Hopeful mothers: Medical breakthroughs for women with common infertility condition

Trying to conceive is not always, ahem, a straight shot.

A diagnosis like polycystic ovary syndrome can throw even more curveballs into the mix, but there’s increasing hope for women attempting to have a baby with this medical condition.

As Dr. Shaun C. Williams, MD, a reproductive endocrinologist at Illume Fertility, in Norwalk, Conn., described it: PCOS involves abnormal egg development, leading to irregular ovulation and abnormal hormone production from the ovaries.

“The normal hormone cycle is also disrupted, as normal female reproductive hormone production occurs with normal egg growth,” Williams added, noting that the ovaries will make more androgens (male testosterone-like hormones) instead of higher levels of estrogen.

This leads to infertility, as oocytes (eggs) are not released regularly, if at all.

It also affects the skin and hair follicles, causing increasing acne or unwanted “male” hair growth, said Williams.

The cause of PCOS varies and can range from genetic to hormonal to environmental, or a combination of factors. Yet despite this, scientists are making steady progress in helping women with the condition conceive.

Here’s a look at the next generation of fertility breakthroughs for those with PCOS.

Improved IVF protocols

PCOS patients regularly have eggs in an immature state of development. For such patients undergoing in vitro fertilization, said Dr. Alexander Kotlyar, MD, a reproductive endocrinologist and infertility specialist at Genesis Fertility in Brooklyn, this results in many of the eggs being inadequate.

“However, numerous groups are working on methods to mature these eggs in the laboratory, which could greatly improve IVF results for these patients,” said Kotlyar.

In the past few years, IVF has become a safe and more effective treatment for many women with PCOS, said Williams. “Stimulation protocols that still result in numerous good quality oocytes for use have evolved to minimize risks typically associated with PCOS, such as ovarian hyperstimulation syndrome,” he added. Medications to trigger ovulation, such as Lupron, to trigger egg release are also less risky for women with PCOS.

A super supplement (maybe)

Dr. Hadi Ramadan, MD (pictured above right), a reproductive endocrinologist with Boston IVF in Boston and Albany, is particularly excited about the use of inositols.

These are natural compounds that help the body process insulin and support egg development.

“Inositols help restore more regular menstrual cycles, improve egg quality and reduce insulin resistance for many women with PCOS,” said Ramadan, highlighting that unlike older supplements or medications, inositols are well-tolerated and can be taken orally, making them an accessible therapy for women looking to regulate ovulation naturally.

While Ramadan dubs them a promising supplement for PCOS-related infertility, he shared that they have not been established as part of PCOS therapy — “but things are moving in that direction.”

As a fertility doctor, Nirali Jain, MD, a reproductive endocrinologist with IVI RMA North America in Seattle, often recommends myo-inositol to patients especially those struggling with irregular cycles or insulin resistance.

“The supplement works at the cellular level to improve how the body uses insulin, which can help lower testosterone levels and promote more predictable ovulation,” said Jain.

“For many of my patients, that means cycles that start to regulate naturally, improved egg quality, and a smoother transition into conception,” she continued, stressing that while it’s not a cure-all, when used strategically and early — often alongside nutrition, movement, and medical support — it can be a gentle yet effective first step toward restoring balance and optimizing fertility.

Worth noting: Jain references a landmark 2025 JAMA study in which researchers followed 464 pregnant women with PCOS to see if taking myo-inositol could make pregnancy safer. Participants began the supplement early in pregnancy and continued until delivery.

“After months of tracking, the results reported that myo-inositol didn’t make a significant difference [in terms of pregnancy issues such as gestational diabetes, preeclampsia and preterm birth]. About 25% of women experienced one of those complications, compared with nearly 27% in the placebo group,” she said. “while the supplement remains safe and may still be helpful for improving fertility or hormonal balance before conception, it didn’t prevent major pregnancy risks once women were already expecting.”

Better timing

Controlling ovulation induction can also turn that “maybe baby” into a tangible one.

Kotlyar is encouraged by a study of 52 patients with PCOS published in 2024 by Mandelbaum et al., which showed that starting patients on an elevated dose of Letrozole, a medication that stimulates the ovaries to release an egg, and/or extending the treatment length to 10 days from 5, gave a significantly higher chance of ovulation. “This discovery could reduce the time needed for dose-finding for PCOS patients and could shorten the time to pregnancy,” said Kotlyar.

Typically, he said, women must undergo a trial-and-error approach of seeing which dose works best. “The findings of the study will help reduce the tediousness of treatment and increase ovulation rates sooner,” added Kotlyar.

Help from GLP-1s

What can’t GLP-1 receptor agonists do? These medications include semaglutide (Ozempic, Wegovy, etc.) and Jain is keen on a comprehensive meta-analysis published in 2025 that reviewed 27 randomized controlled trials involving 1,642 participants.

“The findings indicated that GLP-1 RAs significantly reduced body weight, body mass index, insulin resistance and levels of free testosterone and androstenedione,” she said. “Additionally, improvements were observed in menstrual frequency and the free androgen index.”

This is encouraging for patients with obesity or insulin resistance, common concerns in PCOS management.

“The ability of GLP-1 RAs to address these issues may offer a valuable therapeutic option, especially when traditional treatments like metformin are insufficient,” she said.

“Treating insulin resistance can improve ovulatory dynamics,” echoed Williams. “New weight-loss medications such as semaglutide or other GLP-1 inhibitors can help restore more normal menstrual patterns and ovulation.”

These medications should be discontinued prior to pregnancy.

Back to the basics

Focusing on healthy choices can be a game-changer. When Jain counsels patients with PCOS, she always underscores that lifestyle is the true foundation of hormonal balance, including “eating protein with every meal, choosing high-fiber carbs and healthy fats to prevent glucose spikes,” she said. “Regular movement can improve insulin sensitivity and ovulation rates. Sleep and stress management matter just as much.”