I Was Diagnosed with PCOS: A Case Study

Trying to conceive with PCOS: one couple's experience

You stop using contraception and wait for nature to take its course. When months turn into years without a positive test, the waiting can become exhausting.

Polycystic ovary syndrome, commonly known as PCOS, is one of the most common reasons women experience difficulty conceiving. It affects roughly one in ten women in the UK, though many only discover they have it when they start trying for a baby.

The condition causes a hormonal imbalance that can prevent the ovaries from releasing eggs regularly. Symptoms vary widely. Some women have irregular or absent periods. Others experience acne, excess hair growth, or weight gain. Many women have very mild symptoms and remain unaware of the condition for years. Beyond fertility, PCOS can also increase the risk of type 2 diabetes, metabolic syndrome, and mental health conditions such as anxiety and depression.

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When to seek help

NHS guidance suggests that couples should see their GP if they have been trying to conceive for a year without success. Women over 36, those with irregular cycles, or anyone with a known reproductive health condition should consider seeking advice sooner.

A GP will typically ask about your menstrual history and general health. Irregular periods are often the first clue that something might be affecting ovulation. However, some women with PCOS do have regular cycles, which can make the condition harder to spot without testing.

Initial investigations usually involve blood tests to check hormone levels, including tests for luteinising hormone, follicle stimulating hormone, and androgens. An ultrasound scan may show whether the ovaries contain multiple small follicles. However, PCOS is typically diagnosed using the Rotterdam criteria, which require at least two of three features: signs of high androgens, ovulatory dysfunction, or polycystic ovaries on ultrasound. The follicles visible on scans are not actually cysts but undeveloped follicles that have not released an egg.

Male fertility should also be assessed, though this may happen after initial female investigations or alongside them depending on the clinic. A semen analysis will assess sperm count, movement and shape. In around a third of couples struggling to conceive, the cause lies with the male partner, so testing both people saves time.

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What a diagnosis means

Receiving a diagnosis of PCOS can bring mixed feelings. Some women feel relieved to have an explanation after months of uncertainty. Others feel anxious about what it means for their chances of becoming a parent.

PCOS is one of the more treatable causes of infertility, though outcomes vary considerably depending on individual circumstances. Most women with the condition will be able to conceive, though they may need medical support to do so.

Treatment usually starts with the least invasive options. Lifestyle changes can make a real difference for some women, particularly those who are carrying extra weight. Even a modest reduction can help restore regular ovulation. A GP or fertility specialist may refer you to a dietitian or weight management service if appropriate.

If lifestyle changes alone are not enough, medication to stimulate ovulation is often the next step. Clomifene has traditionally been the first choice in the UK, though letrozole is increasingly used as first line treatment, particularly for women with a higher BMI. Both work by encouraging the ovaries to release eggs. Treatment is monitored carefully with ultrasound scans to check the response and reduce the risk of multiple pregnancy.

For women who do not respond to these medications, other options include injectable hormones or, in some cases, a minor surgical procedure called ovarian drilling. IVF may also be recommended, depending on individual circumstances.

Getting support

Fertility treatment can be physically and emotionally demanding. Waiting for test results, adjusting to medication side effects, and managing the uncertainty all take their toll. Women with PCOS may also be managing other symptoms and health concerns alongside their fertility journey.

The NHS provides fertility treatment in some cases, though eligibility criteria vary by area. Your local Integrated Care Board sets the rules for who qualifies and how many treatment cycles are funded. It is worth checking what your area offers early on, as waiting lists can be long.

Private treatment is another option for those who can afford it or who do not meet NHS criteria. Costs vary considerably between clinics. The Human Fertilisation and Embryology Authority website lists all licensed clinics in the UK along with their success rates and pricing information.

Charities such as Fertility Network UK offer practical information and peer support for anyone going through fertility treatment. Verity, a charity specifically for women with PCOS, provides resources and a community of others who understand what you are dealing with.

Speaking to your GP is always a sensible first step if you are concerned about your fertility. They can arrange initial tests and refer you to a specialist if needed. The sooner you have information, the sooner you can make decisions about what comes next.

The Next Step

Now that you have read through the advice above, you might want to put it into practice. Our Fertility Treatment Options lets you describe your fertility situation and get a clear overview of the treatments that could help. Understand what each option involves so you can have informed conversations with your doctor. Try it now →