Getting Pregnant with PCOS: What You Need to Know

If you’ve been diagnosed with polycystic ovary syndrome (PCOS), you may have heard that it can make getting pregnant more difficult. And while it’s true that PCOS can present some challenges, it certainly doesn’t make pregnancy impossible. In fact, with the right approach, many people with PCOS go on to conceive and have healthy pregnancies.

From understanding how PCOS affects fertility to exploring lifestyle changes and treatment options, there are a variety of ways to support your journey toward conception.

Why Can PCOS Make Pregnancy More Difficult?

For some, getting pregnant with PCOS may take more time, but understanding the underlying reasons can help you take the right steps forward.

Irregular Ovulation

One of the main reasons PCOS can impact fertility is irregular or absent ovulation. Ovulation—the monthly release of an egg from the ovaries—is essential for pregnancy to occur. Without regular ovulation, the chances of an egg meeting sperm drop significantly.

After ovulation, an egg typically remains viable for fertilization for 12 to 24 hours. If ovulation doesn’t happen consistently, this reduces the window of opportunity for conception, making it more difficult to become pregnant.

Hormonal Imbalances

PCOS is often associated with hormonal imbalances that may interfere with the reproductive process. One theory suggests these imbalances can alter the consistency of cervical fluid, which can make it harder for sperm to survive or travel through the reproductive tract.

Weight and Metabolism

Weight can also play a role. Being overweight is linked to hormone disruptions, and these disruptions can make ovulation less predictable. It’s important to note, though, that not everyone with PCOS is overweight—and not everyone who is overweight has trouble ovulating. The connection is complex and personal.

Stress and the Hormonal Cycle

Stress and PCOS often go hand in hand. Chronic stress can impact the delicate hormonal signaling involved in the menstrual cycle. Even fluctuations in weight—whether loss or gain—can influence hormone regulation. The body’s internal balance is sensitive, and stress can easily shift it out of rhythm.

How Much Harder Is It to Conceive with PCOS?

PCOS affects around 1 in 10 women of reproductive age. Among those, about 70% to 80% may not ovulate regularly, making conception more difficult in those cycles. But that doesn’t mean pregnancy won’t happen. In fact, with proper management, most people with PCOS are eventually able to conceive.

Can You Get Pregnant Quickly with PCOS?

It’s natural to want pregnancy to happen quickly once you decide you’re ready. While PCOS can make the process a bit more complex, it's still entirely possible to get pregnant—even quickly—depending on your individual health and circumstances.

Lifestyle Changes

In many cases, positive changes in lifestyle can restore ovulation within a few months. Eating a balanced diet, increasing physical activity, and improving sleep and stress management may make a significant difference.

And the good news? You don’t need to lose a large amount of weight to see an effect. Studies suggest that losing just 5% of excess body weight may improve hormonal balance and increase the chances of ovulation.

Medication Support

If lifestyle changes alone aren’t effective—or aren’t necessary for you—there are oral medications that can help stimulate ovulation. These are typically taken at the start of your cycle and used over several months. They’re often a first step before moving on to more advanced fertility treatments.

Assisted Reproductive Techniques

If other options don’t work, procedures like intrauterine insemination (IUI) or in vitro fertilization (IVF) may be explored. These methods can support fertilization by bypassing some of the natural barriers that PCOS may create.

Tips to Improve Your Chances

Track Your Cycle

Whether your periods are regular or irregular, tracking your cycle is one of the most empowering steps you can take. Understanding your own rhythm can help you identify when ovulation is likely to occur—or when it may be absent.

Consider Timing

Fertility naturally declines with age, for everyone. In general, those under 35 have a higher chance of conceiving within the first year of trying. For those with PCOS, since the journey can take a little longer, starting earlier—if you feel ready—might offer a better window of opportunity.

Focus on the Preconception Phase

The three months before you start actively trying to conceive can be crucial. During this time, consider nourishing your body with whole foods, reducing alcohol, moving your body regularly, and getting quality sleep.

Taking 400 micrograms of folic acid daily is widely recommended, as it plays a key role in early fetal development. Some prenatal vitamins also include additional nutrients like iron, calcium, and zinc, which can further support your reproductive health.

Check Your Vitamin D

There’s growing interest in the role vitamin D plays in fertility. Many people with PCOS have been found to have low levels of vitamin D, and while research is still ongoing, maintaining healthy levels is generally considered beneficial when trying to conceive.

Involve Your Partner

It’s easy to assume PCOS is the only factor when pregnancy isn’t happening right away—but fertility is a shared journey. Around one-third of fertility challenges can be related to the male partner. Getting a simple semen analysis can help rule out or identify any concerns early on.

Final Thoughts

Having PCOS can feel overwhelming, especially when you're dreaming of starting a family. But remember: a diagnosis isn’t a barrier—it’s simply a guide. It means you might need to approach things a little differently, with more attention and care.

With the right support, many people with PCOS go on to experience healthy pregnancies. The most important thing is to stay informed, be gentle with yourself, and reach out for help when you need it.

You don’t have to go through it alone—and you’re certainly not out of options.