Fertulity IVF
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Polycystic Ovary Syndrome (PCOS) What You Need to Know

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders affecting female fertility, causing irregular cycles, weight gain, and difficulty conceiving. Many women seeking natural treatment for PCOS or wondering how to get pregnant with polycystic ovaries face conflicting information and uncertainty. At Fertulity, we offer personalized solutions based on modern diagnostic tools, nutritional interventions, and specialized IVF protocols for women with PCOS.

What Is Polycystic Ovary Syndrome?

Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder that affects ovarian function and normal ovulation. It is characterized by irregular or absent menstrual cycles, elevated levels of androgens (male hormones), and the presence of multiple small follicles in the ovaries that do not develop into mature eggs. It is a disorder that impacts not only fertility but also metabolic health, as it is often associated with insulin resistance, weight gain, acne, hirsutism, and increased risk of developing type 2 diabetes. According to epidemiological studies, about 1 in 10 women of reproductive age in Greece has PCOS, with many cases going undiagnosed due to the heterogeneity of symptoms. Early diagnosis and personalized approaches are critical for preventing long-term complications and improving the quality of life of women affected by the syndrome.

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 inadequate or absent ovulation
Excess hair growth in areas like the face, chest, abdomen, or back (hirsutism)
Acne, especially in oily areas
Tendency to gain weight or difficulty losing weight
Hair thinning or hair loss in a male-pattern distribution
Darkened skin areas, usually on the neck, armpits, or groin (acanthosis)
Elevated androgen levels in lab tests

Clinical signs detected through testing

High androgen levels in blood tests
Multiple immature follicles in the ovaries via ultrasound
Insulin resistance
Elevated LH (luteinizing hormone)
Dyslipidemia (high triglycerides, low HDL)
The presence of three or more of the above may lead to a PCOS diagnosis, especially when other endocrine disorders are ruled out. Women who observe persistent symptoms should consult a specialized gynecologist for proper diagnostic testing and individualized treatment.
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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 is based on the Rotterdam criteria, which require at least two of the following three to be met:
Sparse or absent ovulation (cycle irregularities)
Hyperandrogenism, either clinical (acne, hirsutism) or biochemical (elevated androgen levels)
Polycystic ovarian morphology on ultrasound
At Fertulity, we follow a comprehensive diagnostic approach that includes:
High-resolution gynecological ultrasound for ovary imaging
Hormonal blood tests including LH, FSH, testosterone, AMH, prolactin, and TSH
Evaluation of insulin resistance via HOMA-IR or glucose tolerance test
Early and accurate diagnosis is the first step in optimizing fertility and preventing long-term complications.

PCOS & Infertility

PCOS is one of the most common causes of anovulation (absence of ovulation) and is directly linked to infertility. In women with PCOS, the ovaries often contain many small follicles that do not develop adequately to result in ovulation. Hormonal imbalance – especially elevated androgen secretion and a disproportionate LH/FSH ratio – interferes with the normal process of egg development and maturation.

Even when ovulation occurs, egg quality and the endometrial environment may not be optimal for implantation, further reducing chances of conception. Additionally, women with PCOS often exhibit increased insulin resistance, negatively impacting both ovarian and overall metabolic health.

How PCOS affects fertility

Irregular cycles:  fewer opportunities for natural conception

Anovulation: difficulty identifying fertile days

Disrupted hormonal profile: affects egg maturation

Possible endometrial receptivity issues: implantation difficulties

Assisted Reproduction & PCOS

IVF is often the best option for women with PCOS who have not conceived naturally or with simpler assisted methods. However, careful planning is required due to the increased risk of ovarian hyperstimulation (OHSS).

At Fertulity, we implement personalized stimulation protocols based on each woman’s hormonal and metabolic profile. We also use techniques such as In Vitro Maturation (IVM) – maturing the eggs in the lab – when the ovaries are particularly sensitive to stimulation.

IVF success rates in women with PCOS

Success rates depend on age, BMI, egg quality, and the presence of other fertility factors. In general:
Up to 35 years old with good response: success rates up to 50–60% per cycle
With IVM or cryopreserved eggs: comparable outcomes to conventional IVF
In PCOS + obesity cases: weight loss before treatment increases success rates by 15–20%
Our expertise in PCOS allows us to create treatment programs that respect each woman’s physiology, minimize side effects, and maximize pregnancy chances with safety and support at every step.

Therapeutic Approaches for Polycystic Ovary Syndrome

Managing PCOS requires a holistic and personalized approach, as symptoms and needs vary from woman to woman. At Fertulity, we design treatment plans combining medication, lifestyle changes, and specialized assisted reproduction techniques when needed.

Medical Treatment

Medication targets hormonal balance restoration, ovulation regulation, and metabolic disorder management.

Birth control pills

Regulate the cycle and reduce androgen levels, improving acne and hirsutism.

Metformin

Improves insulin sensitivity and supports weight loss. May also restore ovulation.

Clomiphene citrate or letrozole

Induce ovulation for women trying to conceive.

Anti-androgens

Reduce hyperandrogenism symptoms, mainly when there is no reproductive goal.
The appropriate regimen depends on each woman’s goals – whether regulating the cycle or improving fertility.

Lifestyle Changes

Weight loss and improving daily habits play a key role in managing PCOS, especially in cases of obesity or metabolic syndrome.

Balanced diet

The Mediterranean diet with a low glycemic index has been shown to help regulate insulin levels.

Regular physical activity

Aerobic and HIIT training reduce insulin resistance and regulate cycles.

Stress management

Relaxation techniques like yoga or meditation can reduce inflammation and support hormonal health.
At Fertulity, our approach includes expert dietary guidance, progress monitoring, and everyday support.

IVF for Women with PCOS

When medication or natural methods are not sufficient, IVF is a highly effective tool. Due to the risk of hyperstimulation, the treatment requires specialized management.

Low-dose gonadotropins

Individualized protocols to avoid hyperstimulation.

Monitoring with ultrasounds and hormone markers

Frequent checks ensure safe stimulation progress.

Use of GnRH agonists

Prevent OHSS (ovarian hyperstimulation syndrome).

Embryo freezing (freeze-all)

When many eggs are retrieved, delaying embryo transfer increases safety and implantation rates.
Our team has extensive experience managing PCOS cases with IVF, focusing on safety and high-quality outcomes.

In Vitro Maturation (IVM)

IVM is a cutting-edge option for women with PCOS who prefer to avoid intense ovarian stimulation.
Retrieval of immature eggs with mild or no stimulation
Cultivation and maturation in the lab under special conditions
Fertilization and embryo transfer as in classic IVF
IVM significantly reduces hyperstimulation risk and is ideal for women with high gonadotropin sensitivity. At Fertulity, we have the expertise and state-of-the-art lab equipment to successfully apply this technique.

Treating PCOS is never one-size-fits-all. Instead, it requires a dynamic, multi-dimensional strategy tailored to each woman’s needs. At Fertulity, we stand by you with scientific expertise and a human-centered approach.
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PCOS & Pregnancy: What to Expect

What to expect in the first trimester

During the early stages of pregnancy, women with PCOS face slightly increased risks of complications, so regular medical monitoring is essential.
Common challenges include:

Increased miscarriage risk

Especially with insufficient progesterone

Early bleeding

Usually not dangerous but requires evaluation

Hormonal shifts

Which may intensify fatigue, nausea, or mood swings

Progesterone support

Often needed in IVF pregnancies or with miscarriage history
At Fertulity, women with PCOS are closely monitored from early pregnancy with comprehensive checkups and hormonal support when needed to increase the chances of a healthy outcome.

Risks and complication prevention during pregnancy

Having PCOS is associated with certain increased risks, which can be minimized with proper medical care:

Gestational Diabetes (GDM)

Due to insulin resistance, women with PCOS are at higher risk. Regular glucose monitoring and balanced diet are key.

Gestational hypertension / preeclampsia

Hormonal and vascular imbalances may contribute to increased blood pressure.

Preterm birth or increased cesarean likelihood

Not absolute but more frequent in women with PCOS.

Tips for a healthy pregnancy with PCOS

Get a preconception checkup to optimize hormonal and metabolic markers
Follow a low glycemic index diet and stay physically active if medically allowed
Monitor glucose and blood pressure regularly
Notify your gynecologist promptly about vaginal bleeding, pain, or fatigue
Pregnancy with PCOS can be completely normal, given early diagnosis, proper preparation, and close medical supervision. At Fertulity, we support you at every step – from conception to delivery.
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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 like diet and exercise can significantly improve symptoms and restore ovulation in many women. However, completely avoiding medication is not suitable for every case.

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?

Basic tests include ovarian ultrasound, hormonal testing (LH, FSH, testosterone, AMH, TSH, prolactin), and insulin resistance evaluation. A glucose tolerance test or HOMA-IR is often required.

Is there a risk of long-term health problems?

Yes. If left untreated, PCOS can increase the risk of type 2 diabetes, hypertension, high cholesterol, and endometrial cancer due to chronic anovulation. Regular monitoring significantly reduces these risks.

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. Maria Oikonomou Obstetrician – Gynecologist

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

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