PCOS Facts and Fertility

Shannon M. Clark, MD
October 5, 2020
PCOS Facts and Fertility

Last week, we covered the important topic of fibroids and fertility. This week, we are diving into the facts about polycystic ovary syndrome (PCOS) and fertility. Though PCOS is fairly common, affecting between 8%–10% of reproductive age women (18-44), medical experts do not know the complete list of causes or the full impact it has on a woman’s sexual function.

Defining exactly what PCOS is not as straightforward as one would hope. At its core, PCOS is an endocrine system disorder, but the symptoms can vary widely for each woman. Symptoms can include growth of excess body hair, weight gain, irregular periods, and even infertility


Two of these three criteria must be met to be diagnosed with PCOS:

  1. high levels of androgens (testosterone)
  2. lost or irregular periods
  3. polycystic ovaries

One misconception is that PCOS alway produces ovarian cysts, however, not all women have polycystic ovaries as the name might suggest.


Sometimes there is also misconception that women with PCOS are overweight or obese, but not all women with PCOS fit into this category. As with other health diagnoses, a woman’s outer appearance is in no way indicative of what is going on internally. However, it is important to be aware that many women with PCOS do have signs of insulin resistance and/or obesity.

Some ways to reverse this are to develop a healthy lifestyle, including adopting a clean-eating diet and increasing physical activity. Additionally, getting adequate amounts of Vitamin D can help. It’s been shown that Vitamin D has a therapeutic effect on things like insulin resistance, obesity, inflammation and dyslipidemia.

To learn more about the importance of Vitamin D for reproductive health, read this article!


No matter what lifestyle changes a woman makes, though, she may not return to regular menstrual cycles and ovulation which can affect her ability to conceive. As such, some women with PCOS will require additional treatment to get pregnant.

Treatments include medications to decrease insulin resistance, while others might need the assistance of a reproductive endocrinology and infertility specialist.


Although PCOS is an endocrine dysfunction disorder, meaning it is hormonal, it is not only about the hormones. Symptoms like weight gain, excess body hair, and acne can affect a woman’s body perception leading to psychological blocks during sex.

This can impact a woman’s ability to orgasm, as well as negatively impact her mental well-being. Depression and anxiety have been found to be common among women with PCOS, and if you’re one of the women who suffers with this, be sure to talk about solutions with your doctor.

For additional information about diagnoses and treatment, visit ReproductiveFacts.org.

This video interview also covers PCOS in even more depth.

Shannon M. Clark, MD

Shannon M. Clark, MD

Shannon M. Clark, MD, MMS is a double board certified ObGyn and Maternal-Fetal Medicine Specialist, and founder of Babies After 35. In her roles as a clinician, educator and researcher at UTMB-Galveston, she focuses on the care of people with maternal and/or fetal complications of pregnancy. Dr. Clark has taken a special interest in pregnancy after the age of 35, which according to age alone, is considered a high-risk pregnancy.

Follow Shannon on TikTok @tiktokbabydoc, Facebook @babiesafter35, and Instagram @babiesafter35.

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