One of the most common worries for women with PCOS is: “Can I even get pregnant?” It doesn’t help that many hear something along the lines of: “We’ll pop you on the pill for now, and come back when you’re ready to try for a baby.”
Understandably, this can leave you feeling uncertain about your fertility. While PCOS can throw in some obstacles (like irregular cycles or trouble with ovulation), it does not mean infertility. Many women with PCOS go on to have healthy pregnancies – and with the right support, your chances can improve even more.
PCOS & Ovulation Challenges
One of the main reasons women with PCOS may find it harder to conceive naturally is because of irregular ovulation.
Normally, each month the ovaries develop follicles (tiny sacs that contain eggs). When an egg matures, it’s released during ovulation and travels down the fallopian tube, where it can be fertilised.
With PCOS, this process doesn’t always run smoothly. Higher levels of androgens (male-type hormones) and insulin resistance can interfere with the menstrual cycle, leading to:
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Irregular or absent periods – making it tricky to know when (or if) you’re ovulating.
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Disrupted follicle development – eggs may not mature properly.
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Ovulation problems – sometimes ovulation doesn’t happen at all.
As a result, immature eggs can remain in the ovaries. Having some undeveloped follicles is normal, but in PCOS, too many can build up and make ovulation (and therefore pregnancy) more difficult.
Why PCOS Does Not Mean Infertility
PCOS is the most common hormonal condition affecting fertility. It’s often talked about as a major hurdle – but here’s the truth: many women with PCOS do go on to conceive naturally. It might just take a little longer because cycles can be irregular, but PCOS does not automatically mean infertility.
Why Conceiving Naturally Can Be More Challenging with PCOS
Getting pregnant naturally is all about timing – an egg needs to be released, sperm has to be there at the right time and fertilisation needs to happen. With PCOS, ovulation is often the trickiest part of this process.
Note: We also know that for some women, PCOS can make weight harder to manage (remember that cycle we talked about last week between insulin and higher androgen levels). Carrying extra weight can reduce fertility and sometimes make it take longer to conceive.
But here’s the good news: with the right nutrition, movement and support, many women see improvements in both PCOS symptoms and fertility.
The preconception phase is a key moment in this journey – not just for women with PCOS, but for anyone planning a pregnancy. This is the time to set your body up for success, both for conception and for supporting your baby’s development. Typically, it refers to the three months before you plan to conceive.
During this window, healthy lifestyle strategies can make a real difference: eating a balanced diet, limiting alcohol, ceasing smoking and staying active are simple ways to prepare your body for pregnancy and give yourself the best possible start.
If you’re trying to get pregnant, PCOS treatment usually focuses on a few key goals:
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Restoring regular ovulation – helping your body release eggs consistently.
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Supporting healthy weight management – if needed, to improve fertility and overall health.
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Boosting general health and wellbeing – because a healthy body creates the best environment for pregnancy.
Lifestyle Strategies to Improve PCOS
Weight Management
PCOS is a collection of symptoms, and it can show up differently for each woman. For some, weight gain can make symptoms worse by increasing insulin resistance and androgen levels. Research suggests that losing just 5–10% of body weight can help restore menstrual cycles and improve the chances of pregnancy.
And here’s the important part: this isn’t just about PCOS. Healthy weight management is important for pregnancy outcomes across the board.
However, PCOS doesn’t discriminate – lean women can also experience insulin sensitivity. That’s why nutrition, movement, stress management and supplements are key for all women with PCOS, regardless of body type.
Nutrition
Nutrition is one of the most powerful ways to support fertility with PCOS – it’s how we nourish the body and set it up for success. A key focus is managing insulin resistance and keeping blood sugars steady.
A fertility-friendly diet with PCOS should be built on nutrient-dense, balanced meals made from whole foods. An easy way to visualise this is the Mediterranean-style diet, which emphasises plants, healthy fats and lean proteins.
Think of every plate as a complete meal that includes:
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Low GI carbohydrates – to help manage blood sugar and support hormone balance.
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Healthy fats (like omega-3s) – essential fats we can’t make ourselves: they support egg quality and reduce inflammation.
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Lean proteins – fish, poultry, eggs and legumes are great options. Try to limit processed meats or those high in saturated fats.
And don’t forget about micronutrients. They’re small but mighty when it comes to fertility:
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Folate – found in leafy greens; supports early pregnancy and healthy cell growth.
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Vitamin D – important for hormone regulation; found in foods like mushrooms and fortified dairy.
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Iron – Supports energy and ovulation; found in lean meats, beans and spinach.
Movement
When it comes to exercise and PCOS, there’s no single “best” style. What matters most is finding movement you actually enjoy, because consistency is what really counts.
Regular, healthy movement can:
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Support hormone balance
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Improve insulin sensitivity
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Reduce stress
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Keep your body strong
Whether it’s walking, Pilates, strength training, dancing or yoga – the best exercise is the one you’ll keep coming back to.
💡 Note: overtraining can raise cortisol (your stress hormone), which may disrupt hormone balance. Think balance over burnout.
Stress
Stress is often accepted as part of life, but it has a big impact on how our bodies work. Chronic stress can raise cortisol levels, which may disrupt your menstrual cycle and interfere with ovulation.
Building in calming practices can help balance things out. Think: gentle yoga, breathwork, meditation or simply carving out time to slow down. Small, consistent habits make a big difference.
Sleep
Just like stress, sleep has a big influence on cortisol levels and hormone balance. Sleep is when your body resets, repairs and regulates – making it a vital part of supporting fertility with PCOS.
Aim for 7–9 hours each night, and try to keep a consistent routine. Going to bed and waking up at the same time every day helps regulate your circadian rhythm, which in turn supports healthier cycles and overall wellbeing.
Supplements
Supplements can play a really supportive role in managing PCOS and boosting fertility. Here are some that research has highlighted as especially helpful:
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Inositol – a true multitasker for PCOS. It can help regulate ovulation (and in turn cycle regularity), support insulin sensitivity and even keep cravings in check. Exciting new research also points to its potential for improving sleep quality.
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Vitamin D – many women with PCOS have low levels of vitamin D, which is essential for hormone regulation. Living in the northern hemisphere also means we’re often not getting enough sunshine, so supplementing can be especially important.
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Zinc – with its anti-androgenic properties, zinc may help lower testosterone levels. This can improve symptoms such as acne and excess hair growth, while also supporting ovulation and more regular cycles.
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Magnesium – often low in women with PCOS, magnesium can support better sleep, ease irritability and help manage cravings.
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Omega-3 – these healthy fats help reduce inflammation, support hormone balance and play a role in egg health and quality.
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Folic Acid – vital in the preconception phase, folic acid helps prevent neural tube defects and is recommended for all women trying to conceive.
When Lifestyle Changes Aren't Enough
Of course, sometimes lifestyle changes aren’t enough on their own. For some women, the best approach is combining healthy habits with medical treatment.
The encouraging news? PCOS is one of the most treatable causes of infertility. With the right plan in place, success rates are high – and many women go on to have healthy pregnancies.
✨ Bottom line: Lifestyle changes may not seem like much, but they are the foundation for setting your body up for a successful pregnancy. It’s not about restriction – it’s about building habits that support your hormones, cycles and overall wellbeing. And the best part? These habits don’t just help with conception and pregnancy, they support your long-term health, energy and mood too.