Fertility & Pregnancy8 min read

PCOS and Ovulation: Improving Fertility Outcomes

A deep dive into how PCOS affects ovulation, diagnostic markers, and interventions that improve chances of conception.

What You'll Learn

How PCOS disrupts ovulation
Diagnostic signs of anovulation
Medical and lifestyle approaches to induce ovulation
How ovulation tracking can assist conception

PCOS and Its Impact on Ovulation

Polycystic Ovary Syndrome (PCOS) is one of the leading causes of anovulatory infertility. The condition disrupts the hypothalamic-pituitary-ovarian (HPO) axis, leading to irregular or absent ovulation. Elevated luteinizing hormone (LH) levels and hyperandrogenism impair follicular maturation, often causing multiple immature follicles to develop without a dominant follicle reaching ovulation.

Key Fertility Stats in PCOS

70–80%

PCOS patients experiencing ovulatory dysfunction

50–60%

Women with PCOS who are overweight or obese

70%

Improvement in ovulation rate with lifestyle changes

Diagnosing Anovulation

Irregular menstrual cycles (typically >35 days), absence of cervical mucus changes, and lack of mid-cycle LH surge are clinical indicators. Ultrasound often shows a 'string of pearls' pattern on ovaries, and serum progesterone <3 ng/mL in the luteal phase confirms anovulation.

Interventions to Promote Ovulation

Several first-line and adjunctive therapies are used to trigger ovulation:

Diagnostic Process

Weight loss of 5–10% in overweight women can restore spontaneous ovulation

Clomiphene Citrate or Letrozole are commonly prescribed ovulation inducers

Metformin improves insulin sensitivity, indirectly restoring ovulation in some cases

Gonadotropin therapy may be considered in resistant cases under specialist supervision

Tracking and Supporting Ovulation

In addition to medical support, fertility-focused individuals with PCOS benefit from monitoring their ovulation through:

Monitoring Tools

Basal Body Temperature (BBT) charting
Ovulation Predictor Kits (OPKs) — though LH surges may be unreliable in PCOS
Mid-cycle transvaginal ultrasound
Serum progesterone levels post-ovulation

Lifestyle Support

Low-glycemic diet to stabilize insulin and hormones
Moderate-intensity exercise like brisk walking or swimming
Stress-reduction practices like mindfulness and yoga
Adequate sleep and circadian rhythm alignment

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Fertility Treatments in PCOS: Options & Success Rates

An in-depth review of available fertility treatments for PCOS including success rates, indications, and stepwise approaches.

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PCOS and Pregnancy: Risks and Management Strategies

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Take Control of Your PCOS Journey

Download Aora to track symptoms, monitor cycles, and get personalized insights