Polycystic ovary syndrome (PCOS) is a common hormonal condition that can influence fertility in women. It is estimated that between 5.5% and 11.5% of women are affected by this condition, depending on the diagnostic criteria. PCOS can manifest in many ways, from irregular menstrual cycles and hormonal imbalances to subtle changes detectable only through scans or blood tests.
At Maigaard, we understand that every patient’s experience with PCOS is unique and requires a personalised approach. Some women come to our fertility clinics already aware of their condition, while others discover it for the first time after seeking our help.
In this article, we will walk you through the symptoms of PCOS, what it can mean for fertility, and the options you might consider.
What Is PCOS in Women? Signs and Symptoms
PCOS is a hormonal imbalance affecting the ovaries. The condition arises from disruptions in the hypothalamus-pituitary-ovarian axis, leading to elevated levels of androgens like testosterone, which can affect ovulation.
Women with PCOS often have a higher number of small, immature ovarian follicles, which produce anti-Müllerian hormone (AMH). These immature follicles can give the ovaries a polycystic appearance on an ultrasound scan.
The presence of these follicles is only one of the possible symptoms of PCOS, not the cause of the condition. Some women with PCOS may have normal-appearing ovaries without such morphology. At the same time, healthy ovaries without compromised fertility can also contain small follicles. In these cases, they are merely part of the ovarian structure, which can give the appearance of polycystic ovaries (PCO) on a scan but does not necessarily mean a woman has PCOS.
Common PCOS symptoms include:
- Irregular or absent periods;
- Absence of spontaneous ovulation;
- Excess facial and body hair;
- Weight gain;
- Oily skin;
- Acne after puberty;
- Thinning scalp hair.
However, not every patient experiences these classic signs. At Maigaard, we see both patients with typical symptoms and those whose condition is visible only through scans or blood tests.
How PCOS Is Diagnosed in Denmark?
Medical guidelines for diagnosis of PCOS may vary by region. In Denmark, the diagnostic process assesses the condition against the Rotterdam criteria:
- irregular or absent periods (oligomenorrhea or amenorrhea);
- hyperandrogenism, which includes elevated blood androgens or clinical signs like acne and hair growth in areas where men typically have hair;
- polycystic ovarian morphology, defined as at least one ovary containing 20 or more antral follicles measuring 2–9 mm in size.
The examination may combine:
- assessment of a detailed medical history, including menstrual cycles, fertility, weight, and family history;
- physical examination for signs of hyperandrogenism;
- blood tests for hormone levels.
Transvaginal ultrasound can also be used to evaluate the ovaries as part of the diagnostic process, but it may be optional if other criteria are already met.
PCOS is typically diagnosed when two of the Rotterdam criteria are met and other conditions with similar symptoms have been excluded, including:
- thyroid dysfunction;
- hyperprolactinaemia (elevated levels of the hormone prolactin);
- non-classic congenital adrenal hyperplasia (NCAH), a genetic condition causing androgen overproduction.
Hormonal blood tests are commonly used to help identify or rule out these conditions.
How Does PCOS Affect Fertility and Chances of Pregnancy?
The major negative effect of PCOS on fertility is disrupted ovulation. When ovulation is irregular or unpredictable, it can be more difficult to identify a fertile window, which may make natural conception more challenging. In some cases, ovulation may not occur at all, which means there is no egg released for fertilisation during a cycle.
The impact of PCOS on fertility varies widely from person to person. Factors such as body composition and insulin resistance can play a role. For example, higher levels of abdominal body fat may be associated with increased insulin resistance, which in turn can influence hormone levels and ovulation patterns.
PCOS does not necessarily mean permanent infertility. Some women may experience occasional ovulation, while others may benefit from fertility treatment.
Fertility Treatments for PCOS
At Maigaard fertility clinics in Odense and Aarhus, our approach to fertility treatment for women with PCOS is always personalised.
We carefully assess ovarian function and plan each treatment individually. In women with PCOS, we pay particular attention to balancing ovarian stimulation, as achieving an appropriate number of eggs can be more complex for this group.
Treatment options may include:
Ovulation induction and insemination (IUI)
For some patients, treatment focuses on supporting ovulation and timing conception more precisely.
Ovulation induction helps stimulate the ovaries to release an egg, while IUI involves placing sperm directly into the uterus at the right time, increasing the chances of fertilisation during the cycle.
In Vitro Fertilisation (IVF) and tailored stimulation protocols
Women with PCOS are typically offered gentle and carefully adjusted ovarian stimulation, which supports the development of a suitable number of follicles and reduces the risk of overstimulation.
IVF involves fertilising eggs outside the body in a laboratory before transferring embryos into the uterus, which can be particularly helpful for women whose ovulation is irregular or absent.
Egg freezing and egg donation
These options are offered to women with PCOS on the same basis as for other patients at our clinics.
Egg freezing allows eggs to be preserved for future use, which can be helpful if a patient wishes to delay pregnancy. Egg donation provides an opportunity to achieve pregnancy using donor eggs, for women who may face challenges with their own egg quality or quantity.
Fertility Care for Women with PCOS
At Maigaard, we recognise that every patient’s experience with PCOS is unique. That is why we create a personalised fertility plan for each woman.
Our doctors, embryologists, and nurses work closely with every patient. We offer guidance, reassurance, and clear information at every stage. We are here to support our patients whether they come to us already aware of their condition or learn about it for the first time while beginning treatment at our clinics.
Frequently Asked Questions
Can I get pregnant with PCOS?
Yes, many women with PCOS can achieve pregnancy, either naturally or with the support of fertility treatments. Because PCOS can affect ovulation, timing conception may be more challenging but for many women it is not impossible.
Does PCOS Increase Pregnancy Risks?
PCOS itself does not automatically prevent a healthy pregnancy, but it can sometimes be associated with factors that require monitoring, such as blood sugar, blood pressure, and hormone levels. Women with PCOS may have a higher risk of certain complications, including gestational diabetes and preterm birth, among others.
Is IVF Effective for PCOS?
IVF can be a helpful option for women with PCOS. At Maigaard, IVF protocols are carefully tailored to each patient’s ovarian response, aiming for a balanced approach to support egg development while minimising risks.
Does Pregnancy Cure PCOS?
Pregnancy does not cure PCOS. The hormonal and metabolic aspects of the condition remain, even after giving birth. However, some symptoms may change temporarily during or after pregnancy.