PCOS is more common than many people realise, but that doesn’t make it any less confusing, especially when you’re thinking about pregnancy.
PCOS is a common hormonal condition that can affect ovulation, but it doesn’t take away the possibility of starting or growing your family. The good news is that many people with PCOS do go on to get pregnant, with or without fertility treatment. In this blog, we’ll help you understand how PCOS affects your fertility and what choices are available, so you can understand your options and what your next steps might look like.
What is PCOS, and how does it affect my fertility?
Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that affects how the ovaries function. It can impact ovulation, hormone levels, and, in some cases, egg development.
For some people, PCOS may cause irregular or absent ovulation, which can make it harder to predict fertile windows or conceive naturally. Hormonal imbalances, particularly higher levels of androgens (sometimes called ‘male hormones’), can also interfere with the normal development and release of eggs.
It’s important to remember that PCOS looks different for everyone. Some people experience mild symptoms, while others may face more significant challenges with their cycles and fertility.
Can I still get pregnant with PCOS?
Yes, you can. Many people with PCOS conceive naturally, while others may need some support along the way. The timeline and approach can vary depending on factors such as age, overall health, and how PCOS affects their ovulation.
A 2018 study claims that up to 70–80% of people with PCOS may experience difficulty with ovulation, but this does not mean pregnancy isn’t possible. With the right support and treatment, many go on to achieve healthy pregnancies.
How does PCOS affect conception?
While pregnancy is absolutely possible, PCOS can present a few challenges that may make the process feel more uncertain. These can include:
- Irregular cycles, making ovulation harder to track.
- Infrequent or absent ovulation, which can delay conception.
- Hormonal imbalances, affecting egg development.
- Insulin resistance, which is common in PCOS, can impact reproductive hormones.
For some people, egg quality may also be affected, although this varies widely and is not the case for everyone. Having a clearer picture of these challenges can help you and your care team figure out what feels like the right next step for you.
When should I ask for help with my fertility and PCOS?
If you’ve been diagnosed with PCOS and are thinking about pregnancy, it can be helpful to speak with a fertility specialist early on. Get advice if:
- Your cycles are irregular or absent.
- You’re unsure if you are ovulating.
- You’ve been trying to conceive for 6–12 months without success*.
- You’re unsure what treatment options are available and right for you.
- You’d like to explore IVF or other pathways.
*Seek advice after 6 months if over the age of 35, or 12 months if under the age of 35.
What treatment options are available for people with PCOS?
Lifestyle support
For some, small lifestyle changes can make a meaningful difference. Managing insulin resistance through diet, exercise, and weight balance (where appropriate) has been shown to improve ovulation in some individuals.
Even a modest weight loss (around 5–10% of body weight) has been associated with improved ovulation and pregnancy rates in people with PCOS.
Ovulation induction
If your cycles and ovulation ‘window’ are irregular, medications can help stimulate the ovaries and regulate your cycles. Common options include:
- Letrozole, which is often considered the first-line treatment.
- Clomiphene citrate (Clomid), which was previously the standard option.
A 2014 medical study showed that Letrozole can result in higher live birth rates compared to Clomiphene in people with PCOS, with ovulation rates reaching around 60–80% in some cases.
IVF (In Vitro Fertilisation)
If other treatments aren’t successful, IVF may be recommended. This process involves gently stimulating the ovaries, collecting the eggs, fertilising them in a lab, and then transferring an embryo into the uterus.
For people with PCOS, IVF can take some of the pressure off, as it works around the challenges that ovulation can bring. Success rates vary depending on age and individual circumstances. Still, this 2012 study suggests that IVF outcomes for people with PCOS can be comparable to, or in some cases better than, those without PCOS when managed.
When should I consider using donor eggs?
For some individuals, there may be additional factors affecting fertility, such as reduced egg quality, repeated unsuccessful IVF cycles, medical factors, or age-related changes. In these situations, donor eggs can be an option. Donor eggs typically come from young, healthy donors (many who have had a live birth of their own), so they can:
- Improve embryo quality.
- Increase the likelihood of implantation.
- Lead to higher pregnancy success rates.
Using donor eggs might not be the right path for everyone, but for some, it can feel like a fresh start.
Read: When is the right time to use donor eggs?
The emotional side of PCOS and fertility
PCOS doesn’t just affect your body – it also impacts your emotional well-being. That’s why looking after your mental health is just as important as understanding the physical side.
- Jean Hailes for Women’s Health. Offers trusted, easy-to-understand information on PCOS, along with practical advice to support your overall well-being.
- QENDO. Provides free programs, education, and a supportive community for people living with PCOS and related conditions.
- Beyond Blue and SANE Australia. Offer free mental health support, resources, and helplines if you’re feeling overwhelmed or need someone to talk to.
- Polycystic Ovary Syndrome Association of Australia (POSAA). A dedicated Australian organisation focused on raising awareness, supporting people with PCOS, and connecting individuals with helpful resources and community support.
- PCOS Awareness Association. A global community offering education, advocacy, and support for people navigating PCOS, as well as their families.
- AskPCOS App. A trusted, expert-developed app that provides reliable information, tools, and guidance to help you better understand and manage PCOS day to day.
PCOS can make things feel more complicated at times, but it doesn’t mean pregnancy is impossible. With the right support, many people with PCOS go on to conceive and build the families they’ve been hoping for. Whether that happens naturally, with ovulation support, through IVF, or by exploring other options, there are multiple options available. If you’d like to learn more about your fertility pathways or explore whether options like IVF with donor eggs might be right for you, you can visit our website and explore our available programs. And if you’re ready to take the next step, reach out to us for a free consultation.
