If you've just been diagnosed with PCOS, or you've been living with it for years, this question probably feels enormous. The short answer is: yes, pregnancy is possible with PCOS. For many women, it just takes more understanding and, sometimes, some support.

This article walks you through what PCOS actually is, how it affects your fertility, and what your options are if you're trying to conceive.

What is PCOS?

PCOS is a common condition that affects how a woman's ovaries work.² It's thought to affect around 1 in 10 women in the UK, though more than half of those women have no symptoms at all.²

The condition is defined by three main features. You need at least two of the three to be diagnosed:

• Irregular periods — your ovaries aren't releasing eggs regularly

• Excess androgen — higher levels of "male" hormones, which can cause things like excess facial or body hair

• Polycystic ovaries — enlarged ovaries containing many small, underdeveloped follicles

Despite the name, you don't actually have cysts. Those fluid-filled follicles are underdeveloped sacs where eggs form, and in PCOS, they often can't release an egg properly. ²

PCOS has a new name:

You may have recently heard that PCOS now has a new official name. In May 2026, a global team of researchers, clinicians, and patient advocates published a landmark consensus paper in The Lancet renaming the condition from polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS). ¹

What's really happening is a complex hormonal and metabolic disorder, and that is what PMOS better reflects. The name change is expected to roll out gradually, so you'll still see PCOS used widely. Throughout this article, we'll use both.

What causes PCOS?

The exact cause isn't fully known, but it's linked to abnormal hormone levels — particularly high levels of insulin. Many women with PCOS are insulin-resistant, meaning their body produces more insulin to compensate, which then drives up levels of hormones like testosterone. There's also a genetic component — PCOS often runs in families.

Being overweight can worsen insulin resistance, which is why weight can play a role in symptom severity for some women.

Common symptoms

Symptoms often appear in the late teens or early twenties, and they can vary a lot from person to person. Not everyone experiences all of them.

Common ones include:

• Irregular or absent periods

• Difficulty getting pregnant

• Excess hair growth on the face, chest, or back

• Weight gain

• Thinning hair or hair loss from the scalp

• Oily skin or acne

Some women only find out they have PCOS when they start trying for a baby.

Can you have regular periods with PCOS?

Yes, you can. Not every woman with PCOS has irregular periods. Some have relatively normal cycles while still experiencing other features of the condition like excess androgen or the ovarian appearance on an ultrasound.

If you have PCOS but regular periods and you're wondering whether conception is still possible, it very much may be. Talk to your GP or a fertility specialist, who can run ovulation tests and give you a clearer picture of what's happening.

PCOS vs endometriosis 

These are separate conditions, though they can co-exist. Endometriosis involves tissue similar to the womb lining growing outside the uterus, causing pain, heavy periods, and fertility problems. PCOS involves hormonal disruption and ovulation irregularity. Both can affect fertility, and both are worth discussing with your GP if you're concerned.

Does PCOS cause infertility?

PCOS is one of the most common causes of female infertility in the UK. ³ But infertility and difficulty conceiving are not the same thing. Having PCOS makes it harder, not impossible.

The fertility challenge comes down to ovulation. During a normal menstrual cycle, the ovaries release an egg once a month. Women with PCOS either don't ovulate at all, or ovulate infrequently, which makes conceiving more unpredictable.

If you have regular periods, there's a good chance you are ovulating. Some women with PCOS do have regular cycles, especially with milder presentations of the condition. Regular periods don't guarantee ovulation every cycle, but they're generally a positive sign.

Pregnancy risks to be aware of with PCOS

Getting pregnant with PCOS is possible, but it's worth knowing that the condition does carry some additional pregnancy risks. These include a higher chance of high blood pressure, pre-eclampsia, gestational diabetes, and miscarriage.

These risks are higher if you're overweight, which is another reason managing weight before conception can make a real difference. Your midwife and GP will monitor you through pregnancy if you have PCOS.

At what age is it best to try for a baby with PCOS?

There's no single "best age" that applies universally to PCOS. General fertility does decline with age, for women with PCOS as it does for everyone else. However, younger women with PCOS sometimes find their cycles regulate slightly over time. There's no strong reason to delay trying if you're ready.

What matters more than age is understanding where you are with your cycle, whether you're ovulating, and whether any lifestyle or medical support might help. If you've been trying for 12 months without success (or 6 months if you're over 35), speak to your GP who can refer you for further tests and support.

Ways to improve pregnancy chances with PCOS

Lifestyle changes first

If you're overweight, losing even a modest amount of weight — around 5% — can make a meaningful difference to PCOS symptoms. This is because reducing weight can lower insulin levels, which in turn can help restore more regular ovulation.

The NHS recommends a balanced diet with plenty of fruit, vegetables, whole foods, lean protein, and regular exercise. Your GP can refer you to a dietitian if you want tailored support. ⁴

Fertility medicines on the NHS

When lifestyle changes aren't enough, there are medicines available that can help stimulate ovulation. Clomifene is usually the first medicine offered. It encourages the monthly release of an egg from the ovaries. ⁴

If clomifene doesn't work, metformin may be recommended. It's primarily a diabetes medication but can lower insulin and blood sugar levels, stimulate ovulation, and support more regular periods in women with PCOS. It's used "off-label" for PCOS in the UK, but many specialists prescribe it. Letrozole is sometimes used as an alternative to clomifene, also off-label for fertility use.

If none of these medicines work, gonadotrophin injections may be an option — though these carry a higher risk of overstimulation and multiple pregnancies.

Laparoscopic ovarian drilling (LOD)

If medicines haven't been effective, a minor surgical procedure called laparoscopic ovarian drilling may be considered. A surgeon uses heat or a laser to destroy the androgen-producing tissue in the ovaries. This can help restore hormone balance and trigger more normal ovulation.

IVF

If other treatments haven't led to pregnancy, IVF is an option. Eggs are collected from the ovaries, fertilised outside the womb, and then placed back in. Women with PCOS do have a higher risk of ovarian hyperstimulation syndrome during IVF, so careful monitoring is important. ⁴

twoplus Fertility: Supporting couples during their conception journey

For couples trying to conceive with PCOS, timing and sperm delivery can become important factors to think about. Irregular ovulation means predicting fertile windows is harder, and when ovulation does occur, making the most of it matters.

Trying to conceive can quickly start to feel like a chore. Timed sex, misaligned schedules, and even performance pressure often add up. The twoplus Applicator Extra takes that pressure off, so every fertile window becomes an opportunity again, not an obligation.

The twoplus Applicator Extra is a self-assisted artificial insemination kit that can be used from the comfort of your home. In just 3 simple steps, the Applicator Extra helps deposit sperm close to the cervix, giving nature a helping hand.

• No medical help or clinic visit needed

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• Designed for comfort with soft tip made of 100% medical grade silicone 

• Make your fertile window count

• Affordable alternative to try now: 3 steps. 15 minutes

Frequently asked questions

1. Can I get pregnant with PCOS naturally, without treatment?
   Yes, some women with PCOS do conceive naturally. It depends on whether you're ovulating and how frequently. Lifestyle changes like maintaining a healthy weight and eating well can support more regular ovulation. If you've been trying for a year without success, speak to your GP.

2. Does PCOS mean I can't have children?
   No. PCOS can make conception more challenging, but most women with PCOS are able to get pregnant with the right support. There are several effective treatment options available on the NHS.

3. Does PCOS go away after pregnancy?
   PCOS doesn't disappear after pregnancy. It's a lifelong condition, though symptoms can change over time. Some women find their cycles become more regular after pregnancy, but this varies.

4. Will my PCOS affect my baby?
   PCOS increases the risk of certain pregnancy complications, including gestational diabetes and pre-eclampsia, but many women with PCOS have healthy pregnancies. Your care team will monitor you closely throughout.

Sources

1. Teede HJ et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. The Lancet. Published May 12, 2026. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext

2. NHS. Polycystic ovary syndrome (PCOS) — overview. https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/

3. NHS. Polycystic ovary syndrome (PCOS) — symptoms. https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/

4. NHS. Polycystic ovary syndrome (PCOS) — treatment. https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/