Why PCOS is One of the Most Common Causes of Infertility in Young Women

Among the many conditions that affect women’s health, few are as widely discussed today as polycystic ovary syndrome (PCOS). Its relevance lies not only in how common it has become, but in how often it stands in the way of young women who hope to conceive.

Today, it is increasingly common for women in their twenties and thirties to discover that PCOS is at the root of their fertility struggles.The Numbers Tell Their Own StoryAcross India, research shows striking variation in prevalence. Some studies have reported rates as low as 3–4% in certain regions and as high as over 20% in others. A survey among college students in Delhi found nearly one in six living with PCOS — among the highest rates reported in that age group so far.

Globally too, the picture is shifting. The number of girls and young women aged 10–24 with PCOS has risen steadily since the 1990s, with South Asia seeing one of the steepest climbs.

This is no longer a rare disorder; it has become a defining challenge in women’s health.How PCOS Affects FertilityPCOS primarily interferes with ovulation. Normally, the pituitary gland releases two hormones — follicle-stimulating hormone (FSH) and luteinising hormone (LH) — that help eggs mature and trigger ovulation.

In PCOS, this balance is disrupted. Eggs may fail to mature, cycles become irregular and ovulation may not occur at all.

Excess androgens (male hormones) and insulin resistance — both strongly linked to PCOS — worsen this disruption. Insulin resistance, even in women who are not overweight, can intensify hormonal imbalance and make conception harder. Together, these changes explain why PCOS accounts for so many cases of anovulatory infertility.Beyond ReproductionFor many women, fertility is only the most visible part of the story. PCOS increases the risk of diabetes, cardiovascular disease and endometrial cancer. It also carries a psychological burden that begins early. Teenagers coping with acne, excess hair growth or sudden weight changes may experience anxiety or depression long before they understand the hormonal cause.The good news is that with early diagnosis and proper management, many of these long-term risks can be significantly reduced.Why It Is Rising NowGenes play a major part — twin studies suggest around 70% of the risk is inherited. Yet genes alone cannot explain the surge. Urban lifestyles have amplified the condition. Late nights, high-pressure academic and career routines, processed food and sedentary habits together are fuelling PCOS at rates not seen before.Importantly, PCOS can occur in women of all body types, not just those who are overweight, and lifestyle factors may still have a strong impact regardless of weight.

Early Recognition Makes the DifferenceOne of the real challenges with PCOS is that early signs are often brushed aside. Irregular periods may be dismissed as stress-related, acne as routine adolescence and hair growth as a cosmetic issue. By the time fertility becomes a concern, years may have passed.Key warning signs include:Irregular or missed periodsPersistent acneExcess facial or body hairUnexplained weight gain or difficulty losing weightIf you notice two or more of these, talk to a gynaecologist or endocrinologist early.

Recognising PCOS in the teenage years or early twenties allows for lifestyle adjustments and medical support that can profoundly improve fertility and long-term health.Looking AheadThere is no single cure for PCOS, but early diagnosis, lifestyle changes and appropriate treatment can greatly improve outcomes. For those facing infertility, assisted reproductive options such as ovulation induction and IVF offer new possibilities.

At a broader level, awareness campaigns in schools and universities could help young women identify symptoms sooner and seek care earlier.Closing ThoughtPCOS is no longer a fringe condition. It is one of the most common causes of infertility in young women, shaped by both biology and modern living. With timely diagnosis, personalised care and lifestyle support, young women with PCOS can take charge of their fertility and long-term health — easing the burden not just on reproduction but on overall well-being and confidence for an entire generation.By: Dr Aashita Jain, Fertility Specialist, Birla Fertility & IVF, Surat