Understanding IMSI Treatment
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You have noticed the irregular periods. Perhaps the unexplained weight gain, the stubborn acne, or the hair that seems thinner than it used to be. You searched online and the word PCOS or PCOD came up — and suddenly you have a hundred questions and, if you have been trying to conceive, perhaps a hundred fears.
We want to say something clearly, right at the start: PCOD and PCOS are among the most treatable causes of infertility. The majority of women who come to Wellspring IVF & Women’s Hospital in Ahmedabad with a PCOS diagnosis do not need IVF.
Many do not even need advanced medication. What they need is the right diagnosis, the right lifestyle guidance, and — if fertility is the goal — a carefully sequenced treatment protocol that gives the least invasive approach the full chance it deserves before anything more complex is considered.
That is the philosophy Dr. Pranay Shah has practised for 15 years. It is called a Stepped Care Approach, and it is the reason so many women leave our clinic not just pregnant — but genuinely informed about their own bodies.
PCOD (Polycystic Ovarian Disease) and PCOS (Polycystic Ovarian Syndrome) are related hormonal conditions that affect the way a woman’s ovaries function. Although the names are often used interchangeably, there is a subtle difference:
PCOD is generally considered a milder, more common condition where the ovaries produce many partially matured eggs that accumulate as small cysts. PCOS is a broader metabolic and endocrine disorder with more complex hormonal disruption.
In both conditions, the ovaries produce excess androgens (male hormones like testosterone), which interferes with the normal process of ovulation. Rather than one mature egg being released each month, eggs remain trapped in follicles, causing the characteristic ‘string of pearls’ appearance on an ultrasound scan.
The root hormonal driver in most PCOS cases is insulin resistance. When the body’s cells do not respond efficiently to insulin, the pancreas produces more of it. Excess insulin then signals the ovaries to produce more androgens, creating a cycle that disrupts ovulation, metabolism, skin, hair, and mood simultaneously.
“PCOS is not just a fertility problem — it is a metabolic condition that affects the whole body. In my 15 years of treating PCOS patients in Ahmedabad, I have seen that when we address the root cause — insulin resistance, hormonal balance, and lifestyle — the ovaries often regulate themselves. We do not need to rush to IVF. We need to give the body what it is missing, in the right sequence.”
– Dr. Pranay Shah, MS (ObGy), Director, Wellspring IVF & Women’s Hospital
PCOS and PCOD present differently in different women. Some experience obvious, disruptive symptoms from their teens. Others have very subtle signs that only become apparent when they are trying to conceive. The most common symptoms include:
You do not need to have all of these symptoms to have PCOS. A diagnosis is typically confirmed by the Rotterdam Criteria — the presence of at least two of three features: irregular ovulation, elevated androgen levels, and polycystic ovaries on ultrasound.
What makes Wellspring IVF different from many fertility centres is what we do not do. We do not see a PCOS diagnosis and immediately schedule an IVF consultation. We follow a structured, evidence-based Stepped Care protocol — starting with the simplest, most body-friendly intervention and progressing only when genuinely required.
Here is how that looks in practice:
For many women with PCOS, particularly those who are overweight or insulin-resistant, targeted lifestyle changes produce results that no medication can match. This is not a generic ‘eat healthy and exercise’ directive — it is a structured protocol.
Where lifestyle changes alone are insufficient, particularly in patients with confirmed insulin resistance or elevated fasting insulin, we introduce Metformin. This is a medication familiar from diabetes management, but in PCOS it works by improving the body’s sensitivity to insulin — which reduces androgen production and often restores ovulation.
For patients whose goal is pregnancy and who are not ovulating on lifestyle and Metformin alone, the next step is ovulation induction. This is a simple, non-invasive oral medication protocol that stimulates the ovaries to develop and release one healthy egg per cycle.
Letrozole (our first choice for PCOS)
Current evidence strongly supports Letrozole as the preferred ovulation induction agent in PCOS over Clomiphene. It produces a more physiological hormone response, with better endometrial lining development and higher live birth rates per cycle in PCOS patients.
Clomiphene Citrate
Remains a valid option in specific clinical situations. It works by blocking oestrogen receptors in the brain, triggering a hormonal cascade that stimulates egg development.
All ovulation induction cycles at Wellspring are carefully monitored with serial ultrasound scans to track follicle development and time intercourse or IUI optimally.
If ovulation induction is successful (confirmed egg release) but pregnancy has not occurred after 3–4 monitored cycles, we consider adding IUI Treatment to the protocol. In IUI, a processed and concentrated sperm sample is placed directly into the uterus at the confirmed time of ovulation, increasing the probability of fertilisation.
IVF is recommended for PCOS patients only when the above steps have been given a genuine clinical trial and have not resulted in pregnancy. Specific situations where IVF becomes the appropriate next step include:
Note: At Wellspring, we frequently recommend a Freeze-All approach for PCOS patients to significantly reduce OHSS risk while maintaining excellent outcomes.




The primary fertility impact of PCOS is anovulation — the absence of regular ovulation. Without a released egg, pregnancy is not possible in a natural cycle.
However, it is important to understand that PCOS patients typically have a normal or even high number of antral follicles and a good ovarian reserve.
The problem is not egg quantity — it is the hormonal environment preventing those eggs from maturing and releasing. This is genuinely good news. It means that once the hormonal disruption is corrected — whether through lifestyle, medication, or assisted reproduction — the underlying egg reserve is often healthy and responsive.
Many of our PCOS patients who were deeply concerned about their fertility have achieved pregnancy with relatively simple, low-cost interventions.
After 5 years of marriage and visiting many places, when we came here, we decided on the right guidance here that we will get the ivf procedure done from here, today we have 10 days of treatment. Due to the convenience, arrangement and facility o...
My experience with wellspring hospital is very good .their staff is very supportive. Dr. Pranay is very good and professional.100% transparency at every stage. No last minute surprises.Once again thank you so much to the all team. Highlly recomme...
Wellspring IVF & women hospital is one of the best IVF center in India where me like other infertile Indian and foreigner couples fulfill their dreams of having a healthy baby.Dr Pranay Shah has deep knowledge and skill in his work with positive ...
Such a nice experience at well spring. And we get A childhope from this well spring hospital. Thanks a lot all members of hospital and specially to Dr. Pranay Shah sir
This is one of the best ivf clinic in Ahemdabad, Dr.Pranay shah and his team are highly professional and knowledgeable, and his staff members are too good and supportive. Dr. Pranay shah is result oriented and confident, and gives right instructi...
We were facing some difficulties related pregnancy and we got reference of Wellspring Hospital. We thank God that we found such a talented and knowledgeable Dr. Pranay Sir. The most thing we like about him is the way of treatment he follows. I str...
I've been blessed with two daughters by the treatment given by Dr. Pranay Shah the services given to me were comforting and caring.
This is one of the best hospital in ivf treatment with highest possibility of success, best supportive doctor and staff, thanks and recommended all to visit once
No words are enough to express my gratitude . Thank you for making our dream comes true. You are extraordinary doctor as well as extraordinary human being also.Again thank you so much Dr.Pranay Shah and your team. Best ever doctor I have meet in ...
Great experience with great doctor and very supportive after care facilities. Dr. Shah was not only helpful with numerous questions that we asked for around 6 months before we started the treatment but is also helping us now. He has been very help...
We were looking for a good fertility center we came across some good reviews of Wellspring Spring Ivf Hospital. We decided and visited the hospital and with in no time the process was completed and in first attempt only the result was positive?. ...
It has been one of the best choices that I could have made. Since researching Wellspring on Google till now the end of complete IVF cycle it has been a wonderful experience. I could have gone to biggies referential IVF Centres but I am sure experi...
We had been very desperate to have a child. Visited many IVF centers in India for treatment. But did not get any positive result. Visited the Best IVF Center in Ahmedabad Wellspring IVF and Women's hospital after seeing good reviews. Happy to sa...
Wellspring IVF & Women's Hospital is best IVF Center in Ahmedabad. Best thing, we got positive result in Fist IVF Cycle. Second best thing, Doctor has told us exact amount of Cost of each IVF Cycle before start of treatment so there would be no en...
Me and my husband are very glad we chose to come here for treatment. I would highly recommend Dr. Shah and his team at the Wellspring IVF and Women's hospital to anyone wanting to reach their dream of becoming parents. His medical knowledge and p...
No words are enough to express my gratitude . Thank you for making our dream comes true. You are extraordinary doctor as well as extraordinary human being also.Again thank you so much Dr.Pranay Shah and your team.
Excellent IVF Center. Friendly nature all staff & Doctor. Excellent Treatment for the Doctor. Thanks Wellspring IVF Fullfil our Dreams.
What to say about dr pranay sir Very good human being along with very good doctor Always showers positivity on us Solves every small small queries with open heart and big smile Approachable 24*7 I will suggest everyone to consult at least once if ...
PCOS sometimes co-exists with other conditions that require separate evaluation and management. At Wellspring IVF, a comprehensive diagnostic workup ensures nothing is missed:
Male Factor Infertility — a semen analysis is part of our first-visit evaluation. We also evaluate for conditions like Azoospermia (learn more →) and Oligospermia (learn more →).
Dr. Pranay Shah has treated hundreds of PCOS patients across the spectrum — from young women managing symptoms to couples in their mid-30s who have been trying to conceive for years. His approach is defined by three principles that are often missing in routine fertility care:
Not all PCOS is the same. Dr. Shah reviews your full hormonal panel before making any treatment recommendation.
We do not skip steps. We will only recommend IVF when it is the medically appropriate next step.
Every patient at Wellspring leaves their consultation understanding their diagnosis, the reasoning behind each treatment recommendation, and the realistic probability of success.
They are related but not identical. PCOD typically refers to a milder hormonal imbalance where multiple immature follicles accumulate in the ovaries. PCOS is a broader metabolic and endocrine disorder with more pronounced hormonal disruption. Both are treatable.
Yes — and many women do. PCOS causes infrequent or absent ovulation, but it does not prevent conception when ovulation is restored.
No. IVF is the last step in our protocol, recommended only when simpler approaches have not been successful, or when there is an additional fertility factor. Most PCOS patients respond well to ovulation induction with Letrozole.
Yes — significantly. In women with PCOS who are overweight or obese, a 5–10% reduction in body weight has been shown in multiple studies to restore spontaneous ovulation and improve pregnancy rates.
PCOS patients do carry a higher risk of OHSS during IVF. At Wellspring, we manage this through personalised, low-dose stimulation protocols and a Freeze-All approach, which virtually eliminates severe OHSS.