Managing PCOS When You’re Trying to Get Pregnant
Polycystic ovary syndrome (PCOS) is one of the most common causes of ovulatory infertility, affecting nearly 1 in 10 women of reproductive age. While PCOS can make it harder to conceive, the right combination of medical treatment and lifestyle strategies can help many people achieve a healthy pregnancy.
At the UCSF Multidisciplinary PCOS Clinic, we take an integrated approach, bringing together specialists in reproductive endocrinology, dermatology, nutrition, psychology, and genetics to address each patient’s unique needs. If you’re trying to get pregnant with PCOS, here’s what you should know about how the condition affects fertility, the treatments available, and practical steps you can take to support hormone balance.
How PCOS Affects Ovulation and Fertility
PCOS is a hormonal condition in which the ovaries sometimes produce higher-than-usual levels of androgens (“male” hormones). Women with PCOS often have irregular menstrual cycles due to irregular ovulation. Without predictable ovulation, it can be more difficult to conceive naturally.
Other PCOS-related symptoms—such as insulin resistance, inflammation, and metabolic changes—can also impact reproductive health. Research from UCSF has shown that insulin resistance in PCOS is linked not only to fertility challenges but also to higher rates of depression and sleep apnea risk, both of which can affect overall well-being during preconception and pregnancy.
Fertility Treatments for PCOS
The good news: most people with PCOS who are struggling to conceive respond well to fertility treatments. Your care team may recommend:
- Ovulation induction medications – First-line options, such as letrozole, can help the ovaries release an egg.
- Injectable gonadotropins – Used if oral medications are unsuccessful or not appropriate.
- In vitro fertilization (IVF) – May be recommended for those who do not respond to other treatments or have additional fertility factors.
- Minimally invasive procedures – UCSF is currently participating in the REBALANCE Study, investigating a transvaginal procedure that may restore ovulation in patients who haven’t responded to first-line medications.
If you’re a UCSF PCOS Clinic patient, you may also be eligible to participate in our PCOS Tissue Bank and Longitudinal Study or the PCOS BRACE Study, which help advance our understanding of the condition and its treatments.
Lifestyle Tips to Support Hormone Health
While medical treatment is often necessary, lifestyle changes can help optimize fertility and improve overall health with PCOS:
- Prioritize balanced nutrition – Focus on whole foods, lean proteins, healthy fats, and fiber-rich carbohydrates to maintain stable blood sugar levels. See PCOS nutrition guidance from registered dietitians.
- Incorporate regular exercise – Even moderate physical activity can improve insulin sensitivity and menstrual regularity. A UCSF study found that consistent movement is particularly important for reducing long-term health risks associated with PCOS.
- Manage stress and mental health – PCOS is linked to higher rates of depression and anxiety. Mindfulness, therapy, and social support can make a difference.
- Aim for healthy sleep habits – Poor sleep can worsen insulin resistance and hormone imbalance. If you suspect you have sleep apnea, ask your healthcare provider about screening.
- Track your cycles – Even with irregular periods, tracking signs of ovulation can help time intercourse or treatment cycles.
UCSF Support for PCOS and Fertility
The UCSF Multidisciplinary PCOS Clinic provides comprehensive evaluation, personalized care plans, and opportunities to join groundbreaking research. Our goal is to help you feel informed, supported, and empowered on your fertility journey.
To learn more or schedule an appointment, visit the UCSF PCOS Clinic.
Phone: (415) 885-3674
Fax: (415) 353-7744
Email: pcos@ucsf.edu
Fill out a contact form
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About Blog
There are many causes of infertility. For a successful pregnancy to occur, a healthy egg needs to meet healthy sperm, fertilize, develop and find a good place to grow (a receptive uterus). Problems at any of these steps can cause difficulties in getting pregnant. A woman’s body might not release an egg each month due to hormone imbalances, or perhaps the man’s body isn’t producing enough motile sperm.