Let’s talk about PCOS and fertility, a topic that doesn’t get enough attention yet affects so many women. If you’re struggling to get pregnant or confused by your irregular cycles, PCOS could be at the root of it. Don’t worry, though—you’re not alone, and understanding what’s going on is the first step toward taking control of your health.

What is PCOS, Really?

Polycystic Ovary Syndrome (PCOS) is a hormonal condition that affects about 1 in 10 women (8–13%) of women of reproductive age worldwide. But here’s the thing: a lot of women don’t even realize they have it, so those numbers could be much higher than we think. PCOS often goes undiagnosed, which is why it’s so sneaky. It’s like that annoying guest who overstays their welcome without you even noticing at first.

Studies have shown that women with PCOS have significantly higher risks of obesity, dyslipidemia, impaired glucose tolerance, and long-term complications such as diabetes, endometrial cancer, and cardiovascular disease.

Basically, PCOS messes with your hormones, especially androgens (those are the “male” hormones women have in small amounts). When there’s too much of them, it can cause all sorts of chaos—think irregular periods, acne, excess hair growth, and weight gain that feels impossible to lose. But more importantly, it can also affect your fertility.

How PCOS Affects Your Fertility

PCOS can mess with ovulation, which is the process of your ovaries releasing an egg each month. If your hormones are out of balance, your ovaries might not release eggs regularly or at all. No ovulation = no pregnancy.

A lot of women with PCOS have higher levels of luteinizing hormone (LH) compared to follicle-stimulating hormone (FSH). This imbalance can cause your follicles (those tiny sacs where your eggs develop) to stall out. It’s like your body’s trying to bake a cake, but the oven won’t heat up. So, those eggs just hang out without fully maturing, which means no egg is ready to meet up with sperm.

PCOS can sometimes increase the risk of miscarriage and pregnancy complications, but here’s what’s really going on:

PCOS may affect the placenta's development and function because of reduced blood flow between the uterus and the placenta.

Insulin resistance and hormonal imbalances, like higher testosterone levels, can weaken blood vessel health, which is essential for a strong, healthy placenta to support your baby.

Some women with PCOS have thinner or inflamed placentas, which might contribute to issues with fetal growth.

The good news? There’s no evidence that PCOS directly causes genetic problems, like chromosomal abnormalities, that lead to miscarriage. The increased risks seem to stem more from the hormone and metabolism challenges that come with PCOS.

Just because PCOS can make things more challenging doesn’t mean it’s game over. Plenty of women with PCOS go on to have healthy pregnancies—it might just take a bit more effort and support.

Signs You Might Have PCOS

Not sure if you’re dealing with PCOS? Here are some common signs:

Irregular Periods: Long cycles, heavy bleeding, or periods that show up whenever they feel like it.

Excess Hair Growth: Facial hair, chest hair, or hair in other places you’d rather not have it.

Persistent Acne: Those stubborn breakouts that don’t respond to anything, and are most common on the jawline area.

Weight Gain: Especially around your belly, and it’s tough to lose.

Thinning Hair on Your Head: Hair where you don’t want it and thinning where you do. Not fair, right?

Dark Skin Patches: Sometimes found in areas like your neck or underarms.

If any of these sound familiar, it might be time to check in with your doctor.

Can You Get Pregnant If You Have PCOS?

Yes, absolutely! But let’s be real—it can take some extra planning and effort. Some women with PCOS conceive naturally, while others might need a bit of help from fertility treatments like medications or even IVF. It all depends on your unique situation.

The good news? There are natural ways to support your fertility, even if you have PCOS. The goals are to balance your hormones, reduce inflammation, optimize blood sugar levels, support ovulation, and create a healthier environment for pregnancy.

Foods That Can Support PCOS and Boost Fertility

Food isn’t just fuel—it’s powerful medicine that can help balance your hormones, support ovulation, and improve your fertility. For women with PCOS, choosing the right foods can stabilize blood sugar levels, reduce inflammation, and even boost your chances of getting pregnant naturally.

Here are some foods that can help balance your hormones, improve your cycle, and support fertility:

Leafy Greens (like spinach, kale, and arugula): These are loaded with folate, magnesium, and antioxidants that help regulate insulin levels and reduce inflammation.

Berries: Packed with antioxidants, these can reduce oxidative stress and inflammation, supporting better hormone balance.

Healthy Fats (avocados, olive oil, nuts, and seeds): Fats are essential for hormone production. Omega-3-rich foods, like walnuts, flaxseeds, and fatty fish, can help reduce inflammation and improve insulin sensitivity.

High-Fiber Foods (quinoa, oats, brown rice, lentils, and chickpeas): Fiber helps regulate blood sugar levels, which is crucial if you’re dealing with insulin resistance. It also helps with hormone detoxification.

Cinnamon: This tasty spice has been shown to improve insulin sensitivity. Add it to your morning oatmeal or smoothies, or even sprinkle it on roasted sweet potatoes.

Cruciferous Vegetables (broccoli, cauliflower, Brussels sprouts): These veggies contain compounds that support the liver in detoxifying excess estrogen, helping balance your hormone levels.

Pumpkin Seeds: These are high in zinc, which can help regulate hormone production, improve egg quality, and reduce excess androgen levels.

Turmeric: Curcumin, the active compound in turmeric, is a powerful anti-inflammatory that can support hormone balance. Use it in curries, soups, or even golden milk lattes.

Dark Chocolate (70% or higher): Yes, you heard right! Dark chocolate is rich in antioxidants and can reduce stress hormones like cortisol. Just keep it in moderation.

Spearmint Tea: Research suggests that spearmint tea can lower testosterone levels and reduce unwanted hair growth in women with PCOS.

Also, consider reducing or eliminating the following:

Processed Foods and Advanced Glycosylated End Products (AGEs): These are found in crackers, vegetable oil, potato chips, store-bought cookies, and other packaged foods, which increase inflammation and insulin resistance. Stick to whole, minimally processed foods instead.

Sodium: Studies show women with PCOS consume double the recommended amount of sodium, which can exacerbate inflammation.

Dairy: Dairy products can increase testosterone production, potentially worsening acne and hair growth.

Lifestyle Tips to Support Fertility with PCOS

While food is a game-changer, it’s not the only tool in your toolkit. Here are a few other strategies to consider:

Move Your Body: Gentle exercises like walking, yoga, or strength training can improve insulin resistance and reduce stress. Aim for at least 30 minutes most days.

Prioritize Sleep: Poor sleep can mess with your hormones big time. Try to get 7-8 hours of quality rest each night.

Reduce Stress: Stress releases cortisol, which can further imbalance your hormones. Meditation, deep breathing, or simply taking a moment to unwind can make a big difference.

Supplement Wisely: Consider supplements like Myo-Inositol and N-acetyl Cysteine (aka NAC) to improve insulin sensitivity, Omega-3 fish oil for inflammation and mood support, and vitamin D to achieve adequate levels in the blood. But, always check with a healthcare provider before starting something new.

When to Seek Medical Help

If you’ve been trying to get pregnant for more than a year (or six months if you’re over 35), it’s time to chat with a fertility specialist. Sometimes, lifestyle changes aren’t enough on their own, and that’s okay! There are options that can help.

And if you’re feeling lost, I’m here to help. As a naturopathic doctor, I’m all about empowering women with natural, holistic strategies to support their fertility journey. You don’t have to go through this alone.

Take Back Control of Your Fertility

Want more tips on managing PCOS and fertility? Visit my website to learn how we can work together to increase your chances of conception. You deserve to feel empowered, healthy, and confident on your fertility journey.

The information provided in this article is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare provider with any questions you may have regarding your health or a medical condition.

References:

World Health Organization (WHO). (2023). Polycystic Ovary Syndrome: Fact Sheet. Retrieved from https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

Spritzer, P. M., & Giongo, F. (2020). Dietary Interventions in the Management of PCOS: A Review of Clinical Evidence. BMC Public Health, 20(10028). Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-10028-5

Moran, L. J., & Teede, H. J. (2021). Lifestyle Modifications in the Treatment of Polycystic Ovary Syndrome. Springer Handbook of Nutritional Science, 925-941. Retrieved from https://link.springer.com/chapter/10.1007/978-3-030-92589-5_14