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PCOD and Fertility: Symptoms, Causes, and Management

Written by: Dr. Merlin Levy T S , BDS (K.V.G Dental College and Hospital, Sullia)

Published on August 11, 2025

Introduction

Are you among the many women diagnosed with PCOD who feels anxious about starting a family? You are not alone.

Polycystic Ovarian Disease (PCOD) affects 6–13% of women and ranks among the leading causes of infertility.1

Motherhood represents a beautiful journey – carrying a tiny life for nine months is a cherished dream for many. While PCOD can make this path more challenging, it doesn’t mean you can’t conceive.

With the right knowledge, lifestyle modifications, and medical support, many women with PCOD achieve healthy pregnancies and joyful motherhood. Today, a team-based approach, including doctors, dietitians, makes a big difference in turning this dream into reality.

In this article, you’ll discover all about PCOD. We’ll cover its symptoms, causes, management strategies, and treatment options. This information will help you take control of your reproductive health.

PCOD: The Basics Explained

What is PCOD?

In a healthy menstrual cycle, the ovary typically releases one egg each during ovulation. A normal menstrual cycle typically lasts 21 to 35 days, with bleeding ranging from 2 to 7 days. 2

In PCOD, the egg fails to mature or be released. It remains trapped within a fluid-filled sac, forming small cysts. This disruption prevents regular ovulation, causing irregular or delayed periods and impacting infertility.

Let’s break down the term PCOD to understand it better: 

  • Poly signifies many
  • Cystic refers to cysts, which are small fluid-filled sacs
  • Ovarian pertains to the ovaries which release eggs
  • Disease indicates a medical condition affecting normal function

So, Polycystic Ovarian Disease (PCOD) means a condition where multiple small cysts form in the ovaries.

The incidence of PCOD in women with anovulatory( no ovulation) infertility is higher at 70% to 80%.3

What are the root causes of PCOD?

Polycystic Ovarian Disease (PCOD) arises from multiple factors, indicating that it lacks a single cause. Genetic, environmental, hormonal, and lifestyle factors contribute to its development. Here are the main contributors:

 Let’s look at the key contributors:

1. Environmental Pollutants-

  • Environmental pollutants such as heavy metals, insecticides, and endocrine-disrupting chemicals (EDCs) can disrupt the body’s natural hormonal balance.
  • EDCs are harmful substances present in plastics, cosmetics, and pesticides. They disrupt or block hormones, especially estrogen and insulin, and are strongly linked to PCOD.
  • Smoking has been identified as a risk factor for PCOD. It worsens insulin resistance, affects hormone levels, and may disrupt ovarian function.5

 2. Unhealthy Diet and Sedentary Lifestyle-

  • Diets rich in sugar, refined carbs, and excess calories, paired with lack of physical activity, can lead to weight gain, insulin resistance, and hormonal imbalance, which heighten the risk of developing PCOD.
  • You can effectively manage PCOD by keeping a healthy BMI, staying active, and eating a balanced diet.4

 3. Genetic Predisposition-

  • PCOD tends to run in families. 
  • Research shows that gene-gene and gene-environment interactions may play a major role in its development. If a close female relative has PCOD, your risk may be higher.5

 4. Gut Microbiota Imbalance (Gut Dysbiosis)-

Your gut is home to trillions of microbes, almost like an organ on its own. In women with PCOD, changes in the gut microbiota (dysbiosis) may lead to chronic inflammation, insulin resistance, and hormonal disruptions.

Studies show that the types and balance of gut bacteria differ between women with PCOD and those without.5

What are the common symptoms of PCOD?

As hormonal fluctuations cause PCOD, the symptoms will be varied-

  • Increased body mass index
  • Irregular or no periods at all.
  • Skin- Oily skin and acne
  • Hair- hirsutism( usually on chest/ buttocks/face/ chest), thinning of hair, and loss of hair.6

How do we diagnose PCOD?

For the diagnosis of a patient, 2 of 3 would be required.

  1. Oligo/anovulation –  Reduction in ovulation or no ovulation.
  2. High levels of male hormones (hyperandrogenism – seen in blood tests or physical symptoms)
  3.  Polycystic ovaries.7

Management of PCOD

Polycystic Ovarian Disease (PCOD) is a multifactorial condition, and so managing it requires a holistic and personalized approach. The primary goals focus on restoring hormonal balance, regulating menstrual cycles, improving fertility, and preventing long-term complications like diabetes and cardiovascular disease.

Weight Loss and Lifestyle Modification

Lifestyle changes are the first and most essential step in managing PCOD:

  • Diet and Exercise: A healthy, balanced diet that is low in refined carbohydrates and high in fiber, along with regular physical activity boosts insulin sensitivity and supports hormonal regulation.
  • In PCOD patients, obesity ranges from 42-65%.7 Losing just 5% of body weight can significantly improve menstrual regularity and enhance the effectiveness of fertility treatments.8

Ovulation Induction

Ovulation induction serves as foundation of infertility treatment for women with PCOD. It uses medications to encourage the ovaries to release eggs. 

70-80% women were successful in getting pregnant via ovulation induction.9

These medications are given from day 2-5, and dosages are adjusted accordingly.

Common medications include:

  • Letrozole serves as the first-line agent for inducing ovulation induction, and it carries a lower risk of multiple pregnancies.
  • Clomiphene Citrate (CC) has been a popular treatment for many years.
  • Gonadotropins come in injectable forms and carry greater risks. 8

Laparoscopic Ovarian Drilling (LOD)

For women who do not respond to medical ovulation induction, doctors may recommend LOD.

  • It is a minimally invasive procedure where 5–10 small punctures are made in each ovary.
  • Benefits: It reduces the risk of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies, especially compared to gonadotropin use.8

Assisted Reproductive Technologies (ART)

ART involves manipulating eggs or embryos. These are carried out only after proper counselling.10

ART is recommended when:

  • Ovulation induction fails.
  • Tubal damage exist.
  • Male factor infertility is present.

Common ART options include:

  1. In Vitro Fertilization (IVF) ± Intracytoplasmic Sperm Injection (ICSI):
  • This is the most commonly performed ART procedure.
  • It requires collecting eggs, fertilising them outside the body, and transferring embryos to the womb.10
  • ICSI may assist in cases of male infertility.
  • Generally,  IVF with or without ICSI is generally considered third-line treatment.
  1. In Vitro Maturation (IVM):
  • Doctors perform IVM when IVF fails. 10
  • This process retrieves immature eggs and matures them in a controlled laboratory setting.
  • Typically, IVM has lower success rates than conventional IVF.

Managing PCOD effectively requires a multidisciplinary approach involving gynecologists, endocrinologists, dietitians, and sometimes fertility specialists. Early diagnosis, patient education, and consistent follow-up play crucial roles in enhancing   quality of life and reproductive outcomes.8

Conclusion

PCOD is becoming more common, so it’s important to educate girls early and encourage healthy habits from childhood. A balanced diet and regular exercise help keep the body active and hormones balanced.

If you’re diagnosed with PCOD, talk to your doctor.  PCOD has many causes, so managing it often needs a team approach. This includes gynecologists, endocrinologists, and dietitians working together.

Women with PCOD have every reason to be hopeful – to experience the joy of motherhood.

References

  1. Polycystic ovary syndrome [Internet]. [cited 2025 Jul 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome 
  2. Periods and fertility in the menstrual cycle. nhs.uk [Internet]. 2018 [cited 2025 Jul 9]. Available from: https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle/. 
  3. Sawant S, Bhide P. Fertility Treatment Options for Women With Polycystic Ovary Syndrome. Clin Med Insights Reprod Health [Internet]. 2019 [cited 2025 Jul 9]; 13:1179558119890867. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935873/ .
  4. Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, et al. Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics. J Clin Med [Internet]. 2023 [cited 2025 Jul 9]; 12(4):1454. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964744/. 
  5. Lacroix AE, Gondal H, Shumway KR, Langaker MD. Physiology, Menarche. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Jul 9]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470216/ 
  6. Menopause [Internet]. [cited 2025 Jul 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/menopause. 
  7. https://www.unicef.org/india/stories/do-pcod-and-pcos-mean-same-thing-or-are-they-different 
  8. Cunha A, Póvoa AM. Infertility management in women with polycystic ovary syndrome: a review. Porto Biomed J [Internet]. 2021 [cited 2025 Jul 10]; 6(1):e116. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846416/ 
  9. Vyrides AA, El Mahdi E, Giannakou K. Ovulation induction techniques in women with polycystic ovary syndrome. Front Med (Lausanne) [Internet]. 2022 [cited 2025 Jul 11]; 9:982230. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9411864/. 
  10. Jain M, Singh M. Assisted Reproductive Technology (ART) Techniques. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Jul 11]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK576409/. 

Disclaimer

Please note that the information provided on HealthOdysseyHub is for educational purposes only and, therefore, should not be considered a substitute for professional medical advice, diagnosis, or treatment. While we strive to ensure that the content is accurate and up-to-date, healthcare knowledge is constantly evolving. Therefore, we encourage you to consult with a qualified healthcare professional before making any decisions based on the information found on this site. Additionally, some of the treatments, practices, or approaches discussed on this site may be rooted in alternative or complementary medicine. While we aim to present these perspectives as accurately as possible, they may not always align with conventional medical practices or recommendations.Hence, it is always advisable to approach such content with caution and seek multiple opinions when considering any medical intervention.

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