What are the underlying causes of secondary infertility in individuals with PCOS?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Secondary infertility in people with PCOS (polycystic ovary syndrome) is often caused by hormonal imbalances, irregular or absent ovulation, insulin resistance, or related health conditions such as thyroid disorders and obesity. Even after a previous successful pregnancy, these factors can make conceiving again more difficult.

Because the causes of secondary infertility vary widely, identifying what's driving your symptoms is the critical first step toward effective treatment. A free, instant, online symptom check can help you understand possible causes, clarify next steps, and prepare for a more productive conversation with your doctor—saving you time, stress, and guesswork.

Reviewed for medical accuracy: 07/15/2026

Important Next Steps

Learn if PCOS is causing infertility Discover likely causes of your fertility issues See if you need care for infertility Find OTC options for fertility-related symptoms Find a PCOS specialist near you Discover medically valid PCOS home remedies Understand if infertility could be PCOS

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Explanation

Secondary infertility means having trouble getting pregnant again after having a baby before. For people with PCOS, this can happen for several reasons.

Causes of Secondary Infertility with PCOS:

Hormonal Imbalances: PCOS often causes hormone levels to be out of balance, which can make it hard for the body to release eggs regularly, a process called ovulation.
Ovulation Issues: Because of these hormone changes, ovulation might not happen every month, making it harder to get pregnant.
Other Health Conditions: Sometimes, other health issues can also affect fertility. These can include being overweight or having insulin resistance, which are more common in people with PCOS.

If you're experiencing symptoms related to PCOS or fertility concerns, you can use Ubie's free AI-powered symptom checker to better understand what might be happening with your body and when to seek medical care.

(References)

Vander Borght M, & Wyns C. (2018). Fertility and infertility: Definition and epidemiology. Clinical biochemistry, 29555319.
Collins JA, Rand CA, Wilson EH, Wrixon W, & Casper RF. (1986). The better prognosis in secondary infertility is associated .... Fertility and sterility, 3699169.
Philippov OS, Radionchenko AA, Bolotova VP, Voronovskaya NI, & Potemkina TV. (1998). Estimation of the prevalence and causes of infertility .... Bulletin of the World Health Organization, 9648359.

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