Wondering how to get pregnant quickly with PCOS?! You’re in the right place!

Getting pregnant with PCOS can feel like a race against your biological clock! As a registered dietitian specializing in PCOS and fertility, I’ve helped numerous women navigate their journey to pregnancy.

Polycystic Ovary Syndrome (PCOS) affects approximately 6-12% of women of reproductive age, making it one of the most common causes of infertility.

However, with the right approach, many women with PCOS can successfully get pregnant and give birth to a healthy, happy baby!

This comprehensive guide will walk you through evidence-based strategies to help you get pregnant with PCOS quickly!

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Step 1. Identifying Ovulation

Most advice will dive right into recommendations for diet and exercise, BUT first we want to see if you are actually ovulating.

Because if you aren’t, we need to figure out why so we can tailor your plan accordingly.

See, most women with PCOS don’t ovulate regularly (which is why they have irregular or absent periods.)

This anovulation is essentially why it’s so difficult to get pregnant with PCOS. Because in order for that egg to get fertilized, your ovaries need to be releasing an egg in the first place (aka ovulation.)

So, here are some ways to figure out if you are truly ovulating with PCOS.

Note: Your fertility doctor can also do blood tests throughout your cycle to see if you are ovulating. These methods listed below are how you can check at home.

A. Best Ovulation Tests for PCOS

Most fertility doctors at some point will recommend using traditional ovulation predictor kits (OPKs) when you are trying to conceive. These are the tests that measure your LH levels and will give you that smiley face if there is an LH spike (which means ovulation is about to occur.)

But the issue (and what I was never told when TTC with PCOS) is that these OPKs can be unreliable for women with PCOS due to our naturally elevated LH levels! (It even says this right on the box…)

So, that means these traditional OPKs are not the best way to tell if you are actually ovulating if you have PCOS. Here are better methods to track ovulation to help you get pregnant quickly with PCOS:

Basal Body Temperature (BBT) Tracking:

BBT is one of the most reliable, inexpensive, and simplest methods for confirming ovulation, though it requires consistent effort:

How to Track BBT:

• Take your temperature immediately upon waking, before any activity
• Use a BBT thermometer that measures to 1/100th of a degree (So it measures at least 2 decimal places. I love this one!)
• Record at approximately the same time each morning
• Track in a paper chart or fertility app
• Note: BBT is helpful to confirm if you have ovulated, BUT doesn’t help you know if you are about to.

What to Look For:

• Pre-ovulation temperatures typically range from 97.0-97.7°F (36.1-36.5°C)
• A sustained temperature rise of 0.4°F (0.2°C) or more indicates ovulation has occurred
• The temperature rise occurs after ovulation, usually remaining elevated for at least 3 days
• If pregnancy occurs, temperatures stay elevated beyond your usual cycle length

Cervical Mucus Monitoring:

Tracking your cervical mucus can help you know if you are about to ovulate.

Cervical mucus changes can show where you are at in your cycle and when you are most fertile.

Cervical Mucus Throughout Your Cycle:

1. Post-period: Little to no mucus (dry days)
2. Early fertile window: Sticky, tacky mucus
3. More fertile: Creamy, lotion-like mucus
4. Most fertile: Clear, stretchy, raw egg white consistency (this means, it’s go time!)
5. Post-ovulation: Returns to dry or sticky

How to Check:

• Check internally or observe mucus on toilet paper
• Check at approximately the same time daily
• Record consistency, color, and stretchiness
• Note any feelings of wetness or dryness

PCOS-Specific Considerations:

• Some women with PCOS may have patches of fertile-quality mucus throughout their cycle
• Staying well-hydrated can help improve mucus quality
• Some medications (like antihistamines) can affect cervical mucus

Advanced Ovulation Kits:

Modern fertility monitors are probably the best way to track ovulation for women with PCOS (thanks, modern techonology!) However, these are also the most expensive option…

These monitors can give you a more accurate look at all your hormones (not just LH) to pinpoint when you are about to ovulate or if you already did. In other words, these can be your secret weapon to help get pregnant quickly with PCOS!

These advanced fertility monitors can help you track your hormone levels without having to get your blood drawn AND you can do it in the comfort of your own home by just peeing on a stick (something we become pros at, amiright?)

The fertility monitor I recommend the most is the Inito Fertility Monitor because it:

• Measures both estrogen and LH
• Can help identify false LH surges
• Provides quantitative hormone values
• More accurate for women with PCOS than standard OPKs

Other Digital Monitors:

• Mira Fertility Tracker ($$)
• OvuSense ($$$)

REMEMBER! Regular Periods ≠ Ovulation

Just because you have regular periods doesn’t guarantee you are always ovulating!

Research shows that up to 30% of women with regular cycles may experience anovulation (cycles without ovulation).

So, even if you have regular periods, still a good idea to make sure you are ovulating with the methods mentioned above!

Step 2. Pinpoint Why You’re Not Ovulating

Not ovulating is common in women with PCOS, but understanding the specific reasons why can help guide your treatment plan to help you get pregnant quickly with PCOS.

Let’s dive deep into the potential causes and how to identify them. If you are ovulating regularly (as some women with PCOS do), skip along to step 3!

A. Primary Causes of Anovulation in PCOS

1. Elevated Androgens

• Key labs: Total and Free Testosterone, DHEA-S
• How it affects ovulation: Interferes with follicle development and maturation
• Common signs: Excess hair growth, acne, scalp hair loss

2. Insulin Resistance

• Key labs: Fasting insulin, fasting glucose, HbA1C
• Impact: Increases testosterone production and disrupts ovulation
• Common signs: Dark skin patches, stubborn weight gain, intense cravings

3. FSH/LH Imbalance

• Normal ratio is close to 1:1
• PCOS often shows 2:1 or 3:1 (LH:FSH)
• Result: Irregular or absent ovulation

B. Other Important Factors to Check

1. Thyroid Function

• Key labs: TSH, Free T3, Free T4
• Can prevent ovulation if imbalanced
• Often overlooked but easily treatable

2. Vitamin D Status

• Optimal levels: >35 ng/mL for fertility
• Affects hormone balance and egg quality
• Common deficiency in PCOS

C. Essential Lab Work Checklist

As you can see, the best way to pinpoint why you aren’t ovulating is to look at your lab work.

So, here is a full check list of lab work you’ll want to have done (** indicates important labs!)

And here is a free PCOS lab tracker with this list and to help keep all your results in one place.

Basic Hormone Panel:

• FSH**
• LH**
• Estradiol**
• Total and Free Testosterone**
• DHEA-S**
• Androstenedione
• AMH (Anti-Müllerian Hormone)**

Metabolic Health:

• Fasting insulin**
• Fasting glucose
• HbA1C**
• Lipid panel**

Thyroid Function:

• TSH**
• Free T3**
• Free T4**
• TPO antibodies**
• TG antibodies**

Additional Testing:

• Vitamin D**
• Prolactin
• Omega-3 Index
• Iron
• hsCRP

Step 3. Diet and Lifestyle Changes to Boost Your Fertility

Now that we know 1) if you are ovulating and 2) what might be causing you not to be, we can start creating a personalized diet and lifestyle plan to help you quickly boost your fertility, promote ovulation, and promote egg quality.

Here are science-backed ways to boost your fertility and (if needed) restore your ovulation.

A. Increase Your Fruit and Vegetable Intake

Research shows that women who consume more fruits and vegetables have better fertility outcomes.

A study published in Human Reproduction found that women who ate more fruits and vegetables had a significantly higher probability of pregnancy than those who didn’t.

Aim for 4-5 servings of fruits and vegetables daily, focusing on:

• Dark leafy greens (spinach, kale, collards)
• Colorful vegetables (bell peppers, carrots, tomatoes)
• Antioxidant-rich fruits (berries, citrus fruits)
• Cruciferous vegetables (broccoli, cauliflower, asparagus, brussel sprouts)

These foods are rich in antioxidants and anti-inflammatory compounds that can help improve egg quality and reduce inflammation associated with PCOS.

B. Switch to Complex Carbohydrates

That’s right! You do NOT have to cut out carbs completely if you have PCOS!

In fact, multiple studies have demonstrated that women with PCOS who eat complex carbohydrates experience improved ovulation rates.

A landmark study in the American Journal of Clinical Nutrition showed that replacing refined carbohydrates with complex ones can:

• Reduce insulin resistance
• Lower testosterone levels
• Improve menstrual regularity
• Increase ovulation frequency

To start swapping refined carbs for complex carbs, choose:

• Whole grains (quinoa, brown rice, oats)
• Legumes (lentils, beans, chickpeas)
• Sweet potatoes and other starchy vegetables

C. Incorporate Plant-Based Proteins

A study published in the American Journal of Obstetrics and Gynecology found that replacing animal protein with plant protein can improve ovulation. Good sources include:

• Legumes
• Nuts and seeds
• Tempeh and tofu
• Quinoa

D. Include Regular Seafood Consumption

The omega-3 fatty acids in seafood are crucial for fertility. Research published in the Journal of Clinical Endocrinology & Metabolism shows that regular consumption of fatty fish can:

• Improve egg quality
• Reduce inflammation
• Support regular ovulation

Aim for 2-3 servings weekly of:

• Salmon
• Sardines
• Mackerel
• Trout

E. Prioritize Sleep

If you want to get pregnant with quickly with PCOS, sleep is a non-negotiable! This is because sleep disruption can significantly impact fertility.

A study in Reproductive Biology and Endocrinology found that women with irregular sleep patterns had:

• Higher levels of stress hormones
• Disrupted reproductive hormones
• Irregular menstrual cycles

It’s best to aim for 7-9 hours of quality sleep per night.

F. Exercise

Did you know that physical activity improve your fertility and help you get pregnant quickly with PCOS?! (Just another one of its amazing benefits!)

And while exercise is beneficial, the right type and amount are crucial. Research in Human Reproduction shows that moderate exercise can:

• Improve insulin sensitivity
• Reduce inflammation
• Support weight management
• Enhance fertility

Aim for:

• 150 minutes of moderate exercise weekly
• A combination of cardio and strength training
• Avoid over-exercising, which can negatively impact fertility. (Take those rest days!)

G. Manage Stress

Chronic stress can interfere with ovulation and fertility. Studies in the Journal of Human Reproduction have shown that stress reduction techniques can improve pregnancy rates. Consider:

• Meditation
• Yoga
• Deep breathing exercises
• Regular gentle exercise

Step 4. Additional Assistance to Restore Ovulation

Sometimes even when you eat perfectly, exercise properly, and get enough sleep, you still might not ovulate. Please hear me: this is NOT because you aren’t working hard enough!

It can feel so defeating when you are doing everything right but still not ovulating. Honestly, this is just part of living in a fallen, broken world that doesn’t work the way God originally designed.

So, sometimes we just need some outside assistance to restore ovulation with PCOS. Here are some additional treatments that can help.

A. Research-Backed Supplements

1. Inositol

Inositol is one of the most well-researched supplements for PCOS. It usually gets high praise for helping with insulin resistance, but it can also help you get pregnant with PCOS quickly! Here is the research:

• Multiple randomized controlled trials show effectiveness
• Recommended dosage: 40:1 ratio of myo-inositol to D-chiro-inositol
• Typical dose: 2000mg myo and 50mg d-chiro inositol twice daily with meals
• Benefits:
  • Improves insulin sensitivity
  • Restores regular ovulation
  • Reduces androgen levels
  • Enhances egg quality

2. N-Acetyl Cysteine (NAC)

N-Acetyl Cystine (NAC) is a powerful antioxidant that can be very beneficial for PCOS. It is particularly helpful for reducing inflammation and reducing oxidative stress. When it comes to boosting fertility, the research shows:

• Clinical trials demonstrate improved ovulation rates
• Recommended dosage: 500-600mg 1-2 times daily
• Benefits:
  • Reduces insulin resistance
  • Improves ovulation rates
  • May enhance fertility drug effectiveness

3. Vitamin D

Vitamin D is not only important during pregnancy, but also for helping you get pregnant! And studies show most women with PCOS are deficient in Vitamin D, so it can be a great supplement to add to help with ovulation. Here’s what we know:

• Multiple studies show correlation with ovulation
• Recommended level: >30 ng/mL
• Dosage: Individualized based on blood levels
• Benefits:
  • Improves hormone balance
  • Supports regular cycles
  • May improve pregnancy rates

4. Omega-3 Fatty Acids

Omega-3 is also incredibly important when trying to conceive and during pregnancy. When it comes to helping you get pregnant with PCOS quickly, here what you need to know:

• Studies show anti-inflammatory benefits
• Recommended dosage: 1000-2000mg EPA/DHA daily
• Benefits:
  • Reduces inflammation
  • Supports hormone production
  • May improve egg quality

5. Coenzyme Q10 (CoQ10)

Coenzyme C10 is also a powerful antioxidant that primarily affects fertility by improving egg quality. Research indicates:

• Clinical studies show benefits for egg quality
• Recommended dosage: 200-600mg daily Benefits:
• Supports mitochondrial function in eggs
• Improves egg quality
• Acts as an antioxidant
• May enhance ovulation rates

B. Medications with Strong Evidence Base

There is absolutely no shame in utilizing medications for fertility. And honestly, this is one of the best way to get pregnant with PCOS quickly!

And I’m a firm believer that God has allowed medical advancements like these medications to be invented to help take some of the burden off us.

So, here are some medications to talk with your doctor about to help with restoring ovulation and get pregnant fast!

1. Letrozole (Femara)

• First-line treatment for PCOS-related anovulation
• Superior to Clomid for women with PCOS
• Typical protocol: 2.5-7.5mg for 5 days
• Success rates: 60-80% ovulation rate per cycle

2. Metformin

• Well-established for insulin resistance
• Starting dose: 500mg, gradually increased as needed
• Benefits:
  • Improves insulin sensitivity
  • May restore natural ovulation
  • Can enhance effectiveness of other treatments

3. Clomiphene Citrate (Clomid)

• Traditional ovulation induction medication
• Alternative to Letrozole
• Typical protocol: 50-150mg for 5 days
• Note: Studies indicate it is less effective than Letrozole for PCOS

Step 5. Supporting Male Fertility: It Takes Two

It takes two to tango here, my friend. And your husband’s fertility can also make it harder to get pregnant (that’s right, this isn’t just on you!)

Graciously ask your husband if he would be willing to adopt any (or all) of these lifestyle habits to help boost your chances of getting pregnant quickly.

A. Increased Fruit and Vegetable Consumption

His fertility can be greatly improved through diet as well! And research shows that men who consume more fruits and vegetables have:

• Better sperm quality
• Higher sperm count
• Improved sperm motility

Encourage him to also have a goal of consuming 4-5 servings of fruits and veggies daily (you can do this together!)

B. Regular Seafood Consumption

The omega-3 fatty acids in seafood are crucial for sperm health.

Studies show that men who eat fish 2-3 times per week have:

• Higher sperm count
• Better sperm morphology
• Improved fertility outcomes

Just like with the veggies, he can also have a goal to include more salmon, tuna, and mackerel in his diet!

C. Moderate Alcohol Consumption

Alcohol is no one’s friend when it comes to fertility. Research in BMJ Open shows that excessive alcohol consumption can:

• Reduce sperm quality
• Lower testosterone levels
• Impair fertility

Recommend limiting alcohol to no more than 2 drinks per day. Some good zero-proof, alcohol alternatives include kombucha or HOP WATR.

D. Avoid Excessive Heat Exposure

Studies in Human Reproduction have shown that elevated scrotal temperature can impair sperm production. I advise:

• Avoiding hot tubs and saunas
• Wearing loose-fitting underwear
• Limiting laptop use on lap

E. Regular Exercise Without Overtraining

Exercise can also boost his fertility as well! Studies show moderate exercise improves male fertility, but overtraining can have the opposite effect. Research suggests:

• 150 minutes of moderate exercise weekly
• Avoiding excessive cycling or endurance training
• Including both cardio and strength training

F. Smoking Cessation

Smoking will also hinder your efforts. Multiple studies have shown that smoking significantly impacts male fertility by:

• Reducing sperm count
• Decreasing sperm motility
• Increasing DNA damage in sperm

Step 6. Timed Intercourse

Once ovulation is restored, timing is crucial:

• Have intercourse every other day during your fertile window
• Continue tracking your cycle (as discussed above.)
• Stick to lubricants that are fertility-friendly (Pre-Seed and Good Clean Love Biogenesis are good options!)
• Look for continued elevated BBT as a sign of early pregnancy

Conclusion

While PCOS can make conception more challenging, understanding and addressing the underlying factors can significantly improve your chances of pregnancy.

Remember that everyone’s journey is different, and what works for one person may not work for another. Work with your healthcare team to develop a personalized plan that addresses your specific needs and circumstances.

[Note: Always consult with your healthcare provider before starting any new supplements or making significant lifestyle changes, especially when trying to conceive.]

References:

1. Chavarro JE, et al. (2024) “A prospective study of fruit and vegetable consumption and fertility outcomes in women.” Human Reproduction
2. Moran LJ, et al. (2023) “Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines.” Journal of the Academy of Nutrition and Dietetics
3. Gaskins AJ, et al. (2023) “Seafood intake, sexual activity, and time to pregnancy.” The Journal of Clinical Endocrinology and Metabolism
4. Lim, S, et al. (2019). “Lifestyle changes in women with polycystic ovary syndrome”. The Cochrane database of systematic reviews
5. Beroukhim, et al. (2022). “Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review”. Reproductive Biology and Endocrinology
6. Unfer V, et al. (2023) “Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials.” Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
7. Nordio, M., & Proietti, E. (2012). “The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone”. European Review for Medical and Pharmacological Sciences
8. Nordio, M., Basciani, S., & Camajani, E. (2019). “The 40:1 myo-inositol/D-chiro-inositol plasma ratio is able to restore ovulation in PCOS patients: comparison with other ratios”. European Review for Medical and Pharmacological Sciences
9. Fang, Y. Q., et al. (2024). “N-acetylcysteine supplementation improves endocrine-metabolism profiles and ovulation induction efficacy in polycystic ovary syndrome”. Journal of Ovarian Research
10. Fulghesu, A. M., et al. (2002). “N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome”. Fertility and Sterility
11. Yang, M., et al. (2023). “Effects of vitamin D supplementation on ovulation and pregnancy in women with polycystic ovary syndrome: a systematic review and meta-analysis”. Frontiers in Endocrinology
12. Yang, M., et al. (2023). “Effects of vitamin D supplementation on ovulation and pregnancy in women with polycystic ovary syndrome: a systematic review and meta-analysis”. Frontiers in Endocrinology
13. Albardan, L., et al. (2024). “Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome”. Nutrients
14. Nadjarzadeh, A., et al. (2013). “The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial”. Iranian Journal of Reproductive Medicine
15. Zhang, T., et al. (2023). “Efficacy and Safety of Coenzyme Q10 Supplementation in the Treatment of Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis”. Reproductive Sciences