Polycystic ovarian syndrome (PCOS) is an imbalance of female reproductive hormones that can affect fertility. In addition to symptoms like weight gain, unwanted hair growth, and acne, PCOS can make it more difficult to get pregnant.

Between 5–10% of people between the ages of 15 and 44 have PCOS. The condition may cause ovarian cysts, cycles without ovulation, and irregular periods. Lifestyle changes, medications, and other treatments can improve fertility outcomes.

Can You Get Pregnant If You Have PCOS?

PCOS is one of the leading causes of infertility. Around 70–80% of people with PCOS face challenges when trying to conceive. The good news is that PCOS is also one of the most treatable causes of infertility, with several effective options available.

Ovulation induction and cycle regulation are the main treatment strategies. Effectiveness varies depending on the individual, age, underlying health conditions, and chosen therapy. Medications like Clomid (clomiphene) and gonadotropins can induce ovulation, with success rates around 70%. Surgical techniques like ovarian drilling are less effective, with success rates closer to 50%.

Lifestyle Changes To Improve Fertility

Lifestyle adjustments are often the first step in managing PCOS-related infertility. They may be used alone or alongside medical interventions.

Maintain a healthy weight
Achieving and maintaining a healthy weight looks different for everyone. Weight loss through diet and exercise can improve PCOS symptoms, regulate blood glucose, and restore ovulation.

Exercise
Regular physical activity supports metabolic health and reproductive function. Studies show that consistent exercise improves menstrual regularity and ovulation. International guidelines recommend at least 150 minutes of weekly activity, including about 90 minutes of moderate-intensity aerobic exercise.

Diet and nutrition
Eating a nutrient-rich, balanced diet helps regulate blood sugar and promote ovulation. Because insulin resistance is common in PCOS, focusing on high-protein, high-fiber meals and low-glycemic index foods like whole grains and complex carbohydrates is especially beneficial.

Medical Treatments To Promote Pregnancy

When lifestyle strategies alone are not enough, medical treatments may be necessary.

Ovulation-inducing medication
The first line of treatment is usually medications such as Clomid (clomiphene). If Clomid is not effective, Femara (letrozole) may be prescribed.

Gonadotropins
As a second-line treatment, injectable hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) may be used to stimulate egg release.

Metformin
Although not FDA-approved for PCOS, Metformin is often prescribed off-label to improve insulin sensitivity. By lowering blood sugar and improving hormone balance, it may promote ovulation in some patients.

Surgery
If medications are unsuccessful, surgical options such as ovarian drilling can help. In this procedure, tiny holes are made in the ovaries to encourage egg release.

Assisted reproduction
For more advanced cases, in vitro fertilization (IVF) may be recommended. IVF involves stimulating the ovaries, retrieving eggs, fertilizing them in a lab, and transferring embryos into the uterus. Some may also choose to freeze eggs or embryos for future use.

IUI vs. IVF
Intrauterine insemination (IUI) is often tried before IVF. This involves inserting sperm directly into the uterus. Fertility specialists typically recommend several IUI attempts before moving to IVF, as repeated rounds improve success rates.

Alternative And Complementary Therapies

Some people explore additional therapies to support fertility. These should always be discussed with a healthcare provider before use.

  • Inositol supplements: May increase insulin sensitivity and encourage ovulation.

  • Melatonin: Supports sleep, hormone balance, and ovulation.

  • Vitamins D, B12, and calcium: Help regulate hormones and improve fertility outcomes.

  • Acupuncture: May help regulate menstrual cycles, reduce insulin resistance, and stimulate ovulation.

How To Manage Stress

Struggling with infertility can take a toll on mental health. Many people with PCOS experience anxiety, depression, or emotional stress related to fertility challenges.

Coping strategies include:

  • Allowing yourself to process emotions instead of suppressing them.

  • Seeking support from partners, family, or friends.

  • Setting boundaries around triggering social events.

  • Joining support groups such as RESOLVE.

  • Talking with a healthcare provider about mental health resources.

A Quick Review

PCOS is one of the most common causes of infertility, often linked to irregular cycles and lack of ovulation. However, it is also highly treatable.

Treatment options include lifestyle changes, medications, surgical procedures, and assisted reproductive technologies like IVF. Each case is unique, and the right plan depends on age, overall health, and fertility goals.

Although fertility treatment can take time and persistence, many people with PCOS successfully conceive with the right medical support.