What is PMOS?
Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS) is the most common ovulation problem in women of reproductive age, with 1in 10 women diagnosed with this condition. Women with PMOS can have infrequent or absent ovulation — the body’s process of growing and releasing eggs from the ovary. If you are having irregular menses, this could be related to PMOS.
For individuals with PMOS who are actively trying to conceive, the first step is to understand what PMOS is and then explore what treatments will work best for you as an individual.
Can patients with PMOS get pregnant?
Being diagnosed with PCOS, now known as PMOS, does not mean that you cannot get pregnant, but you may have more difficulty conceiving without fertility treatment.
Unlike women who ovulate and have a period every month, women with PCOS often don’t ovulate in a predictable fashion (or at all), and therefore, may have fewer opportunities to become pregnant over their lifetime.
Can lifestyle changes help increase fertility?
For many patients with PMOS, lifestyle changes, such as achieving and maintaining a healthy weight, can be enough to resume ovulation and become pregnant. Nutritional guidelines like regulating blood sugar and insulin levels, decreasing inflammatory foods, and correcting any nutrient deficiencies such as vitamin D are beneficial for patients with PMOS, too.
Regular movement, stress management practices like mindfulness or gentle yoga, and targeted supplementation can make a meaningful difference, too. Omega-3 fatty acids, in particular, have been studied for their role in supporting hormone balance and reducing inflammation in patients with PMOS. Small, sustainable lifestyle changes often add up to real progress toward ovulation. However, in some cases, medication is still needed to help release an egg.
What does fertility treatment look like for patients with PMOS?
We provide personalized treatment plans for all patients, including those with PMOS. We offer several treatment options for our patients from affordable, low-tech fertility treatment options to advanced treatments supported by our embryologists.
When lifestyle modifications on their own are not enough to help you begin ovulating, simple fertility treatments for patients with PMOS can include oral medications (i.e. pills) to help with ovulation such as clomiphene citrate (Clomid, Serophene) and letrozole (Femara).
For some patients, metabolic support such as metformin may be recommended alongside lifestyle changes to help address insulin resistance, lower blood sugar, and improve metabolic function. This can also help create a more favorable environment for ovulation to resume. A fertility specialist can help determine whether this option fits your personalized treatment plan.
If a patient has not become pregnant after 3-4 rounds of medicated menstrual cycles, it may be time to consider a different course of treatment such as intrauterine insemination (IUI) or in vitro fertilization (IVF).
What other health concerns are related to PMOS?
While many women come to a fertility specialist worried about their chance of getting pregnant, there are other health concerns that patients with PMOS should be aware of and address.
One of the causes of PMOS is a decreased sensitivity to insulin, which in turn causes male-type hormone (aka androgen) excess. This can lead to a higher likelihood of diabetes of pregnancy (gestational diabetes) and greater risk factors — such as high cholesterol — for heart disease. There is also an increased risk of endometrial cancer in women who have gone more than 90 days without having a period.
PMOS can affect sleep and mental health, with some patients experiencing sleep apnea, anxiety, or depression alongside their physical symptoms. Hormonal imbalances have also been linked to a higher risk of disordered eating patterns. Addressing these concerns is part of ongoing comprehensive PMOS care, not a footnote to fertility treatment.
Does PMOS affect your weight?
There is a common misconception that all women with PMOS are overweight. In some cases, insulin resistance can be associated with obesity, but there are many patients with PMOS who are not overweight. However, excess weight which produces hormones, can make it even harder for patients with PMOS to release an egg. Being overweight increases the severity of insulin resistance and further drives the process.
Studies have shown that weight loss of just five percent can lower androgen levels by a significant amount. In some cases, even modest weight loss can significantly help bring on regular menstrual cycles by restoring ovulation.
Could PMOS impact pregnancy?
Because PMOS is linked to underlying differences in blood sugar and hormone regulation, it can also affect pregnancy itself. Patients with PMOS may face a higher risk of miscarriage, gestational diabetes, and high blood pressure conditions like preeclampsia. Babies born to patients with PMOS are also more likely to arrive before 37 weeks, and cesarean delivery rates tend to be higher in this group. None of this rules out a healthy pregnancy; your care team may monitor you more closely along the way. Working on lifestyle modifications to optimize your blood sugar, weight, and blood pressure will help prepare for a healthier and safer pregnancy for mom and baby.
I have PMOS, when should I reach out to a fertility specialist?
If you’ve been diagnosed with or believe you may have PCOS/PMOS or an irregular period, you should seek help from a fertility specialist when you are ready to start trying to conceive.
To learn more about an individualized treatment plan for PMOS or to schedule a new patient appointment, please call our New Patient Center at 877-971-7755.
Medical contribution by Lauren Kendall-Rauchfuss, M.D.
Lauren Kendall-Rauchfuss, M.D., FACOG, completed her residency in Obstetrics and Gynecology at the prestigious Mayo Clinic in Rochester, Minnesota, where she also completed her fellowship in Reproductive Endocrinology and Infertility. Dr. Kendall-Rauchfuss brings her expertise, warmth, and dedication to SGF Orlando, where she is eager to help patients achieve their dreams of building a family.
Editor’s note: This article was originally published in May 2018 and has been updated as of September 2026.
