Background: Polycystic Ovary Syndrome significantly alters the reproductive health status of women, and usually leads to fertility challenges. PCOS has irregular androgens, poor ovulation, and affects metabolism, which has adverse effects on fertility and pregnancy among women. The reduction of these variables will have significant effects on the number of children that women suffering from PCOS can have and the successes of any given pregnancy. There has been a study that has been done to test the effects of various treatment interventions on the reproduction rates, but has only taken a period of three years, leading the current study. Objectives: The purpose of my research is to investigate and record the reduced rates of fertility and pregnancy among women with PCOS over a period of five years. Also, to explore the products of fertilization as outcomes of any interventions that have been implemented to reduce the effects of PCOS on human reproduction rates. Study design: A prospective study. Duration and place of study.Department of Gyne & obs Khyber teaching hospital from jan 2023 to June 2023 Methods: a prospective cohort study using a sample of 150 women who had been diagnosed with PCOS previously. This women were to be followed for a period of five years, and the concepts of natural conception and assisted reproductive technologies were used to monitor and record the pregnancies in the first and the second group. I also collected data over changes in lifestyle, medication, and any other interventions that were administered over the period of the study to manage the rates of conception among participating women. The data was analyzed through standard deviations and p-values. Results: After five pregnant women, prime data came from the treatment of 150 women. Out of these, 35% of women conceived naturally, while 45% conceived due to the ART that was administered to them. Both groups had a shared mean time to conception of 18 months . There are effects of pregnancy such as pregnancy-induced hypertension that was diagnosed in 28% of pregnancies (p-value < 0.05), and there are the resultant differences between patients on lifestyle management (p-value < 0.01). Conclusion: PCOS has adverse effects on the reproduction rates of women and the accompanying pregnancy rates. More women conceiving with the aid of ART gives the extent of the impact the reproductive condition can lead. However, experiences from the study record that this impact is reduced by more than half by simple lifestyle changes. Studies such as the one I have conducted need to be administered in more ways to come up with conclusive interventions that will make affected women conceive easily. Factors studied include time, pharma management drugs, and ART. Some others can always be added to this list.