PCOS and Pregnancy Planning: Natural Steps to Support Fertility and Ovulation

Thinking About Pregnancy with PCOS

If you’ve recently come off the pill or are starting to think about trying for a baby, you might be wondering what PCOS means for your fertility. Many women are told to “just lose weight” or “come back when you’re ready to start IVF” but there’s so much more you can do to prepare your body and rebalance hormones first.

This guide is for you if you’re not quite ready for fertility treatment but want to take proactive steps now. Whether your periods are irregular or missing altogether, or you just want to make sure your cycle is in the best possible shape before trying to conceive, this is where nutrition and lifestyle can make a real difference.

Understanding PCOS and Fertility Challenges

PCOS is one of the most common causes of ovulation-related infertility. But not all women with PCOS are infertile, and many go on to have healthy pregnancies with the right support.

The key issue in PCOS is that ovulation doesn’t always happen regularly. Without ovulation, conception can’t happen. But with the right nutrition and hormone support, it’s absolutely possible to restore ovulation over time, even if your cycle is unpredictable right now. Not sure if you are ovulating? Read this post to check for the signs of ovulation.

Signs of Irregular Ovulation with PCOS

Before jumping into action, it helps to understand what’s going on with your cycle. Signs you might not be ovulating regularly include:

• Long cycles (more than 35 days) or missing periods

• Mid-cycle spotting without clear ovulation signs

• No noticeable shift in cervical mucus or basal body temperature

• Very light or very heavy bleeds without a consistent pattern

Tracking your cycle, even if it feels chaotic, gives us clues. I recommend starting with body temperature, and cervical mucus. This is something I support clients with step-by-step after my 12-week PCOS programme. Learn more about The PCOS Hormone Shift Method here.

1. Balance Blood Sugar to Support Ovulation in PCOS

Blood sugar is one of the most overlooked drivers of hormone imbalance in PCOS. Even if you don’t have a formal diagnosis of insulin resistance, unstable blood sugar can disrupt ovulation by pushing up androgens (like testosterone) and disrupting the LH:FSH ratio. This post is full of tips on what to eat to reverse insulin resistance.

Practical tips for blood sugar balance:

• Build your meals around protein, fibre and healthy fats

• Avoid skipping meals or surviving on caffeine and carbs

• Add slow-digesting carbs like oats, quinoa, lentils, or root veg

• Don’t fear carbs, but do pair them wisely

Balancing your plate helps stabilise insulin, which in turn encourages regular ovulation.

2. Key Nutrients for Fertility and Egg Quality in PCOS

Certain nutrients are particularly important for egg quality, hormone production and building a healthy uterine lining.

Top nutrients to focus on:

• Zinc (pumpkin seeds, lentils, seafood)

• Omega-3s (chia seeds, flax, oily fish like salmon or mackerel)

• Vitamin D (check your levels; supplement if low)

• B Vitamins (especially folate, go for methylated folate where possible)

• Magnesium (leafy greens, dark chocolate, almonds)

I often recommend running a nutrient test before pregnancy to spot any gaps early, especially if you’ve been on the pill, which can deplete many of these nutrients.

3. Reduce Inflammation to Improve Hormone Balance

Chronic low-grade inflammation is common in PCOS and can affect ovulation, egg quality, and implantation. Read more about inflammation triggers here.

Simple anti-inflammatory strategies:

• Add colourful anti-inflammatory veg and herbs (like turmeric and ginger)

• Include oily fish 2–3 times per week

• Cut back on ultra-processed foods

• Support gut health (think: fermented foods, fibre, prebiotics)

Some clients benefit from targeted supplements like omega-3, quercetin or NAC, but these should always be personalised.

4. Supporting Your Cycle After Coming Off the Pill

If you’ve recently come off hormonal contraception, your cycle might be slow to return, especially if you had PCOS symptoms beforehand. It’s common to experience a “pill withdrawal” phase where symptoms flare. Patience and consistency are key.

Nutrition can help shorten this delay by encouraging natural hormone production and supporting your pituitary–ovary communication.

In my programme, I guide you through specific steps to support this transition including targeted meal plans and hormone-friendly lifestyle tweaks. Here is a sample meal plan for you to get started right away.

5. Stress and Sleep: Two Missing Pieces of PCOS Fertility

It’s easy to dismiss stress when you’re focused on supplements or food. But high cortisol (your stress hormone) can suppress ovulation just as much as insulin or androgens.

What helps:

• Regular, predictable meals

• Gentle movement like walking, yoga or Pilates

• Prioritising sleep 7–9 hours with good sleep hygiene

• Nervous system support: breathwork, journaling, magnesium glycinate

6. Functional Testing for PCOS Fertility Support

If your periods still haven’t returned after coming off the pill or after several months of nutrition support, it may be worth running a deeper hormone test.

I often use the DUTCH cycle mapping test to identify whether your oestrogen, progesterone, testosterone and cortisol are supporting ovulation, or creating roadblocks.

This isn’t a first step for everyone, but it’s useful if we need to go deeper in step two of my PCOS programme. Learn more about the DUTCH test here.

The Bottom Line: Preparing for Pregnancy with PCOS

Planning for pregnancy with PCOS isn’t about a magic fix. It’s about laying strong foundations, and giving your body the right tools to restore ovulation, rebalance hormones, and prepare for conception.

If you’re not quite ready to try yet, this is the ideal time to get started. The earlier we support your hormones, the smoother the journey tends to be. For NHS advice see this leaflet.

Next Steps for PCOS Pregnancy Planning

If you’re thinking about pregnancy in the next 6–18 months, my PCOS Hormone Shift Method can help. In Step One, we focus on restoring regular ovulation, reducing inflammation, supporting weight and building a healthy hormone foundation. Then, when your cycle is back on track, Step Two can help you prepare your body for conception.

You can also join my membership here or get my free 7-Day PCOS Reset to get started with blood sugar balance and hormone-friendly meals today. Book a free PCOS Strategy call to find out more.

Disclaimer: The information provided is for educational and informational purposes only and should not be considered medical advice. While I provide guidance based on my expertise as a BANT registered nutritionist and health coach, all health-related decisions should be made in consultation with your GP, specialist, or healthcare provider. Any changes to medication, supplements, or treatment plans should only be made under the supervision of a qualified medical professional. The suggestions outlined are intended to support general well-being and do not replace medical treatment or diagnosis. Always consult a healthcare professional before making significant lifestyle or dietary changes.