Understanding PCOS (Now Called PMOS): A Fertility Guide for Hopeful Parents
Polycystic Ovary Syndrome (PCOS) is one of the most common causes of infertility — but it's also one of the most manageable with the right care and support. At Tennessee Fertility Institute (TFI), we help patients across Nashville and Franklin understand their diagnosis, regain control of their reproductive health, and build the families they've been dreaming of.
In this post, we'll break down what PCOS is, why it now has a new name, how it affects fertility, and the steps you can take to improve your chances of conceiving.
A New Name: From PCOS to PMOS
You may have recently heard PCOS referred to by a new name: polyendocrine metabolic ovarian syndrome (PMOS). In May 2026, an international consensus of more than 50 medical and patient organizations — a process endorsed by leading reproductive medicine bodies, including the American Society for Reproductive Medicine (ASRM) — formally renamed the condition.
Why the change? The old name was misleading. "Polycystic" implies the ovaries are full of cysts, but the small structures seen on an ultrasound are actually immature follicles, not true cysts — and many people with the condition don't have them at all. Experts felt the name obscured the condition's real nature: a hormonal and metabolic disorder, not simply an ovarian one. The hope is that the more accurate name, PMOS, will reduce confusion, cut down on delayed diagnoses, and better reflect what patients actually experience.
Here's what matters for you: nothing about your diagnosis, your body, or your treatment has changed — only the name. Because "PCOS" is still the term most people know, you'll see both used together during this transition, and we'll do the same throughout this guide.
What Is PCOS (PMOS)?
PCOS/PMOS is a hormonal disorder that affects how the ovaries function. It's diagnosed when at least two of the following three features are present (and other conditions have been ruled out):
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Irregular or absent ovulation
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Excess levels of androgens (hormones like testosterone), which can show up in bloodwork or as symptoms like acne or excess hair growth
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Polycystic ovary morphology — ovaries that appear enlarged with many small follicles on ultrasound (increasingly, an AMH blood test can be used as an alternative to ultrasound here)
Despite the original name, not everyone with PCOS/PMOS has what look like ovarian cysts — which is a big part of why the name was updated.
Illustration of a “normal” ovary and one with PCOS
How PCOS (PMOS) Affects Ovulation and Fertility
In a typical menstrual cycle, the ovaries release an egg each month (ovulation). With PCOS/PMOS, hormonal imbalances can interfere with that process, and without regular ovulation, conception becomes difficult. In fact, PCOS/PMOS is the single most common cause of ovulation problems.
Common fertility-related challenges include:
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Irregular or skipped periods, which make ovulation hard to predict
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Impaired egg maturation, which can affect egg quality
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Insulin resistance, which can further disrupt hormone balance and ovulation
The good news: with the right treatment, many people with PCOS/PMOS ovulate regularly and go on to have a healthy pregnancy.
Illustration of a menstrual cycle
How PCOS (PMOS) Is Diagnosed
There's no single test for PCOS/PMOS. Instead, specialists look for at least two of the three features above and rule out other conditions that can cause similar symptoms — such as thyroid disorders or elevated prolactin. A typical evaluation at TFI includes:
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A detailed medical and menstrual history
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A physical exam
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Hormone bloodwork (which may include androgens, and sometimes AMH level)
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A pelvic ultrasound, where the ovaries may show many small follicles arranged in a characteristic "string of pearls" pattern
Because insulin resistance is so common with this condition, your provider may also check blood sugar and related metabolic markers.
Illustration of ovary with “string of pearls” appearance
Does PCOS (PMOS) Cause Infertility?
PCOS/PMOS is one of the leading causes of ovulatory infertility — but a diagnosis does not mean you can't get pregnant. Many people conceive naturally, particularly with milder symptoms or with lifestyle changes. For others, fertility treatment can dramatically improve the odds. The key takeaway: PCOS/PMOS can make conceiving more challenging, but it does not make it impossible.
PCOS (PMOS) and Your Overall Health
The updated name puts the word "metabolic" front and center — a reminder that this condition reaches beyond the ovaries. Addressing these connected areas early supports both fertility and long-term wellness:
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Insulin resistance and type 2 diabetes: Many people with PCOS/PMOS process insulin less efficiently, raising blood sugar and diabetes risk.
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Metabolic syndrome: A cluster of factors — higher blood pressure, cholesterol, and abdominal weight — that can increase heart-disease risk.
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Mental health: PCOS/PMOS is associated with higher rates of anxiety, depression, and body-image concerns.
At TFI, we take a whole-person approach, caring for your reproductive and overall health together.
Fertility Treatment Options for PCOS (PMOS)
When you're trying to conceive, your fertility specialist will usually recommend a step-by-step approach, starting with the least invasive options and advancing only as needed.
1. Lifestyle changes. Because insulin resistance drives much of the hormonal imbalance, lifestyle is often the foundation. Balanced, blood-sugar-friendly nutrition, regular movement that improves insulin sensitivity, and stress management can all help — and even a modest change in body weight (around 5–10%) is enough to restore ovulation for some patients. In certain cases, a physician may also discuss newer weight-management medications; if you're actively trying to conceive, timing matters, since some of these (such as GLP-1 receptor agonists) must be stopped before pregnancy.
2. Ovulation induction medications. Letrozole (Femara) is now generally the preferred first-line medication for PCOS/PMOS, stimulating ovulation with fewer side effects than older options. Clomiphene citrate (Clomid) is a well-established alternative.
3. Insulin-sensitizing medication. Metformin can help address the insulin resistance underlying the condition — sometimes restoring more regular ovulation on its own, and sometimes used alongside ovulation-induction medication.
4. IUI or IVF. If oral medications aren't successful on their own, assisted reproductive technologies like intrauterine insemination or in vitro fertilization may be recommended — especially when other fertility factors are also present.
Your TFI physician will tailor this sequence to your symptoms, hormone levels, metabolic health, and goals — there's no one-size-fits-all path.
PCOS (PMOS) and Pregnancy: What to Expect
Once you conceive, your care team may take a few extra steps to support a healthy pregnancy, because PCOS/PMOS is associated with a somewhat higher risk of certain complications — including gestational diabetes, preeclampsia (high blood pressure during pregnancy), preterm birth, and miscarriage. Carrying extra weight in pregnancy can add to these risks.
The reassuring reality: with proactive monitoring and good prenatal care, the large majority of people with PCOS/PMOS go on to have healthy pregnancies and healthy babies. Blood-sugar-friendly nutrition, gentle low-impact activity, following your provider's guidance on any medications, and keeping up with prenatal appointments all help set the stage for a healthy pregnancy.
You're Not Alone — and You Have Options
PCOS/PMOS affects an estimated 1 in 8 to 1 in 10 women of reproductive age. A diagnosis can feel overwhelming, but with expert guidance and evidence-based care, it is absolutely possible to manage the condition and achieve pregnancy.
At Tennessee Fertility Institute, we understand the unique challenges PCOS/PMOS presents — and our board-certified reproductive endocrinologists are here to help you navigate them with personalized treatment and compassionate support at our Nashville and Franklin locations.
Frequently Asked Questions
Why was PCOS renamed to PMOS? In May 2026, an international consensus of medical and patient organizations renamed polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS). The term "polycystic" was considered inaccurate — the ovaries aren't full of true cysts — and it didn't capture the condition's hormonal and metabolic nature. Only the name changed; diagnosis and treatment stay the same.
Is PMOS the same thing as PCOS? Yes. PMOS and PCOS refer to the exact same condition. During the transition period, you'll see both names used, and either term refers to the same diagnosis and care.
Can you get pregnant with PCOS (PMOS)? Yes. Many people with PCOS/PMOS conceive — often with support like ovulation-inducing medication, and sometimes IUI or IVF. Because PCOS/PMOS mainly affects ovulation, restoring regular ovulation is frequently the key to pregnancy.
How is PCOS (PMOS) diagnosed? Diagnosis is based on having at least two of three features — irregular ovulation, elevated androgens, or polycystic ovary morphology on ultrasound — after ruling out other causes. Your doctor may use bloodwork, an ultrasound, and sometimes an AMH test as part of the evaluation.
Does PCOS (PMOS) go away? There's no cure, but symptoms can be well managed with lifestyle strategies and medical treatment — and many people significantly improve their ovulation and overall health with the right plan.
The Bottom Line
A PCOS — now PMOS — diagnosis doesn't define your path to parenthood. It's a common, well-understood, and highly treatable condition, and the new name reflects how much the medical community continues to learn about it. What hasn't changed is the most important part: with the right care, most people with PCOS/PMOS can go on to build the family they're hoping for.
If you've been diagnosed with PCOS/PMOS or are struggling to conceive, we'd love to help. Request a consultation online to build a plan with a TFI fertility specialist.