Polyendocrine Metabolic Ovarian Syndrome (PMOS), now formally renamed polyendocrine metabolic ovarian syndrome (PMOS), is one of the most common hormonal conditions affecting women of reproductive age, and one of the most frequent questions Dr. Adam Shoman hears from patients at Hackensack CMIGS is: does PMOS mean I cannot get pregnant? The honest answer is nuanced. PMOS is a leading cause of ovulatory infertility, but it is also one of the most treatable. Understanding the connection between PMOS and fertility is the first step toward knowing your options.
What Is PMOS?
Polycystic ovary syndrome is a hormonal condition characterised by elevated androgen (male hormone) levels, irregular or absent ovulation, and polycystic-appearing ovaries on ultrasound. It affects an estimated 6 to 12% of women of reproductive age, according to the Centers for Disease Control and Prevention (CDC), making it the most common endocrine disorder in this age group.
Common symptoms include irregular or missed periods, excess facial or body hair (hirsutism), acne, difficulty managing weight, and ovaries with multiple small follicles visible on ultrasound. Not every woman with PMOS will have all of these features — the condition presents very differently from person to person.
Is PCOS Now Called PMOS?
Yes. In May 2026, an international consensus published in The Lancet renamed polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome, or PMOS. The change was endorsed by more than fifty academic, clinical and patient organisations after more than a decade of consultation with patients and clinicians worldwide.
The reasoning behind the change is clinical accuracy rather than branding. Most women with the condition do not have true ovarian cysts, and the old name suggested a purely gynecologic problem when the condition actually involves hormonal, metabolic, reproductive, dermatological and mental health effects together. That narrow framing contributed to delayed diagnoses, fragmented care and unnecessary stigma for decades.
For patients, nothing about diagnosis or treatment changes. The Rotterdam criteria still apply, the same blood work and ultrasound imaging are still used, and the same treatment options are still available. Both terms will remain in use for the next several years while clinical guidelines, insurance coding and medical record systems complete the transition. At Hackensack CMIGS we use both terms so that patients searching for either one find the care they need.
If you have been trying to conceive under a PMOS diagnosis, nothing about your fertility workup or treatment plan changes because of the rename.
How Does PMOS Affect Fertility?
The primary way PMOS affects fertility is through its impact on ovulation. To conceive naturally, ovulation — the release of a mature egg from the ovary — must occur reliably each cycle. In women with PMOS, the hormonal imbalances that define the condition interfere with the normal ovulation process:
- Elevated LH (luteinising hormone) levels: The hormone surge that triggers ovulation may be abnormal or inconsistent, preventing a mature egg from being released.
- Elevated androgens: High androgen levels can disrupt follicle development, causing follicles to stall before reaching maturity.
- Insulin resistance: Many women with PMOS have insulin resistance, which contributes to elevated androgen production and further disrupts the hormonal environment needed for ovulation.
- Irregular cycles: Infrequent or unpredictable cycles make it difficult to identify the fertile window, even if ovulation does occur occasionally.
It is worth noting that PMOS does not mean permanent infertility. Many women with PMOS do ovulate, even if irregularly — and with appropriate treatment, the majority can achieve conception.
What Treatments Can Help?
Treatment for PMOS-related infertility is highly individualised. The approach depends on how severely ovulation is affected, whether other fertility factors are present (such as male factor infertility or tubal issues), and the patient’s overall health and preferences.
Lifestyle and Metabolic Management
For women with PMOS and insulin resistance, lifestyle modifications — including dietary changes and regular exercise — can improve insulin sensitivity and, in some cases, restore regular ovulation. Even modest weight reduction has been shown in multiple studies to improve hormonal balance and menstrual regularity in women with PMOS. This is not about achieving a specific body size — it is about improving the hormonal environment.
Ovulation Induction Medications
When lifestyle measures alone are insufficient, ovulation-stimulating medications are typically the next step. Letrozole (an aromatase inhibitor) is currently recommended as the first-line oral medication for ovulation induction in women with PMOS, based on evidence from clinical trials including the PMOSACT trial. Clomiphene citrate (Clomid) has also been used for many years for this purpose.
These medications are taken at specific points in the menstrual cycle and are usually combined with monitoring (ultrasound and blood tests) to confirm that ovulation has occurred.
Injectable Gonadotropins
For women who do not respond to oral medications, injectable hormones (gonadotropins) that directly stimulate the ovaries may be recommended. This approach requires closer monitoring due to the risk of multiple follicle development.
Laparoscopic Ovarian Drilling
In selected cases of PMOS-related infertility, laparoscopic ovarian drilling is a surgical option. Small punctures are made in the ovary using heat or laser energy to reduce androgen-producing tissue. This can restore regular ovulation in some women, though it is not a first-line approach and is typically considered when medications have not been effective.
IVF (In Vitro Fertilisation)
When other treatments have not achieved pregnancy, or when additional fertility factors are present, IVF may be recommended. Women with PMOS undergoing IVF require careful ovarian stimulation protocols because of the elevated risk of ovarian hyperstimulation syndrome (OHSS).
Is There a Role for Surgical Evaluation?
At Hackensack CMIGS, a surgical evaluation may be part of the workup for women with PMOS and infertility — particularly to rule out concurrent conditions such as endometriosis, uterine fibroids, or pelvic adhesions that could be contributing to difficulty conceiving. Dr. Shoman coordinates with reproductive endocrinologists to ensure that structural barriers to conception are identified and addressed as part of a comprehensive fertility plan.
You Are Not Alone — and This Is Treatable
PMOS is the most common ovulatory cause of infertility in women — but it is also among the most responsive to treatment. With the right evaluation and a personalised approach, many women with PMOS achieve successful pregnancies. If you have been diagnosed with PMOS and are trying to conceive, or if you suspect PMOS may be affecting your cycle, a specialist evaluation is a meaningful first step.
Frequently Asked Questions
Does PMOS always cause infertility?
No. PMOS is a common cause of ovulatory infertility, but many women with PMOS conceive naturally — particularly those with milder hormonal imbalances or who ovulate irregularly. Treatment significantly improves fertility outcomes for those who do struggle.
Can I get pregnant with PMOS without fertility treatment?
Some women with PMOS do conceive naturally, particularly if they ovulate even infrequently. Lifestyle changes that improve insulin sensitivity can also restore regular ovulation in some cases. A full evaluation helps determine the most appropriate path.
What is the best fertility treatment for PMOS?
Letrozole is currently the recommended first-line oral medication for ovulation induction in women with PMOS, based on clinical trial evidence. The right treatment depends on individual factors including overall health, cycle patterns, and whether additional fertility issues are present.
Does losing weight help PMOS fertility?
For women with PMOS and excess weight, studies have shown that even modest weight reduction can improve hormonal balance, restore menstrual regularity, and improve fertility outcomes. This is one of several approaches discussed during a comprehensive evaluation.
How is PMOS diagnosed?
PMOS is typically diagnosed using the Rotterdam criteria, which require at least two of three features: irregular ovulation, elevated androgen levels (confirmed by blood test or clinical signs), and polycystic-appearing ovaries on ultrasound. Other conditions must be excluded before a PMOS diagnosis is made.
Should I see a gynecologist or a reproductive endocrinologist for PMOS and infertility?
A gynecologist with subspecialty expertise — such as Dr. Shoman at Hackensack CMIGS — can evaluate structural and surgical factors, while a reproductive endocrinologist specialises in hormone-based fertility treatment. In many cases, a coordinated approach between both specialists offers the most comprehensive care.
Is PCOS the same as PMOS?
Yes. PMOS, or polyendocrine metabolic ovarian syndrome, is the new official name for the condition previously called polycystic ovary syndrome. It is the same condition with the same diagnostic criteria and the same treatment options. The name was changed in May 2026 to more accurately reflect the hormonal and metabolic nature of the condition.
Do I need a new diagnosis now that PCOS is called PMOS?
No. If you have already been diagnosed with PCOS, that diagnosis stands. You do not need repeat testing or a new evaluation because of the name change. Your medical records and insurance coding may continue to say PCOS for some time while international classification systems are updated.
Medical Disclaimer: This blog is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. All content is written for general educational purposes. Individual medical situations vary — always consult a qualified healthcare provider before making any decisions about your health. If you are experiencing symptoms mentioned in this article, please seek evaluation from a licensed physician.
Dr. Adam Shoman, MD, FACOG, MBA, is the founder and lead gynecologist at Hackensack CMIGS. With extensive experience in minimally invasive gynecologic surgery, he specializes in treating complex conditions like endometriosis and fibroids using advanced technologies, such as the da Vinci Surgical System. Dr. Shoman is dedicated to patient-centered care and empowering women to take control of their health. He holds his medical degree from Alexandria University and completed his residency at Mount Sinai in New York. Dr. Shoman is a Fellow of the American College of Obstetrics and Gynecology (FACOG) and is certified in Healthcare Quality (CPHQ).
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