Polycystic ovary syndrome (PCOS) is one of the most common reasons women have difficulty getting pregnant, mainly because it can stop ovulation happening regularly. But the reassuring answer is that most women with PCOS can get pregnant, either naturally or with treatment, which is often simple and effective.
This guide explains how PCOS affects fertility, what you can do yourself, the medical options, and when to see your GP.
How PCOS affects fertility
In PCOS, hormonal changes can stop the ovaries releasing an egg every month. Periods may be irregular, infrequent or absent, which makes it harder to know when you are ovulating and reduces the number of chances to conceive each year. When ovulation is restored, pregnancy rates are good.
First steps you can take
- Track your cycle: ovulation tests and cycle tracking help, although results can be less reliable with PCOS.
- Aim for a healthy weight: if you are overweight, losing 5 to 10 percent of body weight can help ovulation return.
- Exercise regularly: this improves insulin sensitivity even without weight loss.
- Stop smoking and limit alcohol, for both partners.
- Take folic acid: start before trying to conceive. Your GP may advise a higher dose if your BMI is 30 or above.
Medical options
- Letrozole: a tablet that helps trigger ovulation, now often used as first-line treatment.
- Clomifene: another tablet to stimulate ovulation.
- Metformin: sometimes used alone or with clomifene, particularly with insulin resistance.
- Ovarian drilling: a keyhole procedure that can restore ovulation when tablets have not worked.
- IVF: an option if other treatments are not successful or there are other fertility factors.
These treatments are arranged through your GP and a fertility specialist.
Pregnancy with PCOS
Women with PCOS have a higher risk of some pregnancy complications, such as gestational diabetes and high blood pressure. Your midwife or doctor may suggest an earlier glucose test and closer monitoring. A healthy weight and regular activity before pregnancy help reduce these risks.
What about acupuncture?
Some women with PCOS use acupuncture for stress and wellbeing while trying to conceive. Evidence that it improves pregnancy rates in PCOS is limited, and a large trial found it did not increase live births compared with a placebo procedure, so it should be used alongside medical care rather than instead of it.
When to see your GP
- Your periods are irregular or absent, even before you start trying
- You have been trying for 12 months without success
- You are over 35 and have been trying for 6 months
- You would like advice before trying to conceive
With PCOS and irregular periods, there is no need to wait a year before asking for help.
Frequently asked questions
Can you get pregnant naturally with PCOS?
Yes. Many women with PCOS conceive naturally, especially if they ovulate some of the time.
How long does it take to get pregnant with PCOS?
It varies. It may take longer than average, but with treatment to restore ovulation, many women conceive within months.
Does PCOS cause miscarriage?
Some studies suggest a slightly higher risk, which may be linked to insulin resistance and weight. A healthy lifestyle and good medical care help.
Can you get pregnant with PCOS and no periods?
Yes, with treatment. Medicines that trigger ovulation are often very effective.
PCOS and fertility support in Chiswick
Omnia Lifestyle supports women with PCOS who are trying to conceive, alongside their GP and fertility team, with nutrition and fitness coaching, body composition scans and supportive therapies at our clinic in Chiswick, W4, close to Turnham Green station, on bus routes 94, E3 and 272. Limited parking is available on request when booking.
Read more about PCOS and fertility, see how to lose weight with PCOS and acupuncture and fertility, explore fitness and nutrition and acupuncture, or book an appointment.
This article is general information, not medical advice. Speak to your GP about fertility treatment for PCOS.
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