Polycystic Ovary Syndrome (PCOS)

What You Need to Know

What Is Polycystic Ovary Syndrome?

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders affecting female fertility. It is associated with ovulation disorders (oligo-ovulation or anovulation), irregular menstrual cycles, weight gain, and difficulty conceiving. Many women searching for natural ways to manage PCOS or wondering how to get pregnant with polycystic ovaries often encounter conflicting information. At FertUlity, we follow a personalized approach that combines advanced diagnostics, nutritional interventions, and specialized IVF protocols for women with PCOS.

PCOS is a multifactorial endocrine disorder of the ovaries that disrupts normal ovulation. It is characterized by oligo-ovulation or anovulation, elevated androgen levels, and the presence of multiple small follicles in the ovaries. Beyond fertility, PCOS can also affect metabolic health, as it is often associated with insulin resistance, weight gain, and an increased risk of developing type 2 diabetes. It is estimated that around 1 in 10 women of reproductive age are affected by PCOS, with many cases remaining undiagnosed. Early diagnosis and individualized treatment are essential for improving fertility outcomes and overall health.

Symptoms & Clinical Signs of Polycystic Ovary Syndrome

Symptoms of polycystic ovary syndrome (PCOS) vary from woman to woman and may appear at different levels of intensity. Often, they go unnoticed for a long time, especially in adolescents or young women just starting menstruation. Recognizing the clinical signs is crucial for timely diagnosis and effective treatment of the syndrome.

Most common PCOS symptoms:

Irregular or absent menstrual cycles (oligomenorrhea or amenorrhea)
Difficulty conceiving due to irregular ovulation timing or absence of ovulation (anovulation)
Excess hair growth in areas such as the face, chest, abdomen, or back (hirsutism)
Acne, particularly in areas with increased oil production
Tendency for weight gain or difficulty losing weight
Hair thinning or hair loss with a male-pattern distribution
Darkened skin patches, usually on the neck, underarms, or groin (acanthosis nigricans)
Elevated androgen levels detected in laboratory tests

Clinical Findings Identified Through Diagnostic Tests

Elevated androgen levels in blood tests
Multiple immature ovarian follicles detected through ultrasound imaging
Insulin resistance
Elevated LH (luteinizing hormone) levels
Dyslipidemia (high triglycerides and low HDL cholesterol)
Elevated AMH (Anti-Müllerian Hormone) levels

Women who experience persistent symptoms should consult a specialized gynecologist or fertility specialist in order to undergo appropriate diagnostic evaluation and receive individualized treatment.

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Peaceful newborn baby wrapped in white, symbolizing successful IVF outcome after PCOS treatment.

Causes & Risk Factors

Polycystic ovary syndrome does not have a single known cause but is believed to result from a combination of genetic, hormonal, and environmental factors. Understanding risk factors helps in targeted prevention and better condition management.

Possible causes and risk factors:

Heredity: Women with a family history of PCOS have increased chances of developing the syndrome.
Insulin resistance: Reduced cellular sensitivity to insulin leads to hyperinsulinemia, which may stimulate the overproduction of androgens by the ovaries.
Hormonal imbalance: Elevated LH (luteinizing hormone) or androgens contribute to ovulatory dysfunction.
Obesity: Increased fat mass worsens insulin resistance and negatively affects hormonal balance.
Low-grade inflammation: Systemic inflammation appears to play a role in PCOS pathogenesis.

Obesity and unhealthy dietary habits are aggravating factors that worsen PCOS
symptoms.

Diagnosing PCOS at FertUlity

The diagnosis of Polycystic Ovary Syndrome (PCOS) is based on the Rotterdam criteria, which suggest the diagnosis when two out of the following three criteria are present, after excluding other endocrine disorders:

Infrequent or absent ovulation (menstrual cycle irregularities)
Hyperandrogenism, either clinical (acne, hirsutism) or biochemical (elevated androgen levels)
Polycystic ovarian morphology detected on ultrasound

At FertUlity, we follow a comprehensive diagnostic approach that includes:

High-resolution gynecological ultrasound for detailed visualization of the ovaries
Hormonal blood testing, including FSH, LH, E2, PRL, Δ4 Androstenedione, 17-OH Progesterone, SHBG, free Testosterone, total Testosterone, DHEA-S, TSH, and AMH
Assessment of insulin resistance using HOMA-IR, HbA1c, or an oral glucose tolerance test

Early and accurate diagnosis is the first step toward optimizing fertility outcomes and preventing long-term health complications.

PCOS & Infertility

Polycystic Ovary Syndrome (PCOS) is one of the most common causes of oligo-ovulation or anovulation, meaning irregular or absent ovulation, and is therefore closely associated with infertility. In women with PCOS, the ovaries often contain multiple small follicles that fail to develop sufficiently to trigger ovulation. Hormonal imbalance, particularly increased androgen production and an altered LH/FSH ratio, disrupts the normal process of follicular development and egg maturation.

Even when ovulation occurs, egg quality and the endometrial environment may not always be optimal for implantation, which can further reduce the chances of conception. In addition, many women with PCOS experience insulin resistance, which negatively affects ovarian function as well as overall metabolic health.

How PCOS Affects Fertility

Irregular menstrual cycles: fewer opportunities for natural conception due to difficulty identifying fertile days
Anovulation: absence of ovulation and therefore no fertile window
Hormonal imbalance: affects proper egg maturation
Possible endometrial receptivity issues: implantation difficulties

Assisted Reproduction & PCOS

In vitro fertilization (IVF) is often the most effective option for women with PCOS who have not conceived naturally or through less complex fertility treatments. However, careful treatment planning is required due to the increased risk of ovarian hyperstimulation syndrome (OHSS).

At FertUlity, we implement personalized ovarian stimulation protocols, tailored to each woman's hormonal and metabolic profile.

IVF Success Rates in Women with PCOS

Success rates depend on several factors, including age, body mass index (BMI), egg quality, and the presence of additional infertility factors. In general:

Women under 35 with good ovarian response: success rates can reach 50–70% per IVF cycle
PCOS combined with obesity: weight loss before treatment may increase success rates by 15–20%

Our expertise in PCOS-related infertility allows us to design treatment plans that respect each woman’s physiology, minimize side effects, and maximize the chances of pregnancy with safety and support at every stage.

Therapeutic Approaches for Polycystic Ovary Syndrome

The management of Polycystic Ovary Syndrome (PCOS) requires a holistic and individualized approach, as symptoms and treatment goals vary from woman to woman. At FertUlity, we design treatment plans that combine medical therapy, lifestyle modifications, and specialized assisted reproduction techniques when necessary.

Medical Treatment

Medical treatment aims to restore hormonal balance, regulate ovulation, and address metabolic disturbances.

Oral contraceptive pills: Help regulate menstrual cycles, protect the endometrium from hyperplasia and polyp formation, and reduce androgen levels, improving acne and excessive hair growth.
Metformin: Improves insulin sensitivity and may support weight loss. In some cases, it can also help restore ovulation.
Letrozole or Clomiphene Citrate: Used to induce ovulation in women who wish to conceive naturally, often combined with ovulation monitoring and timed intercourse or as part of intrauterine insemination (IUI) treatment.
Anti-androgen medications: Used to reduce symptoms of hyperandrogenism, particularly when other treatments have not been effective and pregnancy is not an immediate goal.

The choice of treatment depends on each woman’s goals, whether the focus is cycle regulation, symptom management, or improving fertility.

Lifestyle Modifications

Lifestyle changes play a key role in managing PCOS, particularly in women with obesity or metabolic syndrome.

Balanced diet: A Mediterranean-style diet with a low glycemic index has been shown to help regulate insulin levels.
Regular physical activity: Aerobic exercise and interval training can improve insulin resistance and support menstrual cycle regulation.
Stress management: Relaxation techniques such as yoga or meditation may reduce inflammation and support overall hormonal balance.

At FertUlity, our approach combines nutritional guidance from specialists with ongoing monitoring and personalized support.

IVF for Women with PCOS

When medical treatment and lifestyle changes are not sufficient to achieve pregnancy, in vitro fertilization (IVF) can be a highly effective option. However, because women with PCOS have an increased risk of ovarian hyperstimulation syndrome (OHSS), treatment requires careful and specialized management.

Low-dose gonadotropin stimulation: Individualized stimulation protocols designed to minimize the risk of ovarian hyperstimulation.
Close monitoring with ultrasound and hormone levels: Frequent monitoring ensures safe and controlled ovarian stimulation.
Use of GnRH agonists: Used to trigger final egg maturation before egg retrieval, helping reduce the risk of OHSS.
Embryo freezing (freeze-all strategy): When a high number of eggs are retrieved and the risk of OHSS is increased, delaying embryo transfer may improve safety and implantation outcomes.

Our team has extensive experience managing PCOS-related infertility with IVF, focusing on patient safety and optimal treatment outcomes.

PCOS treatment is tailored to each patient

PCOS & Pregnancy: What to Expect

Risks and Prevention of Pregnancy Complications

The presence of PCOS is associated with certain increased risks during pregnancy. However, these risks can be minimized with appropriate medical care and monitoring.

Gestational Diabetes (GDM): Due to insulin resistance, women with PCOS have a higher risk of developing gestational diabetes. Regular glucose monitoring and a balanced diet are essential.
Pregnancy Hypertension / Preeclampsia: Hormonal and vascular imbalances may contribute to increased blood pressure during pregnancy.
Preterm Birth or Higher Likelihood of Cesarean Delivery: Although not inevitable, these outcomes occur more frequently in women with PCOS.
Luteal Phase Insufficiency: In some cases, progesterone support may be required to support implantation and reduce the risk of miscarriage or bleeding during the first trimester.
Multiple Pregnancies: When ovulation induction treatments are used, more than one egg may be released and fertilized, leading to multiple pregnancies. For this reason, careful medication dosing and close cycle monitoring are recommended.

Tips for a Healthy Pregnancy with PCOS

Undergo preconception evaluation to regulate hormonal and metabolic parameters before conception
Follow a low glycemic index diet and maintain regular physical activity, unless otherwise advised by your doctor
Monitor blood glucose and blood pressure regularly
Contact your gynecologist immediately in case of vaginal bleeding or abdominal pain

Pregnancy with PCOS can be completely normal when supported by early diagnosis, proper preparation, and close medical supervision. At FertUlity, we support you at every step of your journey, from conception to childbirth.

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Frequently Asked Questions About Polycystic Ovary Syndrome (PCOS)

Can I have regular periods and still have PCOS?

Yes, it’s possible. Although irregular periods are a common symptom, some women with PCOS have relatively regular cycles but show other characteristics like hyperandrogenism or polycystic ovarian morphology on ultrasound.

Can PCOS go away after pregnancy?

Pregnancy may temporarily regulate cycles and hormones, but PCOS does not “disappear.” It is a chronic condition requiring ongoing monitoring, even after childbirth.

Does PCOS affect mental health?

Yes, PCOS has been linked to higher rates of anxiety, depression, and reduced self-esteem, particularly due to symptoms like acne, hirsutism, or infertility. Psychological support is a key part of comprehensive management.

How often should I be monitored if I have PCOS but am not trying to conceive?

Even without reproductive goals, annual checkups with a gynecologist and endocrinologist are recommended, including cycle evaluation, ultrasound, and basic blood tests.

Is there a natural treatment for PCOS without medication?

Lifestyle changes such as healthy nutrition and regular exercise can significantly improve PCOS symptoms and help restore ovulation in many women.

Can a teenager have PCOS?

Yes, PCOS can appear in adolescence, often as irregular periods, acne, and excess hair growth. Diagnosis is more challenging during puberty, as symptoms may overlap with normal age-related changes.

What tests are needed to diagnose PCOS?

The basic diagnostic tests include ovarian ultrasound, hormonal blood tests (FSH, LH, E2, PRL, Δ4 Androstenedione, 17-OH Progesterone, SHBG, free Testosterone, total Testosterone, DHEA-S, TSH, AMH), and evaluation of insulin resistance. In many cases, an oral glucose tolerance test or HOMA-IR assessment is also required.

Are there long-term health risks associated with PCOS?

Yes. If left untreated, PCOS may increase the risk of endometrial polyps, endometrial hyperplasia, and even endometrial cancer. Early diagnosis also allows the identification of other conditions that often coexist with PCOS, such as type 2 diabetes, hypertension, and dyslipidemia. Detecting these conditions early enables timely and targeted management, significantly reducing the risk of long-term complications.

Our Doctors

In an era where fertility requires knowledge, care, and substantial guidance, FertUlity is not an impersonal clinic. It is two people who look you in the eye and accompany you step by step on the journey you dream of.

Dr. Chrysostomos (Makis) Papadopoulos Obstetrician – Gynecologist, MD, PhDc, MIC I

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Dr. Chrysostomos Papadopoulos - Specialist in Infertility, Endocrinology & Menopause in Athens

Dr. Maria Oikonomou Obstetrician – Gynecologist

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The First Step Starts Now

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FertulityThrough the Words of our Parents

100% genuine, public Google reviews.
Because every fertility journey begins with honesty and trust.

      EXCELLENT  
   Based on 12 reviews 
    
 
 
 
   
 
 
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   Μαρια 
 26 days ago
 
 
  The word "thank you" to Dr. Makis Papadopoulos is too small to describe the gratitude we feel for this man. I am pregnant after IVF, having succeeded on the first attempt, and we owe this exclusively to our doctor. First Contact & Communication: From the very first contact, he won us over with his kindness, enthusiasm and willingness to dedicate as much time as we needed. Willing to explain everything in every detail, he solved every question we had in depth — not even a professor to students would analyze them with such patience and contagiousness! Scientific Training: He is an excellent scientist, with deep knowledge of the subject, a perfectionist and focused professional who leaves absolutely nothing to chance. He designed the right treatment for us, solving every problem down to the last detail, making us feel that whatever problem arises, it is certain that it will be solved. HUMANITY & SUPPORT: The most important thing, however, is his humanity. Communication with him was Immediate and he always had as much time as you needed on the phone to solve every question. He showed a deep, real interest, embracing us not just as a doctor, but as if he were our brother. We highly recommend him to every couple starting this journey. He deserves blind trust! We thank you from the bottom of our hearts for the greatest miracle of our lives!

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   Alexandra 
 52 days ago
 
 
  I don't often write reviews, but I feel that Mr. Makis truly deserves it. From the very first moment, he made me feel safe and confident. He listened carefully to what was on my mind, answered every question I had, and explained everything in a simple way, always based on scientific data. Many times, he even sent me relevant scientific studies so that I could better understand why he was suggesting a particular approach. But what stood out to me the most was that he didn't stop at the appointment. He followed up, was genuinely interested in my progress, and was available when I needed him. This is something you rarely encounter. Fortunately, he returned to Greece. He is one of the few doctors who, beyond their knowledge, remain above all human beings. He makes you feel like he sees you as a person and not as just another incident.

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   Matina 
 69 days ago
 
 
  A big thank you to Dr. Makis Papadopoulos who supported us from day one, who checked every little detail, who explained to us every move-step, every test, every medication for the reason we were doing it and what we would achieve. With incredible experience, knowledge, a lot of patience (because we had two other failed attempts with another doctor) and trust, within 8 months he adapted the protocols for our case and we achieved the positive result and we hold in our arms a priceless diamond. Above all, a rare person, calm and always available to listen to our concerns and reassure us. I highly recommend him!

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   Eva 
 93 days ago
 
 
  Thanks to Dr Makis Papadopoulos, I am now holding my two beautiful babies in my arms! He is a true expert. Professional with a human centric approach, friendly and empathetic, always available to answer our (many many) questions. I trust Dr Makis blindly and, honestly, I cannot recommend him enough!
  
 
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   Ivy 
 100 days ago
 
 
  My experience with Dr. Makis took me from a clinical stagnation to an incredible breakthrough, highly recommend Dr. Makis! Navigating the exhausting world of IVF, you know how devastating it is to watch your protocol dosages go up while your results go down. After three intense, high-dosage cycles with a previous clinic, I was left feeling incredibly discouraged. Despite escalating medications and growth hormones, my blastocyst yield was dwindling, culminating in a heartbreaking round with zero blastocysts. I knew I needed a doctor who didn't just follow a standard script, but who truly understood the nuances of egg quality and customized protocols. That is when I found Dr. Makis. Dr. Makis completely revolutionized my treatment plan. Instead of just pushing maximum dosages, he took a highly strategic, tailored approach. The result? Quality over pure protocol size. While my previous doctors kept increasing the medication dosages (which yielded fewer or zero blastocysts), Dr. Makis completely changed the strategy. He lowered the heavy stimulation, introduced smart egg-quality support (like melatonin), changed the protocol style entirely, and achieved a 700% increase in blastocysts compared to my best previous rounds. Beyond the incredible results, Dr. Makis brings a level of expertise, precision, and reassuring care that is rare to find. He looks at you as an individual, not a statistic, and knows exactly how to pivot when traditional routes fail. If you are looking for a specialist who can turn a difficult prognosis into an overwhelming success, look no further than Dr. Makis. I am incredibly grateful for his care.
  
 
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   Olga 
 111 days ago
 
 
  Dr. Makis Papadopoulos was excellent, professional, and very reassuring throughout the entire process. Thanks to his expertise and guidance, we were able to identify the issue early and take the appropriate steps from the beginning. He took the time to explain everything clearly, answered all our questions with patience, and made us feel comfortable and confident throughout our journey. We truly appreciated his caring approach, professionalism, and dedication. Highly recommended!
  
 
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   Euaggelia 
 122 days ago
 
 
  Dr. Makis Papadopoulos is an excellent scientist and above all a rare person! He is an approachable and smiling doctor, with excellent medical knowledge, who from the first moment I met him made me feel comfortable and trust him completely, answering every question I had with patience and documenting every answer with scientific studies and articles! The most important thing, however, is that Dr. Makis Papadopoulos is always there on the other end of the line to listen to you and reassure you without a trace of haste, a doctor who truly cares and makes you feel like he is your own person! Makis, thank you very much for everything!!! I am very lucky to have met you!

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   Anastasia 
 129 days ago
 
 
  Dr. Makis Papadopoulos is an excellent scientist with a human-centered interest. Our collaboration was excellent from the very beginning and he made me feel confident and secure by explaining every step of the process in great detail. I highly recommend him!

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   Fay 
 131 days ago
 
 
  Dr Makis Papadopoulos is very professional, caring and attentive. Very thorough in explaining the whole process throughout every step. Thank you! Highly recommended!!
  
 
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   Christina 
 134 days ago
 
 
  I would like to share my experience with Dr. Makis Papadopoulos, an outstanding gynecologist and scientist. We first connected in the summer of 2024, while he was based in Germany, through a mutual acquaintance, following a particularly challenging period for us. Prior to meeting him, we had gone through repeated unsuccessful attempts of stimulation and fertilization with other gynecologists. Unfortunately, those approaches relied largely on standardized protocols, without sufficient personalization to address the specific needs of my case. From the very beginning, Dr. Makis stood out for his human-centered approach and his willingness to dedicate time to truly understand our situation in depth. With strong, up-to-date scientific knowledge, he approaches every case holistically, focusing on individualized treatment and adapting protocols to the patient's unique needs. Throughout our collaboration, which now spans approximately two years (with a few breaks on our side), he has consistently been available, supportive, and clear in his guidance. He inspired confidence and helped us stay positive even during difficult phases of the journey. Beyond his scientific expertise, what truly sets him apart is his genuine care for the person behind each case: his empathy, honesty, and continuous effort to achieve the best possible outcome. My husband and I are deeply grateful for his support and guidance, and we now feel ready and optimistic to move forward to the next final stage. We highly recommend him to anyone seeking a gynecologist with true expertise, professionalism, and compassion. I would like to share my experience with Dr. Makis Papadopoulos, an excellent gynecologist and scientist. We met in the summer of 2024, when he was in Germany, through a mutual acquaintance, after a particularly demanding period for us. Before meeting him, we had gone through repeated failed attempts at stimulation and fertilization with other gynecologists. Unfortunately, the approaches that had been followed were mainly based on standardized protocols, without the necessary individualization to the specifics of my case. From the beginning, Dr. Makis stood out for his human approach and his willingness to spend time to understand our case in depth. With modern knowledge and scientific training, he approaches each issue multidimensionally, emphasizing the individualization of treatment and adapting the protocols to the real needs of the patient. During our collaboration, which now spans about two years (with short breaks on our part), he was always available, supportive and clear in his guidance. He inspired confidence in us and helped us remain optimistic even in difficult phases. In addition to his scientific competence, what sets him apart is his genuine interest in the person behind each case: his empathy, his honesty and his constant effort to achieve the best possible outcome. My husband and I thank him warmly for his support and guidance and we now feel ready and optimistic to move on to the next final stage. We highly recommend him to anyone looking for a gynecologist with real knowledge, professionalism and humanity.

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   Faidra 
 135 days ago
 
 
  Dr. Makis Papadopoulos is an excellent gynecologist and above all an excellent person! I truly thank him for his support and care during the egg freezing process. Although my case was particularly demanding, he stood by me with patience, knowledge, great experience and real interest. Our communication was direct and human, while his availability at the many appointments made me feel safe at every step. The protocols were designed specifically for me, aiming for the best possible result, while also taking into account the cost of the medications. I recommend him with all my heart to every woman who wants to trust someone for something so important and sensitive for her.

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   Iliana 
 137 days ago
 
 
  I highly recommend Dr. Makis, he is an incredible specialist. My journey was far from easy, encountering several challenges that  made the process feel overwhelming at times. What sets him apart is his willingness to go beyond standard procedures. He developed a specialized, custom protocol, tailored to my situation, which ultimately made all the difference. Beyond his technical expertise, his calm and clear communication kept me grounded throughout the process. I am so grateful for his persistence and high level of care!

Why choose FertUlity?

Because every fertility journey deserves the right support. At FertUlity, we provide science-based fertility care with a human approach. We support every path, from fertility assessment and preservation to modern assisted reproduction.

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