If you are struggling with fertility and have been told IVF is your only option, you might be wondering how to get pregnant naturally with PCOS, endometriosis, or other fertility conditions. PCOS is one of the leading causes of an infertility diagnosis, particularly in women over age 35, because it can lead to a reduction in ovulation.

But when it comes to fertility, ovulation is the foundation.

PCOS, or polycystic ovarian syndrome, is a common reason for diagnosed “infertility,” which is rising faster than ever in the US. One of the hallmark signs of PCOS is ovulatory dysfunction, meaning that a woman has irregular periods or anovulatory cycles which are menstrual cycles in which ovulation does not take place. Ovulation is crucial for pregnancy because that is the process that actually releases the egg that will eventually become fertilized. If you’re wondering how to get pregnant naturally with PCOS, the first step is to make sure that you are actually ovulating.

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Why PCOS Causes Infertility

With PCOS, ovulatory dysfunction makes trying to conceive (TTC) difficult because there are fewer eggs released in any given year. Rather than having a monthly period, many women with PCOS have cycles that stretch more than 35 days, sometimes twice that, and some women don’t have periods at all. PCOS can also get in the way of TTC efforts because it’s associated with insulin resistance, inflammation, and hormone imbalances that affect the quality of the uterine lining, damage the fragile embryos in their earliest stages, and increase the risk of miscarriage. These factors combined can add up to the 6 or 12 months of unsuccessful TTC efforts that lead women over, or under, age 35 (respectively) to be diagnosed with infertility and referred for IVF.

Assisted reproductive technology has been a wonderful gift to families who were otherwise unable to conceive without it. But what if there was a way to get pregnant naturally without having to rely on medications, invasive procedures, and tens of thousands of dollars’ worth of medical appointments?

Guess what? There is! Read on to find out.

How to Get Pregnant Naturally with PCOS

Getting pregnant naturally with PCOS means addressing the root cause of fertility problems in PCOS. These main issues include: irregular ovulation, inflammation, and problems with egg quality.

Improving Ovulation in PCOS

The first key step in improving ovulation rates in PCOS is figuring out if and when you are ovulating. You can do this in two ways:

1. Blood Tests: In most ovulatory cycles, progesterone levels are highest on day 21. This is because ovulation usually takes place around 2 weeks before a period starts, and in a “normal” monthly cycle, ovulation would take place somewhere around day 13-16. After ovulation, the ovary starts producing progesterone, but does not do this if it doesn’t release an egg. So, to confirm if a woman is “ovulating on time,” we can run a blood test to measure the progesterone levels in her blood and if they’re in the correct range, we know she ovulated “on time.” If a woman has long but regular cycles, meaning they come after the same number of days, we would run this test one week before her expected period.
2. Tracking BBT: If a woman has irregular cycles, it is difficult to predict when to test “day 21 progesterone” or to complete that progesterone test at the correct time. Plus, the progesterone test doesn’t tell us when she ovulated necessarily, only if she ovulated and when, within a general range, that may have taken place. Instead, a woman can track her period using fluctuations in body temperature that give very specific information about the timing of ovulation. Learn how to do this here: Basal Body Temperature 101

Once you know if and when you’re ovulating, it’s time to take steps to make it more regular! Here are a few key ways to do this:

1. Reduce Stress: Stress is a major driver of adrenal dysfunction, which drives androgen production and worsens the hormone imbalances associated with PCOS. Stress also messes with blood sugar and lowers progesterone levels which can make the uterine environment unfavorable for pregnancy.
2. Consider Androgen Blockers: In the traditional medical model, spironolactone and the birth control pill are prescribed to reduce androgens because these hormones are responsible for many of the problems seen with PCOS. However, spironolactone isn’t safe when TTC, the birth control pill defeats the whole purpose, and neither allows our bodies to naturally get back into balance. Instead, natural herbs like red reishi, Chinese peony, green tea extract and black cohosh reduce androgens and improve ovulation rates. Be careful though; many of these herbs are not safe to take during pregnancy and you can be pregnant for up to a week before a pregnancy test shows positive. I recommend working with a functional medicine doctor if you’re using herbal medicines for this reason.
3. Take Melatonin: Disruptions in the circadian rhythm lead to cortisol and DHEA imbalances, which circle back to point #1 in terms of their hormone-disrupting effect. Short-term melatonin use helps regulate the stress cycle, but has also been shown to improve ovulation rates in PCOS and reduce inflammation.

Reduce Inflammation

Inflammation is caused when the immune system gets triggered by foreign invaders or toxic chemicals. Some of these toxic chemicals come from the body’s own metabolic processes (i.e. “waste products”) but others are caused by lifestyle factors. Here’s how you can lower your own inflammatory load:

1. Take Melatonin: It made it to this list too! Melatonin is just that powerful. If you look back up at point #3 above, you can see that melatonin reduces inflammation in PCOS sufferers in addition to increasing likelihood of ovulation.
2. Eat an Antioxidant-Rich Diet: The more colorful the food, the better! That doesn’t mean that white foods aren’t allowed, it just means that you can amp up your antioxidant load without needing to rely on more supplements. My favorite ways to get antioxidants every day is by eating organic beets, blueberries, arugula and raw walnuts. Better yet, I combine all of these into a salad, topped generously with extra virgin olive oil and balsamic vinegar.
3. Consider Curcumin and Vitex: Similar to melatonin, curcumin and vitex reduce inflammation and improve ovulatory outcomes. I usually have my patients take all three when they are TTC.

Work on Your Egg Quality

From a nutritional perspective, it’s pretty simple: eating eggs improves egg quality! Go figure, right? That’s because eggs are an excellent source of zinc, B vitamins and choline, all of which are essential for egg quality and developing of a growing baby. Here’s an easy, non-supplement way to improve your own egg quality: eat two eggs per day! The additional protein is also valuable for keeping blood sugar balanced and reducing inflammation from insulin.

1. Eat 2 Eggs Per Day: see above for details!
2. Check out my blog post all about Fertility Supplements for Egg Quality

In closing…

If you have been told that IVF is your only option, remember that there may be meaningful steps you can take first to support your body naturally. Learning how to get pregnant naturally with PCOS starts with restoring ovulation, lowering inflammation, and improving egg quality, which are the true foundations of fertility. While assisted reproductive technology has helped countless families, it is not the only path for every woman. By identifying whether you are ovulating, addressing stress and blood sugar balance, reducing inflammation, and nourishing your body with targeted nutrition and supportive therapies, you may be able to create a healthier environment for conception. With the right testing, guidance, and a root-cause approach, many women with PCOS can optimize their fertility and move toward pregnancy with greater confidence and clarity.