Challenges, Choices & Clarity: Breaking the Buzz Around PCOS and Fertility
On this episode of The Care Circle, host Sneha is joined by Dr. Priyanka Dass, Senior Obstetrician and Gynaecologist at Motherhood Hospitals, Kothanur, Bangalore, and Dr. Rohitha, Fertility Health Specialist at Motherhood Fertility & IVF, Kothanur, Bangalore. Together, they unpack one of the most talked-about yet misunderstood conditions affecting women today: PCOS (Polycystic Ovarian Syndrome).
From differentiating PCOS and PCOD, clarifying common misconceptions, and understanding diagnosis criteria, to discussing lifestyle interventions, fertility challenges, and age-related considerations, this episode offers clear, practical guidance for women navigating PCOS at any stage of life. The experts also address emotional and social concerns, emphasizing that PCOS is manageable, treatable, and not a barrier to motherhood.
Here are the key points you shouldn’t miss from this episode:
-> PCOS is a syndrome, not a single disease; its symptoms vary widely, including irregular periods, acne, excess hair, weight issues, or a combination of these.
-> Diagnosis requires at least two criteria: irregular cycles, signs of male hormones, and polycystic ovaries; an ultrasound alone is not enough.
-> Sustainable lifestyle changes, regular physical activity, balanced diet, and consistency, are more effective than extreme diets or social media ‘hacks’.
-> PCOS isn’t just a reproductive issue; it can increase long-term risks like diabetes, cholesterol imbalances, high blood pressure, and heart disease.
-> Fertility is commonly affected due to irregular ovulation, but PCOS is one of the most treatable causes of infertility. With proper guidance, 80% of women conceive within 6 months of treatment.
-> Both lean and obese women can have PCOS; management differs, but lifestyle remains the cornerstone for all.
-> Age affects fertility in PCOS differently; reproductive ageing is slower, but egg quality still matters, and early planning is beneficial.
-> Extra pregnancy risks may include gestational diabetes, high blood pressure, and preterm delivery, but these can be managed with proper monitoring.
-> Stigma around PCOS persists, but women should know it’s common, manageable, and not a reason for judgment.
-> Fertility is a shared journey; PCOS management and conception involve both partners, emotional support, and medical guidance.
Dr. Priyanka Dass, Senior Obstetrician & Gynaecologist at Motherhood Hospitals, Kothanur, Bangalore
Dr. Rohitha , Fertility Health Specialist at Motherhood Fertility & IVF, Kothanur, Bangalore
0:06 – Host intro: PCOS, fertility myths & confusion
0:22 – Guest intro: Dr. Priyanka Dass & Dr. Rohitha
1:19 – PCOD vs PCOS: Difference & why it’s called a syndrome
2:30 – Diagnosis explained: What really defines PCOS
3:23 – Lifestyle management: Sustainable changes vs trends
4:50 – Long-term impact: PCOS beyond periods
5:03 – Real-life story: Ananya’s journey & common concerns
7:02 – PCOS across generations: Awareness & future outlook
9:23 – Fertility concerns: How PCOS affects conception
12:10 – Simple treatment steps before IVF
14:08 – Obese vs lean PCOS: Differences in fertility management
16:02 – Age & pregnancy: Does PCOS make conception harder after 35?
17:07 – Pregnancy risks & managing expectations
18:04 – Social stigma: Addressing misconceptions
18:53 – Final message: PCOS is manageable & fertility is a shared journey
20:11 – Outro: Takeaway for listeners & gratitude to guests
Snehaa (0:06): Hello and welcome back to the care circle, a podcast series by Motherhood Hospitals. I’m your host, Sneha, and today’s episode is about a subject that is everywhere on your Instagram feeds, on news panels, and in everyday conversations among women, and that is PCOS. For those listening who may not know the full form, PCOS stands for polycystic ovarian syndrome.
It’s one of the most talked-about health conditions of all time. Despite all the chatter, there’s still a lot of confusion, fear, and misinformation, especially when it comes to conceiving with PCOS and fertility. So today, we are cutting through the noise with insights from two specialists who see this in their practice every single day.
First, we have Dr Priyanka Dass, Senior Obstetrician and Gynaecologist, Laparoscopic surgeon, and Fertility health specialist at Motherhood Hospitals, Kothanur, Bangalore. She has worked with thousands of women across different age groups, guiding them through PCOS management and supporting their conception journeys. And later, we will be joined by Dr. Rohitha, a Fertility health specialist at Motherhood Fertility and IVF, Kothanur, Bangalore, who will help us understand what PCOS really means for women planning pregnancy.
Let’s dive right in with Dr Priyanka first. Dr Priyanka, welcome to the podcast.
Dr. Priyanka Dass (1:24): Thank you so much for having me here today.
Snehaa (1:27): So, doctor, let’s start by clearing up something that confuses so many women. We hear both terms now and then in the news or on social media, and that’s PCOD and PCOS. Could you explain the difference? And why do we call PCOS a syndrome and not a disease?
Dr. Priyanka Dass (1:42): Great starting point.
PCOD is more of a descriptive term, polycystic ovarian disease. But the correct term is PCOS, also known as polycystic ovarian syndrome. The word syndrome matters because it’s not one single disease with one fixed symptom.
It’s a combination of issues that affect how the ovaries function. One woman may have irregular periods, another may have acne or excess hair growth, someone else may struggle with their weight, and many may have a mix of these symptoms. That’s why PCOS looks so different from person to person.
Snehaa (2:23): That really explains why so many women say my PCOS doesn’t look like my friend’s PCOS. It’s not one picture. It’s many.
So, doctor, diagnosis is another area full of confusion. Some women say they were told they had PCOS just by doing an ultrasound. How do you diagnose the syndrome?
Dr. Priyanka Dass (2:41): Absolutely right.
This is a big issue, and ultrasound alone is not enough. We look at three main factors: irregular periods, signs of male hormones, which act like acne, or excess hair growth, and polycystic-looking ovaries. They look bulky and have lots of water follicles inside them.
If a woman has at least two of these, then we call it PCOS. But we also rule out other conditions. Sadly, many women are misdiagnosed because scans are over-relied upon.
Snehaa (3:15): So if someone is listening has only been told based on a scan, it’s worth asking a few more questions to their gynaecologist. Doctor, let’s talk about the lifestyle. Social media is full of PCOS hacks.
It can be keto, intermittent fasting, cut carbs, cut dairy, and it’s honestly overwhelming. From your experience, what works long term?
Dr. Priyanka Dass (3:37): I completely agree. Social media has made PCOS look like a diet trend.
But what truly works is a sustainable lifestyle change, not extremes. Regular physical activity, even 30 minutes of brisk walking, helps regulate cycles. A balanced diet with fewer refined carbs and sugar makes a difference.
But cutting out whole food groups unless medically required is unnecessary. The golden rule is consistency, but not quick fixes.
Snehaa (4:11): That means so no crash diets or miracle foods, just steady, realistic changes.
One angle we don’t hear enough about is the long-term impact, doctor. Is PCOS just about periods, or does it also affect fertility? Or are there any other health risks involved that women should be aware of?
Dr. Priyanka Dass (4:30): A very important point. PCOS raises the risk of diabetes, cholesterol imbalances, high blood pressure, and even heart disease later in life.
So it’s not just a reproductive issue. It’s also a metabolic and lifestyle condition. The earlier we manage it, the better the protection for long-term health.
Snehaa (4:50): So what the doctor said is, in a nutshell, we can say the overall management of PCOS isn’t only for a few years. It’s really about safeguarding the future. Doctor, I want to share a story that I think many listeners will relate to.
Let’s take the example of a 26-year-old woman, whom we can call Ananya. She isn’t married yet. She’s focused on building her career and her future.
But for years, she has been struggling with irregular periods, sudden weight gain, and breakouts despite trying different diets. With no real guidance, she finally saw a gynaecologist and was diagnosed with PCOS. Now Ananya feels anxious and uncertain.
She wonders how she can control this condition, what it means for her long-term health, and whether it might affect her chances of becoming a mother one day. I bring up her story because so many women like Ananya are asking themselves these same questions. What would you say to them?
Dr. Priyanka Dass (5:46): Ananya’s story is something I see quite often in my clinic.
Young women come in confused and worried because they have read so much online, but don’t know what to trust. What I would tell Ananya and anyone like her is that PCOS is not the end of the road. It’s a condition that can be managed step by step.
With the right guidance on lifestyle, regular checkups, and, if needed, medical support, she can keep her health under control. And when the time comes, PCOS does not mean she cannot become a mother. It just means that she may need a little extra support along the way.
The more important thing is to focus on overall health today because that will automatically safeguard her fertility tomorrow.
Snehaa (6:35): There are many women like Ananya who are suffering and confused regarding this condition. In the coming times, they will find out the best possible way to safeguard their future.
Doctor, you have seen women with PCOS across all age groups, from teenagers to women in their 20s and 30s, like Ananya. Now we have Gen Z coming into adulthood, and eventually, we will see the next generation, too. Based on your experience, what do you think lies ahead when it comes to PCOS? Do you see it becoming more common and worse?
Dr. Priyanka Dass (7:11): Across generations, I have seen how PCOS has changed.
In the past, many women weren’t even diagnosed. They just lived with irregular cycles without knowing why. Today, awareness is much higher.
So more young women are being diagnosed earlier. That’s a good thing because early awareness means early action. Looking at Gen Z and beyond, I do think lifestyle will play a big role.
With changing food habits, more screen time, and less physical activity, we may see PCOS becoming more common. But on the other hand, with the greater awareness, more open conversations, and a shift towards fitness and preventive care, I am hopeful that the next generation will not just live with PCOS but manage it far better than before. So the future depends on how we act today.
Snehaa (8:05): Dr Priyanka, before we wrap up, there are many young women like Ananya or much younger than her, who would be listening to podcasts, and they were told that they have PCOS. What’s the one piece of reassurance you would like to give them?
Dr. Priyanka Dass (8:18): To every young woman out there listening to us who has just been told she has PCOS, please do not panic. PCOS is common, and it is manageable.
It doesn’t mean you will always struggle with your health, and it certainly doesn’t mean you won’t be able to conceive in the future. With lifestyle balance, medical care when needed, and patience, you can lead a perfectly normal, healthy life. My one message would be, don’t let the diagnosis define you.
Let it empower you to take care of yourself better.
Snehaa (8:55): Beautifully put, doctor. Thank you so much for your great insights and for helping us see PCOS more clearly.
Dr. Priyanka Dass (9:02): Thank you so much.
Snehaa (9:03): Now, when women are first diagnosed with PCOS, their biggest worries are usually about things like irregular periods, sudden weight gain, or acne. Fertility isn’t the first thing they think about.
But as they move into a stage of life where they want to plan a family, the question often comes up, Will PCOS make it harder for me to conceive? To help us understand this journey, we have Dr. Rohitha with us today.
Dr. Rohitha, welcome to the podcast.
Dr. Rohitha (9:31): Hi Sneha, happy to be here.Thank you for inviting me.
Snehaa (9:33): Dr. Rohitha, when women with PCOS start thinking about pregnancy, many worry about whether it will affect their chances of conceiving. From your experience, how true is that concern?
Dr. Rohitha (9:45): That’s a very common question asked as well because these days PCOD is very common.
It’s common as early as adolescent age, and it continues to be in their young reproductive age as well. So most commonly, the PCOS actually gets diagnosed when the couple is not able to conceive. That is when they come, and we know that they have PCOD.
So that is how it gets diagnosed. Because the main problem why they don’t conceive is that there is an ovulation problem. The majority of PCOD in India comes with ovulation.
That means the eggs are not getting released every month. That is why they are not having periods on time. This is the most important problem that we need to understand here.
So sometimes it takes a little longer to understand. The patient herself has to understand that she has PCOS because PCOS has a spectrum of phenotypes. It’s not that one patient has regular periods, but the other patient might have irregular periods.
So it is very broad-spectrum. The symptoms are also very broad-spectrum. Based on just one symptom, we can’t say whether PCOS is there or not. Having just one symptom, we can’t just deny that PCOS is not there.
But with proper guidance, lifestyle changes, oral medications, and sometimes assisted treatments, women with PCOS they actually conceive successfully. In fact, PCOS is one of the most treatable causes of infertility. 80% of the PCOS women conceive within six months of coming to us.
Snehaa (11:12): That’s such a relief to hear, doctor. PCOS isn’t the end of the road. Could you explain what happens inside the ovaries of a woman with PCOS that makes conception tricky?
Dr. Rohitha (11:21):You see, in PCOS, the ovaries often contain multiple small follicles, but they don’t mature enough to release an egg. This results in irregular or absent ovulation. Sometimes they ovulate, sometimes they ovulate at the 18th day or the 19th day.
Maybe they are not actually sexually active during those periods. So this is what actually makes it harder to conceive. They don’t know their fertile period.
The fertile period is again a broad range in PCOS. But we have medications that can stimulate ovulation, and in most cases, they are quite effective because the only barricade that we are supposed to break in PCOS is ovulation, which is easily done by ovulogens.
Snehaa (12:02): So it’s not that women with PCOS can’t conceive.
It’s just that ovulation is irregular, and that can be worked on with treatment.
Dr. Rohita (12:09): Correct.
Snehaa (12:10): So, doctor, when a couple comes to you and the woman has PCOS, what are the first simple steps you usually suggest before moving to advanced treatments like IVF?
Dr. Rohitha (12:19): See, in South India, in Bangalore, if we are speaking particularly, if the woman is having PCOS, we usually assume that it is just PCOS because we don’t have much genital tuberculosis going on in South India compared to North India, where we have tubal blocks in association with PCOS. So here we just assume that tubes are not blocked, and we just go ahead with the ovulation induction because of PCOS; there is no problem with the ovarian reserve. The reserve is very good.
So we start with the ovulation induction, a simple treatment, oral ovulogens, just a tablet called letrozole or clomiphene, separate for that matter, just for 5 days they have to take. On the 14th day or 15th day, we are just calling them again just to check whether ovulation is happening or not. If it is happening, then we just leave it, okay.
We just leave it, ask the couple to be sexually active from this day to this day, and this can go on for 3 to 4 months. Usually, if the couple is doing this properly, they usually get within 3 to 4 months, and pregnancy happens. If it is not happening, then we go ahead.
Next step. What else do we have to look into? Definitely, semen analysis will be done before doing all this. Semen analysis should be normal.
That is a prerequisite. After that, after 3 months or 4 months, if the couple is not able to get pregnant, then we are looking into other things, called the fallopian tubes. And there is one more entity called luteal phase insufficiency, which is very common in PCOS, where even if the embryo is getting formed, it is not getting attached because of some hormonal problem, which is very common in PCOS, which usually gets missed.
It’s very difficult to diagnose luteal phase insufficiency. So yeah, some of the challenges are there even after breaking that barricade of ovulation, which we usually tackle in the second step.
Snehaa (14:03): That means it’s reassuring that the path isn’t always straight to IVF.
Dr. Rohitha (14:07): Correct.
Snehaa (14:08): So, doctor, in your practice, you must be seeing different kinds of PCOS cases. Some women are overweight, and others who are lean, but still have PCOS.
From a fertility perspective, how does the management differ between obese PCOS and lean PCOS?
Dr. Rohitaa (14:24): A very challenging question, a very controversial question to be very frank, because PCOS, the mainstay of management, is always the lifestyle here. Obese PCOS, definitely, we ask the patient to, you know, a little weight reduction and lifestyle modification in the form of diet. Then comes our lean PCOS, which is very difficult to treat.
Most of the time, they are actually resistant to whatever oral medications we give. And even if we give, sometimes they blow up, which is called ovarian hyperstimulation. Also, it’s very common in lean PCOS.
So it’s actually very difficult to treat lean PCOS than obese PCOS. Lean PCOS, again, lifestyle modification is the mainstay, but we have other drugs called myoinositol, which we can add, and some patients might need ovarian drilling in lean PCOS, which is where ovarian drilling comes into the picture. Yeah.
And last comes our IVF, where again, lean PCOS will be benefiting from IVF.
Snehaa (15:24): That makes so much sense, doctor. So whether a woman is lean or obese, PCOS can still impact fertility just in different ways.
And the key is getting the right guidance rather than comparing your journey to someone else’s journey.
Dr. Rohitha (15:37): Exactly.
Snehaa (15:38): So, Dr. Rohitha, another big concern many women have is about age.
For someone with PCOS, if pregnancy is delayed into the mid-thirties, does that make fertility challenges more complicated?
Dr. Rohitha (15:50): Honestly, in PCOS, they say the reproductive ageing happens very slowly when compared to other normal women. After 35, I have personally seen in my practice that the fertility actually increases for the PCOS women. Why? Because PCOS gets better with age.
They start getting normal periods, regular periods, and the ovarian reserve also comes down as they cross 35. But it doesn’t mean that you have to wait till 35 in PCOS women for you to conceive, because obviously, the oocyte quality, that means the egg quality, will be diminished, as well as the number. So whatever eggs you are remaining with are usually of a lower quality than when you were 25 years of age.
So definitely age is one of the important factors here. When it comes to IVF, age is one of the most common determining factors of the success 16:40 rate of any fertility treatment, for that matter. So yeah, the younger the couple, the better.
But yeah, PCOS has the advantage that even after 35, conception is easily possible when compared to other factors of infertility.
Snehaa (16:56): That’s very interesting to know, Dr. Rohitha. That means with foresight and planning, women can still make informed choices, taking the right guidance from the expert.
Dr. Rohithaa (17:06): Correct. Yeah.
Snehaa (17:07): Once a woman with PCOS does conceive, are there extra pregnancy risks to watch for?
Dr. Rohitha (17:12): Yeah, that’s a very good question, actually.
See, women with PCOS are slightly more prone to gestational diabetes, that is, sugar in pregnancy, high blood pressure, that is, BP in pregnancy, and preterm delivery for some of the reasons. But with proper prenatal care and regular monitoring, most pregnancies are absolutely healthy. It’s all about vigilance and not panic.
We have to keep screening them for all these things, time and again, to prevent the complications from happening.
Snehaa (17:41): Understood, doctor. Now, I want to bring up something that recently went viral on social media, doctor.
A young woman shared that she was rejected in an arranged marriage setup because the boy assumed that since she has PCOS, she wouldn’t be able to conceive. Now, while that was his personal decision, it also highlights how much stigma still exists around PCOS and fertility. What would you say to women who hear such things? How should they comprehend this?
Dr. Rohitha (18:09): Stigma is definitely there because of the awareness that all obese women have PCOS.
Many people are assuming this. Sadly, I have seen this too, and it reflects ignorance and not reality. PCOS is definitely manageable. Most women with PCOS can conceive.
No one should be judged or rejected because of a health condition, especially one that is very common and treatable. One in five women in India has PCOS, which means one in five women should get rejected if that is the case. Your birth is not tied to a diagnosis, and we as a society need to move toward empathy and understanding, and not judge someone because of some stigma that exists.
Snehaa (18:44): Amazing, doctor. I mean, I love the answer. Finally, doctor, what is your message to women or couples listening, who are struggling with PCOS-related infertility?
Dr. Rohitha (18:53): The message is very simple.
Don’t give up on PCOS. PCOS is very challenging, but definitely beatable. With the right medical guidance and emotional support, parenthood is absolutely possible.
And remember, fertility is a shared journey. So it is not just the woman’s responsibility, it is the couple’s responsibility. So whenever I say the woman is not getting pregnant, it’s the couple not getting pregnant, it is not women not getting pregnant.
So yeah, it’s always the combined factors. And these days, we are seeing other factors also, which are involved. So we need to rule out everything and then come to a final decision.
Snehaa(19:23): Thank you so much, Dr. Rohitha. That perspective really brings comfort. Thank you.
And that brings us to the end of today’s episode of the Care Circle. We began by saying that PCOS is one of the most talked-about subjects. And I think what our experts showed us today is that beyond the buzz and beyond the stigma, PCOS is manageable, treatable, and not something to fear.
It is not a single syndrome, but a spectrum that can be managed with the right lifestyle and medical support. We also understood that this syndrome does not take away the dream of parenthood. With awareness and the right guidance, women can conceive.
Most importantly, what I want every listener to take away is that PCOS does not define you. You are more than a diagnosis, and your health and fertility journeys are uniquely yours. A big thank you to Dr. Priyanka Dass and Dr. Rohitha for sharing their time and wisdom, and to all the viewers for tuning in.
If you found this conversation meaningful, please share it with a friend, a sister, and a colleague, anyone who needs to hear that PCOS is not the end of the road. Until next time, stay informed, stay healthy, stay connected, and take care.
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