Having Polycystic Ovaries (PCO) does not necessarily mean that you also have Polycystic Ovarian Syndrome (PCOS) . There is a subtle but important difference between these two medical conditions. You must understand the difference if you are trying to conceive with polycystic ovaries or polycystic ovarian syndrome . Both PCO and PCOS can have an impact on your fertility as well as your general reproductive health. In this article, we will understand the differences between Polycystic Ovarian Syndrome and PCO regarding both your chances of conceiving and overall health.

What is PCO?

Having polycystic ovaries is not that uncommon. Recent data from the Australian Government Department of Health indicates that nearly one in five women of reproductive age exhibits polycystic ovarian morphology. Often discovered during routine ultrasound examinations, this variation is typically incidental and does not automatically signal the presence of Polycystic Ovarian Syndrome (PCOS).

PCOS, or Polycystic Ovarian Syndrome, is one of the most frequently diagnosed endocrine disorders in women. Updated statistics from the Australian PCOS Alliance reveal that approximately one in six women presenting with menstrual irregularities is diagnosed with PCOS. This condition involves a spectrum of hormonal imbalances, metabolic challenges, and distinctive ovarian changes that require targeted clinical management.

Symptoms

Many women with polycystic ovaries experience only subtle symptoms. Some individuals notice irregular menstrual cycles with variations in cycle length and occasionally skipped periods. There may be mild disruptions in ovulation, where the release of an egg is delayed or inconsistent, potentially affecting fertility. A few women might also experience light abdominal discomfort or cramping during menstruation and slight fluctuations in menstrual flow. However, many cases remain asymptomatic and are discovered incidentally during routine examinations.

Diagnosis

A routine ultrasound exam is the easiest way to diagnose PCO. In most cases, women with PCO don’t have any symptoms, so they find out about their condition by accident. For some women, mild symptoms such as having irregular periods or light abdominal cramps might prompt them to visit the doctor’s office, where they might discover their condition. If you have PCOS, your ultrasound might reveal multiple ovarian follicles.

What is PCOS?

PCOS, or Polycystic Ovarian Syndrome, is a less common form of PCO. However, it remains one of the most frequently diagnosed reproductive conditions among women of reproductive age. The rate of PCOS diagnosis is reported to be around 1 in 5 women consulting their gynaecologist for period-related concerns.

Testosterone and oestrogen

Women with PCOS often experience insulin resistance, where their cells fail to respond properly to insulin—a vital hormone for blood sugar regulation. This leads to consistently high insulin levels, causing metabolic imbalances and increasing the risk of type 2 diabetes. Leading Australian endocrinologists and clinical guidelines stress that early detection and proactive management of insulin resistance are essential to mitigate these long-term health risks.

• • Having Polycystic Ovaries (PCO)

• • Pain in the abdomen

• • Irregular periods
    • • Abnormal menstrual cycles shorter than 21 days or longer than 35 days are considered irregular.
    • • Heavy bleeding during the menstrual phase of your periods

• • Having obesity or being overweight

• • Having insulin resistance

• • Having excessive growth of facial and body hair

• • Female pattern baldness and even acne

Diagnosis

According to current clinical guidelines and the internationally recognised Rotterdam criteria, Polycystic Ovarian Syndrome (PCOS) is diagnosed when at least two of the following three features are present:

• Ovulatory dysfunction
• Clinical or biochemical signs of endocrine imbalance
• Ultrasound evidence of polycystic ovarian morphology

This framework highlights that while many women with PCOS show polycystic ovarian features on ultrasound, these are not required for diagnosis. Supported by leading reproductive health experts, this comprehensive approach ensures more accurate PCOS identification and allows clinicians to tailor management strategies to each patient’s unique clinical profile.

How to treat PCO vs. PCOS?

For polycystic ovarian syndrome (PCOS), treatment strategies are designed to alleviate symptoms while addressing underlying hormonal imbalances. For women with polycystic ovaries who do not experience disruptive symptoms, active intervention may not be necessary. When treatment is indicated, it is important to consider both benefits and potential risks and to discuss these options with a healthcare professional.

• Hormonal birth control pills help to lower androgen levels, control acne, and regulate menstrual cycles. These medications can also carry risks such as blood clots, nausea, and mood fluctuations. It is essential to review these factors with your doctor before beginning treatment.
• Clomid is commonly prescribed to stimulate ovulation and stabilise menstrual cycles. While it may enhance fertility, some patients experience side effects such as hot flashes, breast discomfort, or visual disturbances. Consulting with a healthcare provider can help determine if Clomid is appropriate for your situation.
• Other therapies, including spironolactone for acne management and metformin for insulin resistance, can also be effective. As some of these drugs are used off-label, understanding all potential side effects is important.
• Lifestyle interventions such as weight management and the use of supplements like Myo-Inositol may support overall reproductive health. Always tailor any treatment plan to your individual needs with guidance from your healthcare professional.

Fertility Outcomes Comparison

Recent research shows significant differences in reproductive outcomes between women with incidental polycystic ovarian morphology and those diagnosed with Polycystic Ovary Syndrome (PCOS). Approximately 70–85% of women with isolated polycystic ovaries have regular ovulatory cycles, leading to higher natural conception rates. In contrast, only 30–40% of women with PCOS consistently ovulate without medical assistance, reducing their chances of conceiving naturally.

These findings highlight the need for early clinical evaluation and personalised treatment plans. Reproductive medicine experts in Australia and worldwide recommend that women facing fertility challenges seek specialised guidance. Customized treatment strategies, based on thorough assessments, can optimise reproductive outcomes while carefully weighing potential risks and benefits.

Tracking ovulation PCO vs. PCOS

Irregular ovulation is one of the reasons that women with PCOS find it difficult to get pregnant. If predicting your ovulation is difficult, you might find it difficult to plan sexual intercourse to give yourself a chance of getting pregnant. Women with PCO can also have irregular cycles, making it difficult to track their ovulation, but it is far less common in PCOS than PCOS. Tracking your ovulation using ovulation prediction kits from Fertility2Family can help you determine your fertility window. Our ovulation test kits are available in both strip and ovulation mid-stream forms. We suggest buying the ovulation strip tests as they are cheaper, allowing you to test multiple times a day throughout your cycle without worrying about the cost.

Evan kurzyp

Evan Kurzyp

Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified Registered Nurse and has expertise in guiding & managing patients through their fertility journeys.