1. Home
2. Education
3. AFCC Fertility Blog
4. Polyendocrine Metabolic Ovary Syndrome (PMOS) & Fertility: What You Need to Know About Getting Pregnant

Polyendocrine Metabolic Ovary Syndrome (PMOS) & Fertility: What You Need to Know About Getting Pregnant

Authored and medically reviewed by Dr. Eli Reshef

Dr. Eli Reshef is a reproductive endocrinologist and fertility specialist who sees patients in Chicago and the greater Chicagoland area.

PMOS is one of the most common — but still misunderstood — causes of infertility. Affecting an estimated 1 in 8 to 1 in 10 women of reproductive age, it is a hormonal and metabolic condition that can interfere with ovulation and makes it harder to conceive. But here's the good news: many people with PMOS go on to have successful pregnancies, with or without fertility treatment.

There's also an important update to the name of the condition itself, which we cover first below. Whether you've just received a diagnosis or have been managing symptoms for years, understanding how this condition affects fertility can help you feel more informed and in control of your options.

Illustration of a “normal” ovary and one with PMOS/PCOS

PCOS Has a New Name: PMOS

In May 2026, after a 14-year global consensus process, polycystic ovary syndrome (PCOS) was officially renamed polyendocrine metabolic ovarian syndrome (PMOS). The change was published in The Lancet and endorsed by leading professional bodies, including the American Society for Reproductive Medicine (ASRM).

Why the change? Experts have long felt that "polycystic" is misleading. The small structures seen on an ultrasound of these ovaries are immature follicles rather than being pathological cysts. More importantly, the old name focused attention on the ovaries alone, when the condition actually involves the body's broader hormonal (endocrine) and metabolic systems. The hope is that a more accurate name will reduce stigma, cut down on missed and delayed diagnoses, and reflect the whole-body nature of the condition.

What this means for you, in plain terms:

• Your diagnosis has not changed. PMOS describes exactly the same condition as PCOS. If you were diagnosed with PCOS, you have PMOS.

• Your treatment has not changed. Diagnostic criteria and treatment protocols are unaffected by the renaming.

• The change is gradual. Adoption is rolling out over roughly three years. During that time, you'll likely see both names — PCOS and PMOS — used in medical records, lab reports, and patient materials, including ours.

For the rest of this article, we'll use "PCOS/PMOS" so that information is easy to search no matter which term you're familiar with.

How PCOS/PMOS Affects Ovulation and Fertility

At the core of the condition is a hormonal imbalance that disrupts normal ovulation. In a typical cycle, a mature egg is released from the ovary, creating the opportunity for pregnancy. PCOS/PMOS can interfere with this process in several ways:

• Irregular or absent periods. Many people experience infrequent, unpredictable, or absent cycles, which means they may ovulate less often or not at all. This is a form of ovulatory dysfunction, or anovulation.

• Excess androgens. Elevated levels of androgens (sometimes called "male" hormones) can prevent the development and release of eggs. In women, excess male hormone production may lead to excess hair (hirsutism).

• Insulin resistance. Many patients also have insulin resistance, which can worsen the hormonal imbalance and raise the long-term risk of type 2 diabetes and cardiovascular disease.

• Ultrasound appearance that is characteristic to PMOS/PCOS. Multiple immature follicles arranged in the ovaries like a “string of pearls”.

These disruptions make it harder to predict ovulation or time intercourse for conception — which is why many people with PCOS/PMOS seek fertility support.

Illustration of a menstrual cycle

How PCOS/PMOS Is Diagnosed

There is no single test for PCOS/PMOS. Instead, specialists use what are known as the Rotterdam criteria, diagnosing the condition when at least two of the following three features are present, and after ruling out other conditions that can cause similar symptoms (such as thyroid disorders or elevated prolactin):

1. Irregular or absent ovulation — reflected in infrequent, unpredictable, or missing periods.

2. Signs of elevated androgens — either physical signs (such as excess hair growth or persistent acne) or elevated androgen levels on a blood test.

3. Polycystic ovaries on ultrasound — a higher-than-typical number of small follicles visible on the ovaries (“string-of-pearls” appearance)

A typical evaluation includes a detailed history, a physical exam, hormone bloodwork, and a pelvic ultrasound. Because insulin resistance is so common with this condition, your provider may also check blood sugar and related metabolic markers. You can learn more on our PCOS fertility testing page and our overview of PCOS as a cause of infertility.

Does PCOS/PMOS Cause Infertility?

It is one of the leading causes of ovulatory infertility — but a diagnosis does not equal infertility. Many people conceive naturally, especially with milder symptoms or with lifestyle management. In other cases, fertility treatment can significantly improve the chances of pregnancy.

The key takeaway: PCOS/PMOS can make getting pregnant more challenging, but it does not make it impossible.

Fertility Treatment Options for PCOS/PMOS

If you've been trying to conceive without success, your fertility specialist may recommend a step-by-step approach, starting with the least invasive options.

1. Lifestyle changes

When insulin resistance is a factor, even a modest 5–10% reduction in body weight can help regulate cycles and restore ovulation for some patients. Balanced nutrition, regular movement, and stress management are often the first steps. The use of weight-reduction medications such as GLP1-RAs may also be considered to assist in weight management.

2. Ovulation induction

Medications that trigger ovulation are usually the first-line medical treatment. Letrozole (Femara) is now generally preferred as the first choice for PCOS/PMOS, with clomiphene citrate (Clomid) as an alternative. Learn more about ovulation induction.

3. Insulin-sensitizing medication

Metformin, originally a diabetes medication, can help address the insulin resistance that drives much of the hormonal imbalance in PCOS/PMOS — sometimes supporting more regular ovulation on its own and sometimes used alongside ovulation-induction medication. See our detailed guide to Metformin for PCOS/PMOS.

4. IUI or IVF

If oral medications aren't successful, assisted reproductive technologies such as intrauterine insemination (IUI) or in vitro fertilization (IVF) may be recommended — especially if other fertility factors are also present.

Your provider will tailor the plan to your symptoms, hormone levels, metabolic health, and personal goals.

PCOS/PMOS and Pregnancy: What to Expect

If you conceive, your care team will likely take extra steps to support a healthy pregnancy, because PCOS/PMOS can increase the risk of certain complications:

• Gestational diabetes — diabetes that develops during pregnancy and usually resolves after delivery; managed with monitoring and, if needed, treatment.

• Preeclampsia — a condition involving high blood pressure that requires close monitoring.

• Preterm birth — delivery before 37 weeks.

• Miscarriage — pregnancy loss before 20 weeks.

Obesity in pregnancy may lead to some or all the above, as well as to higher rate of C-sections or difficult vaginal deliveries.

With proactive care and monitoring, most patients with PCOS/PMOS go on to have healthy pregnancies and healthy babies. Helpful habits during pregnancy include maintaining balanced, blood-sugar-friendly nutrition, staying active with low-impact movement, following your provider's guidance on managing insulin or blood pressure, and attending all prenatal appointments.

Frequently Asked Questions

Is PCOS the same as PMOS? Yes. In May 2026, polycystic ovary syndrome (PCOS) was officially renamed polyendocrine metabolic ovarian syndrome (PMOS). It is the same condition — only the name has changed. Both terms will be used during the multi-year transition.

Why was the name changed? The word "polycystic" wrongly suggests ovarian cysts, and the old name overlooked the condition's hormonal and metabolic effects throughout the body. The new name aims to be more accurate, reduce stigma, and help prevent missed or delayed diagnoses.

Can you get pregnant naturally with PCOS/PMOS? Many people do, particularly with milder symptoms or with lifestyle management. When natural conception isn't happening, treatment is highly effective for most patients.

What is the best fertility treatment for PCOS/PMOS? There's no single best option — it depends on your situation. Care usually starts with lifestyle changes and ovulation-induction medication (often letrozole), and may progress to metformin, IUI, or IVF if needed.

Does the name change affect my diagnosis or treatment? No. Diagnostic criteria and treatment protocols are unchanged. The renaming is about clarity and awareness, not a change in care.

You're Not Alone in This

A PCOS/PMOS diagnosis can feel overwhelming — but it doesn't mean the end of your path to parenthood. With expert guidance, personalized care, and the right support, many people with this condition build the families they've hoped for.

Ready to take the next step? At Advanced Fertility Center of Chicago, our experienced team specializes in diagnosing and treating PCOS/PMOS-related infertility. Schedule a consultation today and take control of your fertility journey.

See all articles