PCOS Fertility Preparing for Pregnancy If You Have PCOS 5 Ways to Increase Your Odds of a Healthy 9 Months By Nicole Galan, RN Updated on September 25, 2022 Medically reviewed by Anita Sadaty, MD Print Table of Contents View All Table of Contents Monitor Menstrual Cycles Take Prenatal Vitamins Lose Weight Manage Blood Sugar Stop Smoking 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. M_a_y_a / Getty Images 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. How to Know If You Are Ovulating Regularly With PCOS 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. Preparing for Pregnancy If You Have PCOS 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: Preeclampsia, a serious condition that can lead to seizures Gestational diabetes, which may require treatment to manage blood sugar levels Preterm labor, and its consequences for fetal development 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. Weight Loss and Other Drugs Used in PCOS 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. PCOS Diet: What to Eat to Manage Symptoms 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. What to Know About Nicotine Withdrawal Summary 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. When to Take a Pregnancy Test If You Have PCOS 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. Melo AS, Ferriani RA, Navarro PA. Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo). 2015;70(11):765-769. doi:10.6061/clinics/2015(11)09 Thurston L, Abbara A, Dhillo WS. Investigation and management of subfertility. J Clin Pathol. 2019;72(9):579-587. doi:10.1136/jclinpath-2018-205579 National Institute of Neurological Disorders and Stroke. Spina bifida fact sheet. Bergh CM, Moore M, Gundell C. Evidence-based management of infertility in women with polycystic ovary syndrome. J Obstet Gynecol Neonatal Nurs. 2016;45(1):111-122. doi:10.1016/j.jogn.2015.10.001 Lin AW, Kazemi M, Jarrett BY, et al. Dietary and physical activity behaviors in women with polycystic ovary syndrome per the new international evidence-based guideline. Nutrients. 2019;11(11). pii: E2711. doi:10.3390/nu11112711 National Institute of Child Health and Human Development. Does PCOS affect pregnancy? Flannery CA, Rackow B, Cong X, Duran E, Selen DJ, Burgert TS. Polycystic ovary syndrome in adolescence: impaired glucose tolerance occurs across the spectrum of BMI. Pediatr Diabetes. 2013;14(1):42-49. doi:10.1111/j.1399-5448.2012.00902.x Morley LC, Tang T, Yasmin E, Norman RJ, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev. 2017;11(11):CD003053. doi:10.1002/14651858.CD003053.pub6 Legro RS, Chen G, Kunselman AR, et al. Smoking in infertile women with polycystic ovary syndrome: baseline validation of self-report and effects on phenotype. Hum Reprod. 2014;29(12):2680-2686. doi:10.1093/humrep/deu239 Soneji S, Beltrán-Sánchez H. Association of maternal cigarette smoking and smoking cessation with preterm birth. JAMA Netw Open. 2019;2(4):e192514. doi:10.1001/jamanetworkopen.2019.2514 Additional Reading Rojas J, Chávez M, Olivar L, et al. Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth. Int J Reprod Med. 2014;2014:719050. doi:10.1155/2014/719050 By Nicole Galan, RN Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit