Delayed Parenthood: The Role of Polycystic Ovary Syndrome and Endometriosis in Fertility and Reproductive Outcomes – A Review
DOI:
https://doi.org/10.17140/phoj-11-795Keywords:
Delayed parenthood, delayed childbearing, PCOS, endometriosis, infertility, fertility, reproductive health, ovulatory dysfunction, fertility outcomes, early interventionAbstract
Delayed parenthood has become an increasingly common phenomenon worldwide. Although postponement of childbearing may be influenced by education, career development, financial stability, relationship circumstances, and personal readiness, reproductive health conditions may also contribute substantially to difficulties in achieving parenthood. Among these conditions, Polycystic Ovary Syndrome (PCOS) and endometriosis are important causes of impaired fertility among women of reproductive age. The present review examines the relationship between delayed parenthood and these two reproductive health conditions, with particular emphasis on infertility, reproductive dysfunction, delayed diagnosis, and fertility outcomes. Evidence reviewed in the seminar literature indicates that women with PCOS experience higher rates of infertility, ovulatory dysfunction, menstrual irregularities, and fertility-treatment use. Delayed diagnosis of PCOS was also associated with delayed childbearing. Similarly, women with endometriosis demonstrated higher rates of infertility, pelvic pain, and reduced likelihood of achieving a first live birth. Increasing severity of endometriosis was associated with poorer pregnancy and live-birth outcomes. Evidence regarding interventions in PCOS suggests that lifestyle modification can improve ovulation, menstrual regularity, metabolic health, and conception outcomes. The combination of lifestyle modification with pharmacological treatments such as metformin or letrozole may further improve reproductive outcomes in appropriate patients. Current evidence supports the importance of early recognition, fertility counselling, timely diagnosis, individualized management, and reproductive-health education for women at risk of fertility difficulties. Addressing PCOS and endometriosis early may help reduce avoidable delays in conception and support individuals in achieving their reproductive goals.
References
Markin LB, Korutko OO, Fartushok TV, Fartushok NV, Fedevych YM, Dzhalilova EA, Zhykovskiy VS. Association of polycystic ovary syndrome with multiple health factors and adverse pregnancy outcomes. International Journal of Endocrinology (Ukraine). 2023;19(2):137–142.
Azam SS, Vasudevan S, Bukhari WS, et al. Repro-ductive endocrine disorders: a comprehensive guide to the diagnosis and management of infer-tility, polycystic ovary syndrome, and endometrio-sis. Cureus. 2025;17(1):e78222.
Namazi M, Behboodi Moghadam Z, Zareiyan A, Jafarabadi M. Impact of endometriosis on repro-ductive health: an integrative review. J Obstet Gy-naecol. 2021;41(8):1183–1191.
Endometriosis and infertility: a long-life approach to preserve reproductive integrity. Int J Environ Res Public Health. 2022;19(10):6162.
Ramos ASBF, Bochini LLRM, Andrade LL, Fiúza LB, Silva ACR, Vasconcelos CA, Santos LBM, et al. Polycystic Ovary Syndrome and Endometriosis: Impact on Fertility and Quality of Life and Surgi-cal Options. Brazilian Journal of Implantology and Health Sciences. 2024;6(8):1146–1159.
Salmeri N, Vigano P, Cavoretto P, Marci R, Candiani M. The kisspeptin system in and beyond reproduc-tion: exploring intricate pathways and potential links between endometriosis and polycystic ovary syndrome. Reviews in Endocrine and Metabolic Dis-orders. 2024;25(2):239–257.
Fischer Z, Kolenda D, Ramlau N, Cyrulik M, Prager-Zimny M, Imbirska B, Janiszewska M, Simachi M, Hładki M, Podolak M. Lifestyle Factors and Fer-tility in Couples Trying to Conceive: A Review of Evidence-Based Interventions. Journal of Educa-tion, Health and Sport. 2025;86:66941–66941.
Bai X, Zheng L, Li D, Xu Y. Research progress of en-dometrial receptivity in patients with polycystic ovary syndrome: a systematic review. Reproduc-tive Biology and Endocrinology. 2021;19(1):122.
van Tienhoven XA, Ruiz de Chávez Gascón J, Cano-Herrera G, Sarkis Nehme JA, Souroujon Torun AA, Bautista Gonzalez MF, Esparza Salazar F, et al. Vi-tamin D in reproductive health disorders: a narra-tive review focusing on infertility, endometriosis, and polycystic ovarian syndrome. International Journal of Molecular Sciences. 2025;26(5):2256.
Zamani P, Hemati Z, Kelishadi R, Kolahdozan S, Dianatinasab M, Keikha M. Association between anogenital distance as a noninvasive index in the diagnosis and prognosis of reproductive disorder: a systematic review. International Journal of Re-productive Biomedicine. 2023;21(8):599.
Barbu LA, Mărgăritescu ND, Cercelaru L, T, enea Cojan TS, Stănică MC, Enăchescu I, T, enea Cojan AM, Căluianu V, Mogos, GFR, Vasile L. Long-term re-productive outcomes after Palmer-type neosalp-ingostomy in hydrosalpinx: a seven-year real-world cohort study. Journal of Clinical Medicine. 2025;14(22):8043.
Zoccoli SG, La Marca A. Endometriosis affects nat-ural and ART fertility in different ways: let’s look at the whole patient and not at the single lesion. Reprod Biomed Online. 2024;49(5):104354.
Bellver J, Garrido N, Remohí J, Pellicer A, Meseguer M. Influence of paternal age on assisted reproduction outcome. Reproductive Biomedicine Online. 2008;17(5):595–604.
Mutlu L, Manavella DD, Gullo G, McNamara B, Santin AD, Patrizio P. Endometrial cancer in re-productive age: fertility-sparing approach and re-productive outcomes. Cancers. 2022;14(21):5187.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Public Health - Open Journal (PHOJ) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
