More than just irregular periods: How PCOS affects fertility and why it's easier to manage than you think

Time of India

20-05-2025

Many women in India believe
irregular periods
are just how their body works – something that will 'get better with time'. For years, they live with unpredictable menstrual cycles, sudden acne, unexplained weight gain or thick facial hair.
Some might even know that this is due to Polycystic Ovarian Syndrome (
PCOS
) but don't realise its actual impact till they try to conceive and start facing issues.
PCOS affects 1 in 10 women of reproductive age and 70-80% of those women face
fertility challenges
due to hormonal imbalances. Clearly, it is one of the most prevalent hormonal disorders in women but also heavily misdiagnosed.
The connection between PCOS and fertility
PCOS impact ovulation – release of an egg from the ovary – in multiple ways.
At the root of PCOS is a
hormonal imbalance
, often driven by
insulin resistance
and increased visceral fat. This metabolic disruption leads to higher levels of insulin and androgens (male hormones), both of which interfere with normal ovulation and menstrual cycles.
Without routine ovulation, it becomes harder to predict fertile windows or conceive naturally. The hormonal disturbances due to PCOS can also have consequences on egg quality and maturation.
All of this makes it more difficult to conceive naturally. And if pregnancy does happen, women with PCOS are at slightly increased risk for complications such as miscarriage, gestational diabetes, and high blood pressure. But prompt treatment and ongoing monitoring can minimise these risks immensely.
The symptoms of PCOS aren't merely cosmetic or emotional concerns – they are your body's signals informing you of a hormonal imbalance.
PCOS may also creep up on metabolic health and long-term cardiovascular well-being.
Why early awareness is a game-changer
Being aware of your
reproductive health
and fertility in your 20s and early 30s helps you plan better and make informed decisions at the right time. Early tests like AMH (Anti-Müllerian Hormone) to determine ovarian reserve, Antral Follicle Count (AFC) by ultrasound and insulin and testosterone levels can provide valuable information for timely action.
Managing PCOS is easier than you think
The good news about PCOS is that it is one of the most manageable reproductive conditions, especially when identified early, and approached with the right support.
Here's what works
1. Even a 5-10% weight loss restores ovulation
2. Hormonal control is provided by a low-glycemic index diet
3. Exercise and sleep are foundational as both reduce insulin resistance
4. Mental health support is crucial, as PCOS is often linked with anxiety and low mood
5.
For women trying to conceive, ovulation induction medications, folic acid supplements, IUI, or IVF can significantly improve chances, especially when supported by a personalised treatment plan.
The real power? Knowledge + action
PCOS may feel complex but it's not a permanent roadblock to your dreams, especially if you don't ignore the signs early on and consult in a timely manner.
It's important that reproductive health be treated as a regular focus to improve life instead of an emergency when planning a family and things aren't working out. Reproductive health is a fundamental aspect of overall well-being.
Authored by: Dr Rakhi Goyal, Fertility Specialist, Birla Fertility & IVF, Chandigarh
The link between PCOS and insulin resistance
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