Understanding Infertility

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a common reproductive hormonal disorder that is often associated with irregular ovulation and infertility. It is found in 10% of reproductive-aged women, and is frequently marked by elevated levels of androgen hormones, which can result in acne and/or increased facial and body hair. Women with PCOS sometimes show signs of “insulin resistance,” meaning that their bodies do not process sugar as efficiently as they should, which can make it more difficult to maintain a healthy weight.


The work-up for suspected PCOS typically includes the following

  • A careful review of medical and gynecologic history, including the regularity of ovulation, along with a physical exam
  • A pelvic ultrasound to visualize the ovaries (women with PCOS typically have multiple ovarian follicles)
  • A series of hormonal blood tests


For women who are not actively trying to become pregnant, symptoms of PCOS can typically be managed using oral contraceptive pills. Women with PCOS who desire fertility may have difficulty conceiving because of infrequent ovulation. Oral medications such as clomiphene citrate and letrozole can be used to cause a woman to ovulate in a regular and predictable way, allowing her to time intercourse appropriately so that she has an opportunity to conceive. Sometimes, if she is resistant to these medications and does not ovulate in response to either clomiphene citrate or letrozole, injectable medications will be used instead. Glucophage, a medication used to treat diabetes, can also be added in women who have documented signs of insulin resistance.