syndrome, where you experience 2 of the 3 symptoms outlined above.

The names are similar, however PCO does not affect fertility like PCOS. PCO affects up to 20% of women of childbearing age and is often not diagnosed as there are no other symptoms. If you have PCO it does not mean you will also have PCOS. Only 5% of women have PCOS. (source: 2023 International evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS))

How does PCOS affect fertility?

If you are diagnosed with PCOS, you may have problems having a baby. Irregular periods can affect ovulation, making it harder to know when to try to get pregnant, irregular periods also means less opportunities to fall pregnant than if you had a regular cycle. Research has also found that the hormones that control appetite and hunger may not be regulated as effectively with women with PCOS. Meaning some women are more likely to gain weight and may have trouble losing weight.

What to do after a PCOS diagnosis

Treatment options to help you have a baby can include:

• reducing your BMI through diet and exercise
• drugs to induce ovulation (such as clomid and letrozole)
• Insulin-sensitising medications (such as metformin)
• IVF or another assisted reproductive treatment

Talk to your fertility specialist about the best way forward for you.

If you have not been diagnosed with PCOS, but you are concerned about it affecting your fertility, book a free chat with one of our experienced fertility nurses to talk about the next steps.