Polycystic Ovarian Syndrome (PCOS)

Dr Sarah Johnson

Reviewed by Dr Sarah Johnson on May 17, 2017
Written by Julie Macken.

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a leading cause of female infertility; in fact, PCOS is the most common cause of chronic anovulation (when a woman’s ovary does not release an egg). It is estimated that about one in five women in the UK have polycystic ovaries1.

  • PCOS may mean a woman has multiple cysts on her ovaries. It is thought to be caused by a hormone imbalance.
  • One in five women in the UK have polycystic ovaries1
  • Your doctor will be able to diagnose it with blood tests and pelvic examination.
  • Symptoms can include weight gain, excess hair growth as well as problems trying to conceive
  • With treatment, most women with PCOS are able to become pregnant1
  • Ovulation tests may give a misleading result if a woman has PCOS

What is Polycystic Ovarian Syndrome (PCOS)?

Polycystic ovaries contain a large number of harmless ‘cysts’ or egg-containing follicles that haven’t developed properly. The exact cause of PCOS is unknown but it is thought to be caused by a hormone imbalance, resulting in women with PCOS having elevated levels of LH throughout their cycle.

It is estimated that more than half of women with polycystic ovaries have no symptoms at all1 and some women only discover they have PCOS when they have difficulty conceiving. If present, symptoms can vary from mild to severe, and may include irregular periods or no periods at all (amenorrhea), excess body hair, oily skin, acne, weight gain and depression.

To diagnose PCOS a healthcare practitioner takes a detailed medical history, to rule out other potential causes of the symptoms, then a pelvic examination and an ultrasound may be used to detect any ovarian cysts; blood tests are often also used to establish hormone levels.

PCOS cannot be cured, but for many women their symptoms can be effectively managed. For women who are overweight, the initial recommended course of action is usually to lose their excess weight, exercise regularly and have a healthy balanced diet; this can greatly improve many symptoms. Infertility due to PCOS can be treated with fertility drugs such as clomiphene which stimulates the pituitary gland to release a hormone called FSH that then results in a normal menstrual cycle with ovulation. Gonadotrophins may also be used to directly stimulate the ovary. There are also other treatments.

Rest assured, with treatment, most women with PCOS are able to become pregnant1.

I have been diagnosed with polycystic ovarian syndrome, will this make getting pregnant difficult and why?

Professor Bill Ledger, Fertility Specialist

Women with polycystic ovarian syndrome often don’t ovulate, or at least not regularly. This group of women will have irregular or infrequent periods. If you are not ovulating then the egg is not released from the ovary to pass into the Fallopian tube in order to be fertilised and implant in the uterus. There are several treatments for anovulation (a cycle when no egg is released) with polycystic ovarian syndrome. These include clomiphene tablets (Clomid) and injections of fertility drugs. Your doctor will be able to advise on this and refer you to a specialist clinic for help.

Can I use an ovulation test if I have PCOS?

The short answer is no, as they are likely to give misleading results, ovulation tests are not designed for women with ongoing anovulation due to an underlying hormonal disorder such as PCOS.

Clearblue Ovulation Tests identify the onset of ovulation by detecting a surge of LH above a baseline level. Women with PCOS may have a high baseline level of LH, and so there may not be a sufficient change in LH for the test to detect a surge, so ovulation may not be indicated. Or the baseline may be so high that it appears the surge is already underway, and the test will indicate ovulation on the first day of testing.

The Clearblue Advanced Digital Ovulation Test measures estrogen as well as LH, to identify more fertile days than is possible with LH alone. Women with PCOS may also have a high baseline level of estrogen. Women with PCOS may therefore see more ‘high fertility’ days than expected, or an incorrect result due to high background levels of LH.

If you are using ovulation tests, you may see unexpected results, and we recommend that you seek advice from your healthcare provider.


Advanced digital ovulation test

In every cycle there are only a few days when a woman can conceive, so having sex on these days is very important if you are trying to get pregnant. The Clearblue® Advanced Digital Ovulation Test is the first and ONLY test that typically identifies 4 or more fertile days each cycle.