Can You Still Get Pregnant With Polycystic Ovary Syndrome (PCOS)?

If you have polycystic ovary syndrome (PCOS), you may have heard that it can make getting pregnant more difficult. While this can be true, having PCOS certainly does not mean that you cannot get pregnant.

PCOS can affect ovulation, which may reduce your chances of conceiving or make it harder to predict when you are most fertile. However, many people with PCOS still ovulate and can become pregnant naturally. Others may need some additional support or fertility treatment to help them conceive.

This is particularly important to remember if you are sexually active but are not currently trying for a baby. Irregular periods or a PCOS diagnosis should never be treated as a form of contraception. Pregnancy can still happen, even if you have very infrequent periods.

So, what exactly does PCOS mean for your chances of getting pregnant, and should you still use condoms if your periods are irregular? Let’s take a closer look.

 

What Is PCOS?

Polycystic ovary syndrome is a common condition that affects how the ovaries work. Despite the name, having PCOS does not necessarily mean that you have cysts on your ovaries.

PCOS is associated with hormonal differences that can affect the menstrual cycle and ovulation. Some people experience very noticeable symptoms, while others may only discover that they have PCOS when investigating irregular periods or difficulties becoming pregnant.

Common signs and symptoms can include irregular periods, infrequent periods or no periods at all, excess facial or body hair, acne, oily skin, thinning hair or difficulty becoming pregnant.

Not everybody with PCOS will experience the same symptoms, and the condition can affect fertility differently from one person to another.

 

Can You Get Pregnant With PCOS?

Yes, you can get pregnant if you have PCOS.

One of the biggest misconceptions surrounding PCOS is that having the condition automatically means that you are infertile. PCOS is associated with fertility problems, but that is not the same thing as being unable to become pregnant.

The main reason PCOS can make conception more difficult is its effect on ovulation.

Ovulation happens when an ovary releases an egg. If sperm fertilises that egg, pregnancy may occur. For people with a relatively predictable menstrual cycle, ovulation tends to happen regularly. With PCOS, ovulation can be less frequent or unpredictable.

This means there may be fewer opportunities for an egg to be fertilised, and it can also make it harder to work out when those opportunities are happening.

Crucially, though, irregular ovulation does not necessarily mean no ovulation.

Some people with PCOS ovulate occasionally rather than every month. If you happen to have unprotected sex around one of those occasions, pregnancy is possible. The Royal College of Obstetricians and Gynaecologists (RCOG) specifically advises that people with PCOS may still become pregnant even if they do not have periods.

 

Can You Get Pregnant With PCOS If You Have Irregular Periods?

Yes. Having irregular periods can make becoming pregnant more difficult, but it does not make pregnancy impossible.

Your menstrual cycle and ovulation are closely connected. With PCOS, hormonal differences can prevent an egg from developing or being released as regularly as expected. You could therefore go for an extended period without ovulating before unexpectedly ovulating again.

That unpredictability is one reason why relying on your periods to judge whether pregnancy is possible can be risky.

For example, someone who has not had a period for several months might assume that they cannot become pregnant. However, ovulation happens before a period. If ovulation unexpectedly resumes and you have sex without contraception at the right time, conception could occur before you have another period.

This is why having irregular or absent periods should not be viewed as protection against pregnancy.

 

Does PCOS Mean You Are Infertile?

No. PCOS and infertility are not interchangeable terms.

PCOS can cause fertility problems because of irregular or absent ovulation, but fertility varies considerably between individuals. Some people with PCOS become pregnant naturally without experiencing significant difficulties, while others may take longer or require treatment.

Other factors can affect fertility too, including age, general health, the frequency of sex and fertility factors affecting either partner.

If you know you have PCOS and are concerned about your fertility, it is worth speaking to your GP rather than assuming you will struggle to conceive.

Current NICE guidance recommends offering a specialist consultation when either partner has a suspected or known clinical cause of fertility problems, rather than necessarily waiting for the usual 12 months of trying to conceive.

 

Can You Get Pregnant Naturally With PCOS?

Many people with PCOS can and do become pregnant naturally.

Your individual chances will depend partly on whether and how frequently you ovulate, as well as the other factors that influence fertility.

For some people, PCOS may mean that becoming pregnant simply takes longer. Others may benefit from medical support designed to encourage ovulation or address other factors affecting fertility.

It is therefore worth avoiding comparisons with somebody else's experience of PCOS. Two people with the same diagnosis can have very different menstrual cycles, symptoms and experiences when trying for a baby.

If you want to become pregnant, speaking to your GP can help you understand your individual circumstances and whether any further investigations or support would be beneficial.

 

Do You Still Need to Use Condoms If You Have PCOS?

If you do not want to become pregnant, yes, you still need to use contraception if you have PCOS.

PCOS itself is not a contraceptive method.

Even if your periods are extremely irregular, you have not had a period for several months or you have previously experienced difficulties conceiving, there is still a possibility that you could ovulate.

NHS patient information on PCOS makes this particularly clear. Although fertility can be reduced, contraception is still required if you want to avoid pregnancy because some people with PCOS continue to ovulate occasionally.

Using condoms correctly every time you have vaginal sex can therefore help prevent an unintended pregnancy.

Condoms have another important benefit too. Unlike hormonal contraceptive methods, condoms can also help protect you and your partner against sexually transmitted infections (STIs), including HIV.

If you are using another contraceptive method to prevent pregnancy, you may therefore still choose to use condoms for STI protection, particularly with new or multiple sexual partners.

 

Can You Track Ovulation If You Have PCOS?

Tracking ovulation can be more complicated when you have PCOS.

Some people use menstrual cycle tracking, changes in vaginal discharge, body temperature or ovulation tests to estimate when they are most fertile. However, irregular menstrual cycles can make fertility awareness methods more difficult to use reliably.

The NHS advises that fertility awareness may not be suitable for people who have irregular periods.

This is particularly important if your aim is to avoid pregnancy.

If you have PCOS, you should not assume that a period tracking app can reliably tell you when you are safe to have sex without contraception. An app can estimate when ovulation might happen based on previous cycles, but PCOS can make those cycles much less predictable.

If avoiding pregnancy is important to you, speak to a GP, pharmacist or sexual health professional about a suitable contraceptive method and continue using condoms as appropriate.

 

What If You Want to Get Pregnant With PCOS?

If you're hoping to start a family, having PCOS does not mean you should automatically expect difficulties.

You can begin by speaking to your GP, particularly if your periods are very irregular or absent. Because PCOS is a known condition that can affect ovulation, your doctor may be able to investigate your fertility or refer you for specialist advice where appropriate.

It is also worth looking at your overall pre-pregnancy health. NHS guidance recommends taking 400 micrograms of folic acid each day before becoming pregnant and continuing until you are 12 weeks pregnant, alongside other steps such as avoiding alcohol and stopping smoking. Your doctor can advise if you require a different dose of folic acid based on your individual circumstances.

If you take medication for PCOS or another condition, speak to your GP before trying for a baby. Do not stop taking prescribed medication without medical advice.

Depending on how PCOS affects your ovulation and fertility, treatment may also be available if you are struggling to conceive.

 

What If You Don't Want to Get Pregnant?

This is where one of the most important messages about PCOS comes in.

Do not assume that PCOS will prevent pregnancy.

If you're having vaginal sex and do not want to become pregnant, you should continue using an appropriate form of contraception.

There are several contraceptive options available, and the right choice will depend on your health, preferences and circumstances. A GP, pharmacist or sexual health clinic can help you explore the available options.

Condoms can be particularly useful because they provide a barrier against pregnancy while also helping reduce the risk of transmitting many STIs.

It can be tempting to think that having very irregular periods means there is little point in using contraception, especially if you've previously been told that PCOS could make conception harder. The problem is that you cannot necessarily predict when your ovaries might release an egg.

It only takes one ovulation at the right time for pregnancy to become possible.

 

When Should You Speak to Your GP About PCOS and Fertility?

If you have PCOS and are considering trying for a baby, there is no harm in discussing your plans with your GP.

This can be particularly useful if you rarely have periods, have no periods at all, take medication or have other health conditions that could affect pregnancy.

You should also seek advice if you've been trying to become pregnant without success. NICE guidance recommends further assessment after one year of regular unprotected vaginal sex for people without a known cause of fertility problems, but an earlier specialist referral can be appropriate when there is already a known or suspected clinical reason that fertility may be affected.

Getting advice does not necessarily mean you will need fertility treatment. It simply allows your individual circumstances to be assessed and gives you a clearer idea of the options available.

 

PCOS Doesn't Mean Pregnancy Is Impossible

Perhaps the most important thing to remember is that PCOS affects fertility differently for everyone.

For some people, it can make becoming pregnant more difficult because ovulation happens less frequently. For others, natural conception may happen without any significant problems.

What PCOS does not provide is reliable protection against pregnancy.

You can still ovulate when you have irregular periods, and you can potentially become pregnant even if you have not had a period for some time. If you're sexually active and don't want to become pregnant, continue using contraception rather than relying on PCOS or irregular periods.

And remember that pregnancy prevention is only part of the picture. Using condoms remains important for protection against STIs, particularly with a new partner or where either partner's STI status is unknown.

Whether you're trying to become pregnant, actively avoiding pregnancy or simply trying to understand what PCOS means for your body, getting personalised advice from your GP or sexual health professional can help you make informed decisions about your fertility and sexual health.