PCOS and Fertility: The Truth I Wish I Knew at 19 (And Why Preconception Care Changes Everything)

Understanding PCOS and Its Impact on Fertility: The Importance of Preconception Care

If you have PCOS and you’re thinking about having a baby one day, there’s a quiet fear that can sit in the background for years.

Even if you’re not trying right now, it can still show up as: “What if I can’t fall pregnant?”“ What if PCOS makes this harder?” “What if my body doesn’t work properly?”

I know that fear intimately, because I lived with it.

When I was 19, I saw an endocrinologist because I was experiencing hormonal symptoms. I wasn’t officially diagnosed with PCOS at the time, but I was given medication that was commonly prescribed for PCOS-related hormonal imbalance.

And I’ll never forget what happened when I asked about fertility.

I said something along the lines of, “Will this affect my ability to have kids one day?”And the response was basically:“Don’t worry, there’s medication for that.”

That sentence stuck with me.

Not because it reassured me… but because it planted the belief that pregnancy would be difficult for me. That my body wouldn’t be able to do it naturally. That fertility would be something I’d have to fight for, or rely on medication to achieve.

And what frustrated me even more is that no one explained ovulation. No one educated me about insulin resistance. No one helped me understand that there are proactive steps women can take to support hormone balance and fertility long before trying for a baby.

Just a diagnosis (or near-diagnosis), a prescription, and a “we’ll deal with it later.”

But fertility doesn’t start when you decide to start trying.

It starts with what’s happening in your body months, even years before conception.

That’s why preconception care matters so much for PCOS.

Pregnant woman holding an ultrasound

How PCOS Impacts Fertility (It’s Not Just About “Cysts”)

PCOS is a hormonal and metabolic condition, and one of the biggest ways it affects fertility is by disrupting ovulation.

For conception to happen naturally, ovulation needs to occur, the release of an egg. But in PCOS, ovulation can be irregular or absent because hormone signals are not functioning in a predictable way.

Common PCOS fertility challenges include:

• irregular or absent ovulation

• hormone imbalances affecting egg development

• insulin resistance disrupting reproductive hormones

• increased inflammation, which can impact implantation

• higher risk of miscarriage and pregnancy complications

PCOS affects far more than the ovaries. It affects blood sugar regulation, inflammation, stress hormones and nutrient status all of which play a role in fertility outcomes.

The Part No One Tells You: PCOS Doesn’t Mean Infertile

This is something I want every woman with PCOS to understand:

PCOS does not automatically mean infertility.

But it does mean your body may need targeted support for ovulation, egg quality, metabolic health, and inflammation before pregnancy becomes easy and sustainable.

Many women are told:

• “Just lose weight.”

• “Just go on the pill.”

• “Come back after 12 months of trying.”

But for women with PCOS, waiting until you’ve already struggled can lead to unnecessary stress, delays and heartbreak.

Preconception care gives you a completely different experience.

It shifts the focus from panic and pressure to preparation and confidence.

Why Preconception Care Matters (Especially With PCOS)

If you have PCOS and you want a baby, now or in the future the goal isn’t to rush in and hope for the best.

The goal is to build a foundation in your body where:

• ovulation is supported

• blood sugar is stable

• inflammation is reduced

• hormones are balanced

• nutrients are adequate

• your nervous system feels safe

Because pregnancy is not just about conception.

It’s about staying pregnant, supporting baby’s development, and reducing risks like:

• miscarriage

• gestational diabetes

• pre-eclampsia

• high blood pressure

• growth restriction

• postpartum depletion

When preconception care is done properly, outcomes improve — and confidence improves too.

My Turning Point: When I Realised PCOS Was Affecting My Whole Body

In 2020, my health hit a point where I couldn’t ignore it anymore.

I was experiencing symptoms that went far beyond the typical “PCOS label”:

• extreme exhaustion

• nutrient deficiencies

• hair loss

• fatty liver disease

• high blood pressure

That’s when I realised PCOS wasn’t just something that affected my cycle.

It was affecting my metabolism, inflammation, liver health and cardiovascular risk.

And it was the wake-up call that made me stop trying to “manage symptoms” and start addressing the drivers underneath.

That’s when everything changed.

The Truth About Fertility With PCOS: Strategy Beats Fear

Over the years, I supported my body through:

• improving insulin sensitivity

• reducing inflammation

• targeted nutrients and testing

• building strength, routine and metabolic resilience

• regulating stress and nervous system load

I even chose to train for a marathon partly because I knew consistency and accountability were essential for my long-term health and future fertility.

And when the time came that I was ready to conceive… it happened naturally, without hiccups.

That experience is a huge reason I do what I do now.

Because so many women with PCOS are walking around carrying fear about fertility, when the truth is, with the right support, their bodies are capable of so much more than they’ve been led to believe.

What PCOS Preconception Care Should Include

Preconception care is not a strict diet or a supplement list.It’s personalised support based on your symptoms, your cycle, your hormones, and your metabolic health.

Here’s what it commonly involves:

1) Targeted Testing

To understand what’s actually driving your symptoms.This may include:

• reproductive hormones

• insulin + glucose markers

• thyroid function (and antibodies if needed)

• nutrient deficiencies (iron, B12, vitamin D, zinc)

• inflammatory markers where appropriate

This is how you stop guessing.

2) Insulin Resistance Support

Because insulin resistance is one of the biggest barriers to consistent ovulation.Support may include:

• blood sugar balancing meals

• protein-first breakfast

• strength training

• supplement support (where needed)

• medication like metformin if appropriate

3) Cycle Tracking + Ovulation Awareness

If you don’t know whether you’re ovulating, it becomes impossible to plan pregnancy.This includes:

• tracking ovulation signs

• understanding fertile windows

• correct progesterone testing timing

• identifying cycle patterns early

4) Inflammation Reduction + Egg Quality Support

Food, gut health, minerals and antioxidants all play a role in fertility.

5) Nervous System and Stress Support

Because fertility is not only hormonal.It’s also about safety, regulation and resilience.

What to Expect When You Prioritise Preconception Care

When PCOS is supported proactively, women often notice:

• more predictable cycles

• improved energy and mood

• fewer cravings and better appetite control

• stronger ovulation patterns

• improved response if fertility treatment is needed

• reduced pregnancy complication risks

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Preconception care doesn’t just improve fertility. It changes the entire experience of trying to conceive.

Final Thoughts

If you have PCOS, it’s completely understandable to feel fear about fertility.

But you deserve to know the truth: PCOS is not the enemy. Your body is not broken. And fertility is not just about medication it’s about preparation.

Preconception care gives you clarity, support and strategy, so you’re not walking into pregnancy with uncertainty and overwhelm.

If you have PCOS and you want to start preparing your body for pregnancy, whether you’re trying now or planning ahead I can help.

Book a FREE Naturopathic PCOS Assessment Call and we’ll map out what’s driving your symptoms, what testing is worth prioritising, and what steps will best support ovulation, hormone balance, and a healthy pregnancy.