Searching “PCOS and pregnancy” online brings up millions of results—many of them confusing, conflicting, or downright overwhelming. If you’ve ever gone down a Google rabbit hole, you’re not alone!
But here’s the truth: While PCOS (Polycystic Ovary Syndrome) can impact fertility, it’s also one of the most treatable causes of infertility. With the right approach, many women with PCOS go on to conceive and have healthy, thriving pregnancies. Let’s break down what you need to know to support your body and fertility every step of the way.
Please note this blog post is not a substitute for official medical advice and is for informational purposes only. If you are concerned about your PCOS symptoms, suspect you have fertility problems, or wish to start a new diet/lifestyle/supplement plan, please consult your doctor or a fertility specialist first. Neither the author(s) nor the publishers of this content take responsibility for any potential health consequences experienced by any person reading this educational content.
First up…how does PCOS affect getting pregnant?
Polycystic ovary syndrome (PCOS) is a common endocrine condition that affects women of reproductive age. These women with PCOS have hormonal imbalances that interfere with the growth and release of eggs from the ovaries (ovulation). In a normal menstrual cycle with ovulation, a number of eggs mature in follicles in the ovaries. The ripest egg is released into one of the fallopian tubes, where it meets the sperm if there is any.
Many of us Cysters have irregular periods, or no periods at all because the ovaries aren’t getting the right hormonal signals from the pituitary gland. Abnormal levels of androgens (often referred to as “male” hormones) disrupt the monthly cycle of ovulation and menstruation. If a healthy egg isn’t released, it can’t be fertilized by sperm, meaning you can’t get pregnant.
Can PCOS cause pregnancy complications?
Women with PCOS may have a higher risk of certain pregnancy complications, especially if symptoms like insulin resistance or inflammation haven’t been addressed before conception. Some of the most commonly reported complications include gestational diabetes, high blood pressure during pregnancy, preterm delivery, miscarriage, and preeclampsia.
But take a deep breath, Cyster…this doesn’t mean these outcomes are guaranteed.
With the right combination of lifestyle shifts, early screenings, and regular check-ups, many of these risks can be managed or even prevented. In fact, most complications tend to be tied to common PCOS co-factors like insulin resistance, weight gain, or inflammation, not the diagnosis itself. That means there’s so much you can do to support a healthy pregnancy before it even begins.
For example, research shows that women with insulin resistance or a higher BMI may face a slightly elevated risk of early pregnancy complications, but when those root issues are addressed ahead of time, their chances of a healthy pregnancy increase significantly.
And yes! Plenty of Cysters go on to have smooth pregnancies and healthy babies.
According to international, evidence-based guidelines for PCOS, lifestyle factors like blood sugar balance, anti-inflammatory nutrition, sleep, movement, and cutting out smoking or alcohol are some of the most effective ways to boost fertility and support your body through each trimester.
At the end of the day, a healthy pregnancy with PCOS is 100% possible—and you deserve a care plan that honors your unique body and journey.
How to have a healthy pregnancy with PCOS
Managing Weight with PCOS (Especially Before Pregnancy)
Weight gain is a common struggle for many women with PCOS, and it’s not just about diet or exercise—it’s about what’s happening hormonally. PCOS can cause insulin resistance, which means your body isn’t using insulin efficiently. In response, your pancreas produces more insulin, which can trigger hunger, increase fat storage (especially around the belly), and make weight loss feel frustratingly difficult.
If you’re trying to conceive, even a small amount of weight loss—just 5–10% of your current body weight—can help improve insulin sensitivity and reduce the risk of complications like gestational diabetes. And while there’s no one-size-fits-all approach to PCOS weight loss, many Cysters find that reducing gluten and dairy can ease inflammation, stabilize blood sugar, and help manage cravings.
That’s why we often recommend trying a gluten- and dairy-free anti-inflammatory approach for at least 30 days to see how your body responds. It’s not about restriction—it’s about figuring out what fuels your body best so you can feel better, have more energy, and support your fertility. But what is most important is that you and your doctor are on the same page for what is the ideal diet for you and your baby. Be sure to check-in with your doctor and dietitian before taking the next steps.
A helpful tip? Build your meals around foods that keep your blood sugar stable—like fiber-rich veggies, lean proteins, healthy fats, and slow-digesting carbs.
If you’re looking for support, check out The Cysterhood App! You’ll find PCOS-friendly recipes, meal plans, and guidance for four different carb ranges—so you can discover what works best for your unique body.
Eat regularly
What you eat now will help your baby grow and develop healthily, giving them the best possible start in life. Make sure you eat regularly – 3 meals a day and a couple of snacks in between if necessary. Eating foods that are rich in fiber, protein, iron, calcium, and healthy fats will keep you and your baby as strong and healthy as possible. Needless to say, smoking and drinking alcohol should be cut out altogether!
Protein-rich foods include:
- Beans
- Legumes
- Fish (but watch out for mercury levels)
- Eggs
- Meat (but avoid liver)
- Poultry
- Nuts
When preparing meat during pregnancy, always make sure it’s cooked all the way through—no pink centers or runny juices. Cook until it’s steaming hot to reduce the risk of harmful bacteria.
It’s great to include a variety of protein sources like poultry, beef, and fish, but stick to two portions or less of oily fish per week (like salmon, mackerel, or trout). These types of fish are rich in omega-3s, which are amazing for your baby’s brain development, but too much may expose you to environmental toxins, so moderation is key. And don’t shy away from healthy fats while cooking—your body needs them now more than ever! Use options like olive oil or avocado oil to support hormone production and nutrient absorption while keeping your meals nourishing and satisfying.
Fiber-rich foods include:
- Whole grains
- Avocados
- Beans
- Broccoli
- Berries
- Dried fruits
- Apples
When you reach for the snacks, opt for nutritious options such as:
- Salad vegetables, such as celery, cucumber, or carrot
- Hummus with vegetable sticks
- Fruit
- Ready-to-eat apricots, figs or prunes
For a more exhaustive list of PCOS-friendly snacks, check out our blog post on PCOS snack ideas.
Limit caffeine
It’s a good idea to limit your caffeine intake while pregnant, as high levels have been linked to pregnancy complications. If you’re drinking coffee and caffeinated beverages because you’re tired, try boosting your energy levels by taking walks outside to get vitamin D (something us Cysters are usually deficient in) and eating a balanced, PCOS-friendly diet where you pair your carbs with protein and/or a fat.
Gentle exercise
Regular, pregnancy-safe exercise can have a hugely positive effect on your blood glucose levels and lower the risk of gestational diabetes. Try to aim for around 150 minutes of moderate-intensity exercise a week. This should raise your heart rate, make you breathe a little faster, and make you feel warmer. Try to practice something you enjoy, be it yoga, pilates, walking after meals or slow, weighted workouts.
Take the right supplements.
Nutrient deficiencies are pretty common for any person, but especially a woman with PCOS. The root issues of this condition can impact your body’s absorption of important vitamins and minerals, so it’s SO important you get the right supplements to support your body and keep it working at its best. Here are my favorite supplements for fertility, which you can get at Ovafit! Be sure to talk to your doctor about adding these to your routine.
Speak to your healthcare provider
If you have PCOS and get pregnant, work with your health care provider to promote a healthy pregnancy and delivery. If you are concerned about your symptoms or worried about complications, always speak to your doctor. The risk of these complications can be reduced by monitoring PCOS symptoms, making healthy lifestyle changes, and taking extra care during your pregnancy. You can also discuss fertility treatments for women with PCOS, including, intrauterine insemination (IUI), in vitro fertilization (IVF), or an ovarian surgery called laparoscopic ovarian drilling (LOD.)
With or without PCOS, it’s sadly not always clear why pregnancy complications arise. Despite this, avoiding alcohol, giving up smoking, staying physically active, and managing your weight are key factors in contributing to healthy pregnancy in women with PCOS.
For more tips on PCOS diet dos and don’ts, check out our podcast, A Cyster and Mister, and our handy blog posts on PCOS Weight Loss.
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