Pregnant woman with PCOS against a yellow background

Can you get pregnant with PCOS?

Medically reviewed on January 3, 2023 by Jordan Stachel, MS, RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Polycystic ovary syndrome (PCOS) is a hormonal imbalance condition that impacts 6–12% of women and people assigned female at birth (AFAB) [1]. PCOS patients tend to produce excess androgen, a male hormone. There are many PCOS symptoms, however, one of the most notable symptoms of PCOS is menstrual irregularities, which can be a sign of anovulatory infertility [2].

So, can you get pregnant with PCOS? Yes—while PCOS can affect female fertility, many people with PCOS still get pregnant. Sometimes, it just takes a few lifestyle changes or medications to make it happen.

Below, we’ll explain how PCOS can affect fertility and the pregnancy journey.

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Is it hard to get pregnant with PCOS?

Getting pregnant when you have PCOS may be more difficult. That’s because you may not ovulate as often as other people.

The average menstrual cycle in people without PCOS is 28 days [3]—in people with PCOS, it’s 35 days or more [4]. As a result of the irregular menstrual cycle, people with PCOS may only experience six to eight periods each year, if any at all.

This then leads to irregular ovulation. Ovulating less frequently reduces the number of chances you have to get pregnant throughout the year. While it’s still possible to get pregnant under these conditions, it may take more time.

How to improve your chances of getting pregnant with PCOS

While getting pregnant with PCOS can be challenging, there are many steps you can take to improve your chances, such as the following.

Maintaining a healthy weight

Between 38% and 88% of people with PCOS are overweight [5]. Being overweight can exacerbate the symptoms of PCOS and may make it more difficult to conceive.

Fortunately, losing just 5% of your body weight may improve your fertility [6]. Weight loss can also potentially enhance the effectiveness of any fertility treatment you pursue, depending on your specific medical conditions.

If you want to reach a healthy weight, you can do so through a combination of exercise and eating a balanced diet.

Taking ovulation-inducing medications

If diet and exercise don’t work on their own, your healthcare provider may suggest taking fertility medications to regulate ovulation. Some of these ovulation induction medications may include:

  • Clomiphene citrate – Clomiphene citrate is an oral fertility medication that can induce ovulation. It’s the most common fertility medication for people with PCOS [7].
  • Letrozole – While Letrozole is primarily used as a cancer medication, it can also stimulate ovulation in people with PCOS [8].
  • Gonadotropins – Gonadotropins are injectable drugs that can cause ovulation [9]. They contain female fertility hormones, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

Undergoing in vitro fertilization (IVF)

Improving chances of pregnancy with PCOS can also involve reproductive medicine, such as IVF. During IVF treatment, your healthcare provider or fertility specialist uses injections to stimulate your ovaries to produce mature eggs. They can then retrieve these eggs from your ovaries and fertilize them outside of your body. Once the eggs are fertilized, one or more is placed into your uterus, which will hopefully lead to a successful pregnancy. IVF treatment can be time-consuming and expensive, so it’s best used as a last resort.

How long does it take to get pregnant with PCOS?

The time it takes to get pregnant with PCOS can vary. You may get pregnant naturally within a year if you’re still ovulating.

If you take medication for ovulation induction, you can get pregnant quite quickly too. Studies have shown that 75–80% of people ovulate after taking clomiphene citrate and have an average conception rate of 22% per cycle [10].

If you use the IVF fertility treatment option, your chances of getting pregnant with PCOS can be as high as 50% [11]. Just keep in mind that being over the age of 35 or being obese may lower these chances.

How does PCOS affect pregnancy?

Once you get pregnant, having PCOS can cause some complications. Pregnant people with PCOS are at a higher risk of having [12]:

  • High blood pressure
  • Gestational diabetes
  • Preeclampsia
  • Premature birth
  • C-section delivery
  • Miscarriage

Due to these risks, it's important to have your healthcare provider monitor your PCOS symptoms carefully throughout your pregnancy.

Check your fertility hormones with an at-home test from Everlywell

While PCOS can make your pregnancy journey a little more complex, there’s still a good chance that you can conceive if you take the right steps.

One of the first steps you can take is to check your fertility hormone levels. You can do so with ease with an Everlywell at-home hormone test. Our at-home female hormone test can check 11 important biomarkers, including:

  • Estradiol
  • Progesterone
  • Luteinizing hormone
  • Follicle-stimulating hormone
  • DHEAS
  • Cortisol
  • Thyroid-stimulating hormone
  • Free T3
  • Free T4
  • Free testosterone
  • Thyroid peroxidase antibodies

Once you receive your Everlywell test, all you have to do is collect your blood and saliva samples at home and send them to us. We’ll test your samples at a CLIA-certified lab. After your results are reviewed by an independent board-certified physician, we can share them with you securely so you can pass them on to your healthcare provider. It’s that easy.

What causes low estrogen levels?

How to lower estrogen: what you need to know

What this women’s hormone test can reveal about your health

How to test for PCOS: here's what to know

References

  1. Centers for Disease Control and Prevention. PCOS (Polycystic Ovary Syndrome) and Diabetes. Centers for Disease Control and Prevention. Published August 12, 2019. URL
  2. Sawant S, Bhide P. Fertility Treatment Options for Women With Polycystic Ovary Syndrome. Clinical Medicine Insights: Reproductive Health. 2019;13:117955811989086. doi:10.1177/1179558119890867
  3. Cleveland Clinic. Normal Menstruation | Cleveland Clinic. Cleveland Clinic. Published 2019. URL
  4. Harris HR, Titus LJ, Cramer DW, Terry KL. Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population-based case-control study. International Journal of Cancer. 2016;140(2):285-291. doi:10.1002/ijc.30441
  5. Barber TM, Hanson P, Weickert MO, Franks S. Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. Clinical Medicine Insights: Reproductive Health. 2019;13:117955811987404. doi:10.1177/1179558119874042
  6. Cena H, Chiovato L, Nappi RE. Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists. The Journal of Clinical Endocrinology & Metabolism. 2020;105(8):e2695-e2709. doi:10.1210/clinem/dgaa285
  7. Treatments for Infertility Resulting from PCOS. URL
  8. Treatments for Infertility Resulting from PCOS. URL
  9. Treatments for Infertility Resulting from PCOS. URL
  10. Sawant S, Bhide P. Fertility Treatment Options for Women With Polycystic Ovary Syndrome. Clinical Medicine Insights: Reproductive Health. 2019;13:117955811989086. doi:10.1177/1179558119890867
  11. Sawant S, Bhide P. Fertility Treatment Options for Women With Polycystic Ovary Syndrome. Clinical Medicine Insights: Reproductive Health. 2019;13:117955811989086. doi:10.1177/1179558119890867
  12. Does PCOS affect pregnancy? http://www.nichd.nih.gov/. Published January 31, 2017. URL
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