Being diagnosed with polycystic ovary syndrome (PCOS) often raises immediate concerns about fertility. Many people worry that PCOS means they won’t be able to get pregnant, or that pregnancy will be difficult or unlikely.
The reassuring reality is that having PCOS does not mean you cannot get pregnant. While PCOS can make ovulation less predictable and conception may take longer, many people conceive naturally. For others, simple and effective treatments to support ovulation can significantly improve the chances of pregnancy.
PCOS is common, manageable, and very treatable. With the right support and a personalised plan, the outlook for pregnancy is often far more positive than people are initially led to believe.
In this article, I explain how PCOS affects ovulation, how ovulation can be tracked, what lifestyle changes may help support fertility, and when it may be helpful to consider fertility treatments or specialist support.
How can you track ovulation with PCOS?
Ovulation tracking with PCOS can be more challenging, but it is still possible, and it does not have to be perfect.
- Ovulation predictor kits (LH tests) can be helpful, but in PCOS they may show frequent positives. For this reason, they are best used alongside other signs rather than on their own.
- Cycle tracking, including noting cycle length, symptoms, and the timing of periods, can still provide useful information, even when cycles are irregular.
- Many people find that using a combination of methods works better than relying on just one approach.
If cycles are very irregular, ultrasound scans or blood tests can help clarify whether and when ovulation is happening.
How can lifestyle changes improve fertility with PCOS?
Lifestyle changes can genuinely make a difference to fertility in PCOS, and they do not need to be drastic.
Often, it is the small, realistic changes that help the most, such as:
- Eating regular, balanced meals
- Moving your body in ways you enjoy
- Prioritising sleep
- Finding manageable ways to reduce stress
Over time, these changes can help hormones settle and make ovulation more regular.
For some people, even small amounts of weight optimisation can improve cycle regularity and egg quality. Because insulin resistance is common in PCOS, supporting blood-sugar balance through food can also have a positive impact on fertility.
What treatment options are available for PCOS-related infertility?
There are several effective treatment options for PCOS-related infertility, and the right approach depends on what is happening with ovulation and menstrual cycles.
For many people, treatment starts with ovulation-induction medications, which help the ovaries release an egg more regularly and have very good success rates.
Sometimes metformin is used alongside ovulation-induction treatment, particularly when insulin resistance is a factor.
If these options are not successful, treatments such as:
- IUI (intrauterine insemination)
- IVF (in vitro fertilisation)
may be considered. Both can work well for people with PCOS when used at the right time. With appropriate support, many people with PCOS go on to achieve a pregnancy.
Does IVF work for women with PCOS?
Yes. IVF can work very well for women with PCOS, but it does require careful management.
People with PCOS often respond strongly to ovarian stimulation, so clinics use tailored protocols, including:
- Lower medication doses
- Careful monitoring
- Strategies such as freeze-all cycles when needed
These approaches help reduce the risk of ovarian hyperstimulation syndrome (OHSS). When managed properly, IVF is very safe.
It is also important to think about time to live birth. While IUI can be suitable for some people, IVF often leads to pregnancy more quickly, particularly if ovulation is unpredictable or if several IUI cycles have already been tried.
The best approach always depends on individual circumstances, with the aim of achieving a healthy pregnancy in the shortest and safest time.
When should you see a fertility specialist for PCOS?
It may be a good idea to see a fertility specialist if you have PCOS and:
- You have been trying to conceive for 12 months (or 6 months if you are over 35) without success
- Your periods are very irregular or absent, suggesting ovulation may not be happening regularly
- You find ovulation or cycle tracking confusing or unreliable
- You have already tried basic treatments without success
Seeing a specialist does not mean you are committing to IVF. Often, it is about gaining clarity, reassurance, and a personalised plan, and sometimes a small adjustment can make a significant difference.
About the author
Dr Yusuf Beebeejaun is a London-based Consultant in Reproductive Medicine and Fertility Specialist at London Pregnancy Clinic, providing research-led fertility care across private and NHS settings. He specialises in fertility assessment, IVF, ovarian stimulation, recurrent implantation failure, and PGT-A, and sees patients privately at King’s Fertility and Spital Clinic.
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