The article provides data on a differentiated approach to the treatment of patients with PCOS for the natural restoration of fertility. The study examined 150 patients who applied to the gynecological department of the regional Perinatal Center in Samarkand and the gynecological department of clinic No. 1 of the Samarkand State Medical University for infertility in 2017-2019. Fifty patients underwent an attempt to restore fertility without surgery. Endosurgical interventions were performed in 100 patients in order to normalize ovulatory function and treat infertility: in 64 women - drilling or unilateral ovarian resection, in 36 - bilateral ovarian resection.We analyzed the effect of surgical treatment of PCOS, taking into account the volume of surgery, on the levels of homocysteine, AMH, total testosterone, FSH, LH, the ratio of FSH / LH and total estradiol, which were determined before - and three months after the intervention. All patients were divided into 4 subgroups depending on the diagnosed phenotypes. Using the methods of differentiated conservative and surgical treatment of infertility in women with different phenotypes of PCOS based on the study of clinical, laboratory and ultrasound parameters, pregnancy occurs in 75.3% of patients.