Introduction
Are you struggling with irregular periods, unexpected weight gain, or acne, and also trying to get pregnant? You might be dealing with Polycystic Ovary Syndrome (PCOS). It affects nearly 6-13% of reproductive age women globally and is one of the leading causes of infertility. So, can it also affect your chances of a healthy pregnancy? Keep reading to find out the link between infertility and PCOS. You will also explore how to get pregnant with PCOS by adapting realistic solutions that range from lifestyle changes to fertility treatments.
What Is PCOS and How Does It Affect Fertility?
Before we get into fertility, let’s quickly understand what PCOS actually means and how it differs from PCOD.
PCOS full form is Polycystic Ovary Syndrome. It is a hormonal disorder that causes multiple small cysts on the ovaries, irregular periods, and high androgen levels (male hormones). On the other hand, the full form of PCOD is Polycystic Ovarian Disease. It is a condition where the ovaries produce immature or partially mature eggs. However, it is often used interchangeably with PCOS.
What Are the Symptoms of Infertility Due to PCOS?
Infertility linked to PCOS isn’t always obvious at first. Many women live with symptoms for years before realising they are connected to ovulation problems. However, the most reported signs among women with PCOS are:
- Irregular periods or no periods at all
- Oily skin or acne
- Excess hair on the face, chest, or back (hirsutism)
- Thinning hair on the scalp
- Weight gain, especially around the waist, or trouble in losing weight
- Difficulty getting pregnant
Some women also experience emotional health issues like anxiety, low mood, and poor body image due to PCOS symptoms. These emotional struggles can indirectly impact fertility by adding stress to the body.
Can PCOS Cause Infertility?
Yes, PCOS is one of the most common causes of ovulation-related infertility in women. Not all women with PCOS are infertile, but many experience difficulty getting pregnant due to hormonal and metabolic imbalances. The most common reasons why PCOS causes infertility are discussed as follows:
1. Hormonal Imbalance in Women with PCOS
Women with PCOS have an imbalance of several reproductive hormones. The most common problems include:
- High LH (Luteinizing Hormone): Stimulates the ovaries to produce testosterone instead of triggering ovulation
- Low or Normal FSH (Follicle Stimulating Hormone): Fails to mature follicles properly
- High Androgens: Lead to acne, excess facial hair, and disturbed egg development
- Low Progesterone: Results in an unstable uterine lining, which makes implantation difficult
This imbalance blocks the body’s ability to develop and release a healthy egg each month. That’s why the question “Can PCOS cause infertility?” has a clear medical basis.
2. Insulin Resistance and Fertility Impact
Over 70-80% of women with PCOS also have insulin resistance. This means their body does not use insulin properly, which causes higher insulin levels in the blood. High insulin levels cause:
- The ovaries to produce more androgens
- Reduced sex hormone-binding globulin (SHBG), which allows free testosterone to rise
- Disruption of the regular ovulation cycle
Insulin resistance also increases the risk of weight gain, type 2 diabetes, and miscarriage. All these factors can worsen fertility outcomes.
3. Poor Egg Quality
The hormonal environment in PCOS can affect egg maturation and egg quality. Eggs may not mature correctly or may be released late. This reduces the chances of fertilisation. In some cases, the egg’s outer layer becomes thick and resistant, making sperm penetration difficult.
4. Endometrial Health and Implantation Problems
Women with PCOS often have fewer cycles in a year. That means the endometrial lining (inner wall of the uterus) builds up for longer periods. This can lead to:
- Thickened or unstable uterine lining
- Poor timing for implantation
- Higher risk of miscarriage or early pregnancy loss
Even if fertilisation occurs, implantation may fail due to poor progesterone levels and endometrial instability.
5. Obesity and Fertility
Many women with PCOS struggle with weight gain or obesity, which worsens hormone imbalance. Obesity increases:
- Estrogen levels from fat tissues
- Insulin resistance
- Inflammation, which can affect egg and embryo health
Weight-related hormonal changes make ovulation more irregular. Even assisted reproductive techniques may have lower success rates in obese PCOS patients.
6. Irregular Ovulation
Women with PCOS often don’t ovulate every month, and sometimes not at all. This drastically lowers the chances of conception. So, if you are asking, with PCOS, can I get pregnant? Yes, but ovulation might not be happening as regularly as it should.
Will PCOS Affect Pregnancy?
Yes, PCOS doesn’t just make conception difficult; it can also affect how your pregnancy progresses. Hormonal imbalance, irregular ovulation, and insulin resistance can increase pregnancy-related complications. However, with timely monitoring and support, many women go on to have healthy pregnancies. Some of the more common pregnancy-related risks in women with PCOS are listed in the table below:
| Complication | Risk with PCOS |
| Gestational diabetes | 2 to 4 times higher due to insulin resistance |
| Preeclampsia | Increased risk due to obesity and hormonal imbalance |
| Preterm birth | Higher chance, often due to pregnancy complications |
| Miscarriage (first trimester) | 30% to 50% higher risk compared to women without PCOS |
That said, many women go on to have completely healthy pregnancies after treatment and support.
How to Get Pregnant with PCOS?
If you have been searching “how to get pregnant with PCOS,” you have probably come across a lot of complicated advice and conflicting information. The truth is, PCOS can make getting pregnant more challenging, but it is absolutely possible when you follow the right steps. Here’s a clear and simple breakdown of what actually helps:
1. Diet
Your diet is the major factor behind managing PCOS. A low-carb, high-protein diet can improve insulin resistance, which is one of the root problems in PCOS. High insulin levels increase testosterone, which disrupts ovulation. So, try including the foods mentioned in the given table in your diet:
| Food Group | What to Include (Recommended) | What to Avoid (Not Recommended) |
| Whole Grains | – Brown rice
– Quinoa – Rolled oats – Whole wheat roti |
– White rice
– Maida-based products (pasta, naan, white bread) |
| Lean Proteins | – Boiled eggs
– Grilled fish or chicken – Moong dal, chana dal – Paneer, tofu |
– Processed meats (sausages, salami)
– Fried dals or deep-fried paneer |
| Healthy Fats | – Ground flaxseeds (1–2 tbsp/day)
– Almonds, walnuts (handful/day) – Chia seeds – Avocado |
– Hydrogenated oils
– Packaged fried snacks (chips, namkeen) |
| Vegetables | – Spinach, kale, methi
– Broccoli, cauliflower – Bottle gourd (lauki), ridge gourd (turai) |
– Potatoes, sweet corn (limit use)
– Frozen/canned vegetables with added salt |
| Sugars & Sweets | – Fresh fruits (in moderation, like apples, papayas)
– Jaggery (in controlled amounts) |
– Soft drinks, sweetened tea/coffee
– Cakes, mithai, flavored yogurts |
| Snacks & Junk | – Roasted chana
– Air-fried makhana – Homemade hummus with cucumber |
– Instant noodles
– Fried samosas, burgers, street food |
2. Exercise
Consistent physical activity helps manage weight, improves insulin sensitivity, and reduces androgen levels, all essential for regulating ovulation in PCOS. The table below mentions exercises you should perform if you want to manage PCOS symptoms effectively:
| Type of Exercise | Frequency | Examples | Why It Helps |
| Cardio (Moderate) | 5 days/week, 30 min | Brisk walking, cycling, swimming, treadmill walking | Improves insulin action, supports fat loss |
| Strength Training | 2–3 times/week | Bodyweight exercises, resistance bands, and light weightlifting | Builds muscle, reduces insulin resistance |
| Yoga/Pilates | 3–5 times/week | Surya Namaskar, Trikonasana, Setu Bandhasana, Cat-Cow, Child’s Pose | Reduces stress hormones, supports hormone balance |
| HIIT (Optional) | 2 times/week | 30-sec sprint + 90-sec rest (5–8 cycles), jump squats, mountain climbers | Boosts metabolism, burns fat efficiently |
You don’t need to hit the gym every day. Even 30 minutes of walking, yoga, or cycling can improve insulin sensitivity and reduce androgen levels. Aim to move your body at least 5 days a week.
3. Sleep and Stress Management
Poor sleep and chronic stress worsen hormone imbalance in women, increasing symptoms like irregular periods, acne, and cravings. Here’s how you can improve both:
| Category | Action | How to Do It | Why It Helps |
| Sleep Duration | 7–8 hours of uninterrupted sleep | Set a fixed bedtime (10:30–11 PM), avoid late-night screen time | Supports hormone regulation and ovulation |
| Bedtime Routine | Wind down before bed | Warm shower, reading, or light stretching instead of screens | Promotes better melatonin production |
| Reduce Blue Light | Avoid screens at least 60 minutes before bed | Use night mode or blue light filters if screens are unavoidable | Improves sleep quality and duration |
| Mindfulness Meditation | Practice 10–15 minutes daily | Use guided apps (e.g., Headspace, Calm) during mornings or before sleep | Reduces cortisol and improves mental clarity |
| Deep Breathing Exercise | Try the 4-7-8 method | Inhale for 4 secs → Hold for 7 secs → Exhale for 8 secs; repeat 5 times | Calms the nervous system and lowers stress hormones |
| Journaling | Daily gratitude or thought journaling | Write 3 things you’re grateful for, or thoughts causing anxiety | Helps declutter the mind and reduces emotional overload |
| Nature Exposure | Spend at least 20 minutes in natural surroundings | Walking in a park, balcony gardening, barefoot grounding | Lowers cortisol and improves mood |
4. Medications
There are specific medications to stimulate ovulation. However, you should always consult a qualified gynaecologist or fertility specialist before starting any medication. Dosage, timing, and suitability depend on individual health history, hormone levels, and other factors. The key details about these medications are as follows:
| Medication | Main Use | When It’s Prescribed | Key Info |
| Metformin | Improves insulin resistance | When insulin levels are high, or PCOS is linked to weight gain | May reduce testosterone and support ovulation |
| Letrozole | Stimulates ovulation | Often preferred for ovulation induction in PCOS | Taken early in the cycle, fewer side effects than with Clomiphene |
| Clomiphene Citrate | First-line ovulation trigger | For women not ovulating regularly | May not work in some PCOS types; requires monitoring |
These may be prescribed before trying advanced fertility treatments.
5. IVF for PCOS Patients
When oral medications or intrauterine insemination (IUI) don’t help, IVF for PCOS patients becomes the next step. Here is what makes IVF both promising and slightly complex in PCOS cases:
| Aspect | Details |
| Success Rate | 60–70% per cycle in women under 35 with PCOS (higher than average IVF rates) |
| Why IVF Works for PCOS | Controls ovulation precisely; retrieves multiple eggs; bypasses natural ovulation issues |
| Risk | OHSS (Ovarian Hyperstimulation Syndrome) – swelling, pain, fluid retention |
| Precautions in IVF | Doctors may use “mild stimulation protocols” or freeze-all strategies to prevent OHSS |
| Duration | 4–6 weeks from stimulation to embryo transfer |
| Cost in India (2025) | ₹1.2 to ₹2.5 lakhs per cycle (excluding meds & tests) |
IVF is highly effective, but always requires careful planning and expert monitoring, especially in PCOS cases prone to overstimulation.
What About Unmarried Women? Is There a Treatment?
There is help available, even if you are not planning a baby right now. PCOS is not just associated with pregnancy. It also affects your skin, weight, mood, and even your future health. That’s why treatment is important for all women, regardless of marital status. There is no specific PCOS treatment for unmarried women. However, you can manage it effectively with the following strategies:
| What You Can Do | Why It Helps |
| Get regular checkups (blood tests + ultrasound) | Helps monitor hormone imbalance in women and track changes in the ovaries |
| Birth control pills | Regulate irregular periods, lower testosterone, reduce acne, and facial hair |
| Anti-androgens (like spironolactone) | Target excess hair growth (chin, upper lip), reduce scalp hair thinning |
| Focus on weight management | Losing just 5–10% body weight can help restore regular cycles and lower insulin levels |
| Stay active | Exercise 5 days a week (30–45 min) improves hormone balance and mood |
| Balanced diet (low-sugar, high-protein) | Controls insulin levels and reduces testosterone spikes |
When to See a Doctor?
Don’t wait too long. PCOS symptoms can quietly affect your life for years. Talk to a gynaecologist or endocrinologist if:
- You haven’t had your period for more than 2–3 months
- You are dealing with heavy or painful periods
- You see excess facial hair, acne, or scalp hair thinning
- You are gaining weight fast, especially around your belly
- You feel anxious, sad, or frustrated more often
- Your skin has dark patches around the neck or underarms
The earlier you start treatment, the better your results will be. Even small changes can make a big difference.
Take Control of PCOS to Manage Fertility Effectively!
PCOS can impact your ability to conceive, but it does not make infertility a certainty. If you have been wondering whether PCOS cause infertility or can PCOS lead to infertility, it’s important to understand that with timely intervention and the right treatment plan, pregnancy is very much possible.
What helps the most? Adopting a PCOS-friendly diet, staying active, sleeping well, considering timely medication, and reaching out when things feel off. If you have been trying to conceive or are simply looking for answers, consult a fertility specialist at Femcare Fertility today to get a personalised treatment plan!
FAQs (Frequently Asked Questions)
Question: Does PCOS cause infertility in all women?
Answer: No, PCOS does not cause infertility in all women. Although it is one of the most common causes of ovulation-related infertility, many women with PCOS ovulate regularly or respond well to treatment. With proper care, most can conceive naturally or with medical help.
Question: Can PCOS be cured?
Answer: No, PCOS cannot be cured, but it can be effectively managed. It is a chronic condition linked to hormonal imbalance and insulin resistance. Lifestyle changes, medications, and early diagnosis help control symptoms, improve ovulation, and support better long-term health and fertility outcomes.
Question: With PCOS, can I get pregnant naturally?
Answer: Yes, many women with PCOS get pregnant naturally, especially if they make healthy lifestyle changes and maintain a healthy weight. However, some women may need ovulation-inducing medications or further fertility support if their cycles remain irregular or if other factors are involved.
Question: Can PCOS lead to infertility even if I have regular periods?
Answer: Yes. Even if your periods appear regular, you may not be ovulating consistently. Some women with PCOS have what’s called “anovulatory cycles,” where bleeding happens but no egg is released. That’s why hormonal blood tests and ultrasound scans are important to check for ovulation.
Question: Will PCOS affect pregnancy after conception?
Answer: Yes, PCOS can affect pregnancy in several ways. It increases the risk of miscarriage, gestational diabetes, high blood pressure, and preterm birth. Doctors often monitor pregnancies in women with PCOS more closely to ensure a safe pregnancy and delivery outcome.
Question: What is the difference between PCOS and PCOD?
Answer: PCOS and PCOD in full form are Polycystic Ovary Syndrome and Polycystic Ovarian Disease. PCOD is a broader term used earlier; PCOS is now medically preferred. PCOS usually causes more serious hormonal imbalances, whereas PCOD may involve milder or temporary ovarian cyst formation.