Preparing for Pregnancy If You Have PCOS

5 Ways to Increase Your Odds of a Healthy 9 Months

Polycystic ovary syndrome (PCOS) presents a challenge in getting pregnant and maintaining a healthy pregnancy for people living with this reproductive health issue. In fact, some 80% of infertility cases linked to ovulation failure are caused by PCOS.

Most people with PCOS can get pregnant with appropriate treatment for their inability to conceive. However, PCOS presents some specific and significant challenges before and during pregnancy. Some of them may be reduced by maintaining a healthy lifestyle.

This article discusses the intentional steps you can take to improve your chances of getting pregnant. Losing weight, managing blood sugar well, and other lifestyle factors will help during pregnancy, too.

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Monitor Menstrual Cycles

Many people with PCOS have irregular menstrual cycles, which means that they may not be ovulating regularly or reliably. This can severely hamper attempts to get pregnant.

If you have menstrual difficulties, you may want to see your healthcare provider or a reproductive endocrinologist for help early on. There are certain medications, like Femara (letrozole), that you can take to induce ovulation and boost your chances of pregnancy success.

Take Prenatal Vitamins

Prenatal vitamins are a must if you get pregnant. Not only do they help ensure nutrition for maternal health, but they also help to protect the developing fetus.

For example, studies have shown that neural tube defects like spina bifida, in which a fetus's spine develops incorrectly, may be linked to a folic acid (B vitamin) deficiency during pregnancy.

A prenatal vitamin has higher amounts of certain vitamins and minerals like folic acid, vitamin D, choline, and docosahexaenoic acid (DHA), which are essential for a healthy pregnancy. 

People should start prenatal vitamins three or more months before trying to conceive. A B-complex vitamin called myo-inositol may also promote fertility (especially in people with living PCOS) by increasing insulin sensitivity, menstrual regularity, and ovulatory function.

Lose Weight

Being significantly overweight or obese can put you at risk for developing pregnancy complications that affect both you and the developing fetus. These complications include:

People with PCOS are already at higher risk of being overweight or obese, making this lifestyle change even more important. In the United States, some studies report that the prevalence of overweight and obesity in people with PCOS may be as high as 80%.

In addition to diet and exercise, people with PCOS may benefit from treatment with medications including Glucophage (metformin), a drug used to improve insulin resistance, and obesity drugs like Xenical (orlistat) and Wegovy (semaglutide).

PCOS, Miscarriage, and Metformin

People living with PCOS are three times as likely to miscarry in the early months of pregnancy as people who don't. Some research shows that metformin may reduce the risk of miscarriage in pregnant people with PCOS, but results are mixed and more research is needed.

Manage Your Blood Sugar

People living with PCOS are more likely to have insulin resistance than those who are not. Some studies have shown that between 31% and 35% of people with PCOS have impaired glucose tolerance. When these people become pregnant, they are at a higher risk of developing gestational diabetes.

Apart from pregnancy, all people with PCOS who have insulin resistance need to be treated. In addition to diet, aerobic exercise, resistance training, and metformin, drugs like Actos (pioglitazone) and Avandia (rosiglitazone) may help increase insulin sensitivity and promote ovulation.

PCOS, Pregnancy, and Blood Sugar

If your blood sugar isn’t well-controlled, see your healthcare provider and make a plan to get it under control before you get pregnant. This may mean improving your diet or increasing your activity level. These may be difficult changes to make, but they can make a world of difference in your health.

Stop Smoking

Smoking in people with PCOS is associated with increased insulin resistance and metabolic dysfunction, both of which can complicate pregnancy or make it more difficult to become pregnant. Smoking has also been linked to premature delivery and pregnancy loss.

If you intend to become pregnant, give yourself the time you need to quit smoking. If you have trouble doing so, speak with your healthcare provider about smoking cessation aids that can help.


Many people with PCOS face difficulty getting pregnant because of their irregular menstrual cycles and missing or limited ovulation. It's possible for people with PCOS to conceive, given the right medical treatment and support from a healthcare team.

But there also are steps you can take to improve your chances of becoming pregnant and having a healthy pregnancy. Diet, exercise, and weight loss are important lifestyle choices. Taking prenatal vitamins and, in some cases, medication will help to support conception and pregnancy.

People with PCOS who don't plan to get pregnant can also benefit from steps to improve blood sugar management or stop smoking. Speak with your healthcare provider about the best approach.

A Word From Verywell

Most healthcare providers now recommend a preconception counseling appointment with your obstetrician (OB/GYN). This visit aims to discuss your overall health and how to prepare for a pregnancy. It's a good time for people with PCOS to plan for pregnancy and discuss smoking cessation, weight management, or blood glucose control if needed.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."