From the Guidelines
Women with Polycystic Ovary Syndrome (PCOS) have a significantly higher risk of infertility, with approximately 70-80% of women with PCOS experiencing difficulties conceiving, as supported by 1. The exact rate of infertility in women with PCOS can vary depending on several factors, including age, body weight, and the severity of hormonal imbalances. PCOS affects 5-10% of women of reproductive age and is characterized by irregular menstrual cycles, high androgen levels, and polycystic ovaries, which can interfere with ovulation and make it harder to conceive naturally. According to 1, about 80 percent of women with PCOS ovulate when treated with clomiphene citrate, and one half of these patients conceive, highlighting the potential for medical interventions to improve fertility outcomes. Despite these challenges, many women with PCOS can still become pregnant, either naturally or with medical assistance, such as lifestyle changes, ovulation induction medications, or assisted reproductive technologies. Key factors that influence fertility in women with PCOS include:
- Age: Advanced maternal age can reduce fertility
- Body weight: Obesity can further reduce fertility
- Severity of hormonal imbalances: High androgen levels and irregular menstrual cycles can interfere with ovulation
- Presence of other medical conditions: Such as endometriosis or uterine cavity abnormalities Early diagnosis and management of PCOS can help improve fertility outcomes and overall health for affected women, as emphasized by 1.
From the Research
Infertility Rate in Women with PCOS
- The rate of infertility in women with Polycystic Ovary Syndrome (PCOS) is approximately 75% due to anovulation, making PCOS the most common cause of anovulatory infertility 2.
- Another study estimates that around 80% of women who suffer from anovulatory infertility have PCOS 3.
- A community-based cohort study found that 72% of women reporting PCOS experienced infertility, which is 15-fold higher than women not reporting PCOS 4.
Factors Affecting Infertility in PCOS
- Obesity is a significant factor, and lifestyle changes are often recommended as the first-line treatment for infertile anovulatory PCOS women who are overweight or obese 2, 3.
- The use of fertility hormone treatment is higher in women reporting PCOS, with 62% of women with PCOS using fertility hormone treatment compared to 33% of women without PCOS 4.
Treatment Options for Infertility in PCOS
- Clomiphene citrate and letrozole are commonly used as first-line pharmacological treatments for ovulation induction in women with PCOS 2, 3, 5.
- Metformin alone has limited benefits in improving live birth rates, but it can be used in combination with other treatments 2, 3.
- In vitro fertilization (IVF) can be considered as a third-line treatment for women with PCOS who fail lifestyle and ovulation induction therapy or have additional infertility factors 2, 3, 6.