Polycystic Ovary Syndrome (PCOS) is found in 14.4% of women undergoing fertility evaluation, according to a study led by Dr Jasmine Dahiya, clinical director and fertility specialist, Nova IVF Fertility Centre, Jalandhar.The study, which evaluated 2,082 women aged 21–40 years, found that PCOS prevalence was highest among women aged 21–25 years, 29.4%, as compared to 5.3% among women aged 36–40 years. The findings were presented at a fertility conference in Jalandhar attended by more than 100 gynaecologists. The study, titled “Prevalence of PCOS in Women Attending Fertility Clinics in North India,” was mentored by Dr Sonia Malik, chief clinical mentor, Nova IVF Fertility.Early diagnosis importantPCOS is much more than a cause of irregular periods or a simple fertility concern. It is a condition that can affect hormonal function, ovulation, fertility and metabolic health. Importantly, PCOS can occur in both lean and obese women. Our study found PCOS in approximately one in every seven women in the fertility-care population, with the highest prevalence among women aged 21–25 years. This reinforces the importance of recognising the condition early rather than waiting until a woman faces difficulty conceiving.A woman with PCOS should receive an individualised assessment and treatment plan. Many women with PCOS can conceive naturally or with appropriate medical treatment, and IVF is not always required.Personalised care crucialWomen with PCOS may have a high ovarian reserve or a high number of follicles and can sometimes respond strongly to ovarian stimulation. Therefore, when IVF is required, medication doses and ovarian response need to be monitored carefully and treatment should be personalised for each patient. Hirsutism may help identify PCOS, but its absence does not exclude it. The study found a strong association between hirsutism, or excessive facial or body hair, and PCOS.However, approximately half of the women with PCOS in the study did not have documented hirsutism. This is an important clinical observation because women should not assume that they do not have PCOS simply because they do not have excessive facial or body hair. PCOS does not look the same in every woman. Some women may have irregular periods, some may have signs of increased androgen levels, while others may primarily present with fertility difficulties. The absence of hirsutism should not by itself rule out PCOS.Fertility treatment should involve both partnersInfertility evaluation should not focus exclusively on women. Infertility is a couple’s issue. While conditions such as PCOS are important causes of female reproductive problems, male factors also contribute to infertility. Both partners should therefore be appropriately evaluated before deciding on treatment. Every woman with PCOS and not every couple experiencing infertility requires IVF. Our objective is not simply to move patients towards IVF. Wherever medically appropriate, we aim to help couples achieve pregnancy using their own eggs and sperm, with treatment tailored to their individual circumstances.The retrospective observational study analysed 2,082 women aged 21–40 years, after 263 women were excluded from the 2,345 women initially screened. PCOS was assessed using clinical and reproductive parameters, including menstrual irregularity, hyperandrogenism and/or polycystic ovarian morphology, according to the diagnostic framework used in the study.The study also examined associations between PCOS and factors including age, BMI and hirsutism. The research team has called for further studies to better understand the relationship between PCOS, metabolic health and fertility among women seeking fertility care.