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Hi, I’m Alyssa! AKA, The PCOS Nutritionist Alyssa!

I’m a Registered Dietitian dedicated to helping you eliminate your PCOS symptoms with sustainable and realistic nutrition changes.

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Best Age To Get Pregnant With PCOS According To Science

If you have PCOS and have heard fertility may be challenging, you may be wondering what the best age to get pregnant with PCOS is. 

As a registered dietitian who also has PCOS and struggled with infertility, please trust me when I say that I get it. I remember the instant fear of “omg should I have tried to get pregnant earlier?!” 

Let me try to put your mind at ease a bit. This blog post is going to dive into what affects PCOS fertility, how to improve overall health and your fertility chances with PCOS, and the best age to get pregnant with PCOS. 

photo of a pregnant woman holding her pregnant belly while smiling; the text overlay states best age to get pregnant with pcos.

What Impacts PCOS Fertility

Polycystic ovarian syndrome (PCOS) is a common hormonal disorder that affects approximately 6-12% of women of reproductive age in the United States. Some common symptoms of PCOS include irregular periods, weight gain, acne, cravings, hair loss, and hirsutism (aka excess hair growth such as facial and body hair). It’s also a leading cause of infertility worldwide (1). 

When it comes to PCOS, there are some key factors that can impact what the ideal age to consider expanding your family is. Let’s explore each of these a little bit. 


Age is one of the biggest factors of female fertility, whether you have PCOS or not. Females are born with all of the eggs they’ll ever have (wild, right?!). As we age, the amount of eggs we have decreases.

The American College of Obstetricians and Gynecologists (ACOG) have reported that all female fertility gradually declines with age, but there is a significant decrease at age 32, and another significant decrease at age 37 years old (2). 

One study found that women under 35 with PCOS had better pregnancy chances than those over 35 years old (3).

The bottom line is that age is a huge predictor of someone’s ability to get pregnant, whether they have PCOS or not. Based on this info, the best age to get pregnant with PCOS may be somewhere between 18 to 34 years old. 

However, if you’re 35 years or older, please don’t panic thinking that you’ve missed your fertile window. These are generalizations based strictly on age, not taking into account other factors that may improve your fertility beyond this age. If you’re more metabolically healthy at age 38 than you were at age 24, your chances of getting pregnant and having a healthy pregnancy may actually be higher. 

If you are older than 35 years of age and struggling to get pregnant, you may want to seek consultation with a fertility specialist sooner rather than later to discuss your fertility difficulties and options.

infographic on the factors that impact pcos fertility.

Insulin Resistance

Insulin resistance and high blood sugar levels can make pregnancy more difficult. Up to 80% of PCOS patients experience some degree of insulin resistance (4). 

Insulin is a hormone responsible for regulating your blood glucose levels (aka blood sugar levels). High insulin levels can increase testosterone levels and inhibit or delay ovulation. If you’re not ovulating regularly, you have less opportunities to conceive. Some research also suggests that insulin resistance can decrease egg quality, which may make it more difficult to conceive. 

In addition, untreated insulin resistance is also linked to a higher risk of miscarriage, gestational diabetes, and high blood pressure in pregnancy (5). Research has also found that those with PCOS undergoing IVF treatment are at a higher rate of miscarriage, regardless of their weight or body mass index (BMI), which may be due to underlying insulin resistance (6, 7).


Chronic low grade inflammation is another key contributing factor to the development of PCOS. Research has also shown that low grade inflammation can negatively impact fertility by decreasing ovulation rates and egg quality (8). 

Inflammation and insulin resistance are often linked too. Low grade inflammation can increase insulin resistance and vice versa…so it can be a vicious cycle. 

Hormonal Imbalances

Other hormonal imbalances are common and may be contributing to some of your PCOS symptoms and fertility issues. Many women with PCOS have an excessive production of androgens (aka male sex hormones) such as testosterone or DHEA-S, which can contribute to irregular periods.

An underactive thyroid is common in PCOS. Hypothyroidism, particularly Hashitmoto’s thyroiditis (an autoimmune disease that can cause hypothyroidism), is a health problem that occurs at a 3x higher rate in those with PCOS (9). Suboptimal thyroid levels can cause infertility and miscarriage. 

Additionally, vitamin D deficiency can affect fertility and it’s very common in PCOS, occurring in up to 85% of women with PCOS (10). 

These hormone levels can be checked by your healthcare provider with simple blood tests. 

Ok, I know this all seems very doom and gloom, but let’s move onto some factors that you can do to optimize your fertility!

Can You Get Pregnant With PCOS Naturally?

Yes, it’s a common misconception that those with PCOS cannot get pregnant without the help of fertility treatments, such as in vitro fertilization (IVF), intrauterine insemination (IUI), or fertility medications such as clomiphene citrate. Although, side note: there’s no shame in using fertility treatments to achieve your dream of becoming a mom! My first baby was conceived with the help of Clomid and I wouldn’t change a thing!

When you have PCOS and are struggling to get pregnant, it seems like so many things are out of your control. Please know that this is not your fault! While you cannot change your age, the good news is that there are many things you can do to improve your metabolic and reproductive health. This can dramatically increase your chances of getting pregnant naturally. Let’s talk more about what those look like!

How To Improve Your Fertility With PCOS

A balanced diet and healthy lifestyle changes can make a significant impact on your fertility. Since I am a dietitian, the first thing I want to talk about it a healthy PCOS diet!

PCOS Fertility Diet

The foods you eat can really impact your blood sugar levels, inflammation status, and egg quality. Your top goals here are to balance your blood sugar levels and reduce inflammation. You’ll also want to include lots of nutrient dense foods that can improve egg quality and reduce the chance of any pregnancy complications.

This usually means incorporating a variety of fruits, vegetables, whole grains, lean protein sources, and healthy fats like olive oil, avocado, fatty fish, and seeds

Limiting or avoiding alcohol and caffeine may be helpful as well while trying to conceive.

For a realistic approach on what this looks like, check out this post: PCOS Diet Plan To Get Pregnant (Free PDF & Recipes).

Take A Quality Prenatal Supplement

There are several nutrients that your body needs before conception and of course while pregnant to reduce the risk of birth defects and complications. Folic acid, calcium, iron, choline, and omega 3 fatty acids are just a few important nutrients that you’ll need to get from your diet or supplements.

If possible, it’s recommended that you start taking prenatal vitamins at least 3-6 months before conceiving. For more information on the nutrients you need more of and my top brand recommendations for prenatal vitamins, check out this blog post: 5 Best Prenatal Vitamins For PCOS

photo of a woman's pregnant belly along with her holding a glass of water and prenatal vitamins.

Exercise Regularly

Regular physical activity may improve your fertility since it can improve insulin sensitivity, inflammation, and androgen levels. It also may make it easier to maintain a healthy weight, reduce stress, and sleep better. All of these factors may help to promote regular ovulation and improve egg quality, which will increase your chance of pregnancy!

Get Enough Sleep

In our fast paced society, sleep is often put on the back burner. But let me tell you, sleep plays a big role in hormone regulation. When you’re not sleeping well, it can cause unpleasant symptoms such as painful periods or even cause you to experience irregular menstrual cycles (11, 12). 

Try to implement a bedtime routine to improve your sleep hygiene. This may look like a good skincare routine, reading a few chapters in your book, journaling, stretching, or a cup of herbal tea before bedtime.

Reduce Your Stress

Chronic stress is not ideal for your hormones. For starters, stress can increase your stress hormone, cortisol. High cortisol levels can further worsen things by making your body less sensitive to insulin and increasing blood sugar levels. 

You may need to do some deep diving to figure out your personal stressors. Establish a PCOS self-care routine that can help you alleviate stress on a regular basis. This may include practices such as a gratitude journal, relaxing candles, meditation, deep breathing exercises, walking, or yoga. 

The Bottom Line

There are many things that can impact your fertility with PCOS, such as your age, insulin resistance, inflammation, and other hormone imbalances. Age is predictor of fertility outcomes regardless of whether PCOS is present or not. Research indicates that fertility decreases significantly around 32 years of age, and then further decreases significantly at 37 years old. 

Some research indicates that those with PCOS under the age of 35 years have an easier time getting pregnant. This may mean that the best age to get pregnant with PCOS is your late teens to age 34 years old. However, there’s no one-size-fits-all answer on the best time or age that you need to have children by if you have PCOS, it’s all very subjective and individualized. 

A healthy diet and lifestyle modifications can dramatically improve your metabolic and overall health, which may increase your chances of getting pregnant regardless of what your age is. These should not be overlooked.

If you want a done-for-you approach to take the overwhelm out of eating well, grab the PCOS Meal Plan. This 3 week meal plan provides you with 3 meals and 1 snack daily, all necessary recipes, and weekly grocery lists to make shopping a breeze. 

More PCOS Posts You’ll Love:

8 Ovasitol Benefits For PCOS

Best Milk For PCOS: Should You Go Dairy Free?

75 Easy PCOS Recipes

Is A Vegan Diet Good For PCOS?

Disclaimer: this information is for educational purposes only. It is not intended to substitute for or replace professional medical advice for polycystic ovary syndrome (PCOS) or any other health conditions. If you’re experiencing fertility challenges, always consult with your medical provider for individualized guidance and support.

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