Ovulatory dysfunction refers to the irregularity, abnormality, or absence of ovulation. 

This usually means you might only have 9 periods per year, instead of monthly. 

Some women don’t have periods at all in the span of a year. 

If you track your period and find that your cycles often last 35 days or more, it could also signal ovulation problems that need to be addressed.

Ovulatory dysfunction, characterized by oligo-ovulation or anovulation, is one of the Rotterdam criteria used to diagnose PCOS. 

Diagnosis is usually done by conducting a series of physical exams, blood tests, and ultrasounds. 

Hormone levels are typically measured through the blood, and the uterus and ovaries are examined via ultrasound.

When you have PCOS, paying attention to your ovulation health is important because regular ovulation increases your chances of conceiving naturally. 

An egg is released from your ovaries every time you ovulate, where it will stay in your uterus for up to 24 hours.

If you have sexual intercourse during this period and a sperm fertilizes the egg, then you have a good chance of conceiving. 

As such, having irregular periods can make it a bit more challenging to conceive because you’re often unsure whether or not ovulation will occur monthly.

Preliminary research has revealed a link between obesity and being overweight and infertility, highlighting how extra weight may play a role in hormonal imbalances like PCOS, thereby affecting fertility.

Among the difficulties associated with being overweight are anovulation, painful cramps, heavy bleeding, and problems with methods of assisted reproduction like IVF. 

However, it’s important to highlight that the link between these is not causative, which means that not everyone with PCOS is overweight, nor are all overweight individuals with PCOS automatically infertile.

Insulin resistance is another key factor in PCOS fertility. 

Insulin, produced by the pancreas to regulate blood sugar, may cause insulin resistance when there is too much sugar in the blood—and encourage the ovaries to create excess androgens.

An average woman’s peak reproductive years occur between her late teenage years and early 20s. 

After that, someone in her early to mid-20s will have a 25% to 30% chance of getting pregnant every month during her cycle. 

The odds become slightly lower by age 30 and as a woman enters her mid-30s to 40s.

However, this isn’t to say that pregnancy is impossible past one’s peak reproductive years, even when you have PCOS.

 In many cases, there have been successful stories of women conceiving even well into their 40s, as it very often boils down to how well you can support your fertility at any age through the right diet, lifestyle, and supplementation.

Period regularity is an important factor when determining the best age to conceive with PCOS. 

As mentioned earlier, supporting your fertility and addressing your PCOS root cause helps encourage more regular periods, and raises your chances of falling pregnant.

Around two-thirds of women with PCOS struggle with irregular periods, and up to 80% deal with fertility issues. 

To improve their chances of falling pregnant, women with PCOS need to strike a balance between timing and improving fertility—and this often begins with hormone regulation to encourage period regularity.

Metabolic health is another critical consideration. 

As mentioned earlier, women with unmanaged PCOS symptoms have higher chances of developing metabolic disorders as they age, so improving one’s cardiovascular and overall health is paramount in raising the chances of a successful and healthy pregnancy.

Research has also shown that being at a healthy weight can improve things like ovulation, egg quality, and embryo implantation. 

And while studies unfortunately show that the risk of miscarrying is higher for women with PCOS, evidence also shows that arriving at a healthy weight and managing one’s PCOS symptoms can significantly reduce this risk.

As mentioned earlier, natural fertility is highest during the late teens to early twenties. 

Biology dictates that ages 21 to 24 are, on average, a woman’s most fertile. 

But for women with PCOS, this also usually coincides with the time their symptoms first appear and a diagnosis of the condition is made.

This is why in most cases, younger women with unmanaged PCOS may find it challenging to fall pregnant. 

The good news is that with a combination of healthier habits and a better grasp of managing PCOS according to your root cause, you can leverage natural fertility and raise your chances of having a healthy pregnancy.

This is actually considered the best age to get pregnant when you have PCOS! 

It is generally when most women with PCOS have already found the lifestyle, supplementation, and treatments that suit them and can thus improve their chances of falling pregnant.

But of course, if you’ve already mastered how to handle your PCOS symptoms at an earlier age—that’s awesome too.

However, this age bracket is just when most women have already settled down and have better access to resources for improving their health and fertility, so it’s also a great time to start conceiving.

The ages 32, 35, and 37 are when one’s fertility naturally decreases, so as a general rule, it’s good to conceive before and between these fertility windows. 

But then again, there are always steps you can take to ensure that you’re in peak health through these ages.

After 35, women with PCOS can still fall pregnant. 

However, the risks of pregnancy complications are also unfortunately higher in this age range, including gestational diabetes, preeclampsia, and miscarriage.

More than half of women aged 40 to 45 trying to get pregnant can still successfully do so. 

With PCOS, there are certain risks, but provided that the person has taken steps to be in their best health, a healthy and successful pregnancy is still possible.

PCOS is technically an endocrine system disorder. 

As such, there are also many different PCOS subtypes that require a more targeted approach. 

These include:

What you eat, as well as how you eat can vastly improve your PCOS symptoms, especially if you know what types of foods can benefit your health. 

Generally, the ideal diet for PCOS includes lots of healthy proteins from lean meats and fish, gentle carbohydrates that don’t spike your insulin, fruits, vegetables, and fiber.

Incorporating “The PCOS Repair Breakfast” as recommended in the PCOS Repair Protocol is also something you can try. 

You’ll want to have at least 30 grams of protein paired with non-starchy vegetables, like kale, spinach, cauliflower, or zucchini, and see how you feel when you consume a protein-rich breakfast that’s low in carbs and sugar.

Additionally, using the PCOS Plate Method is a good way to remember healthy portions so that you’re eating everything that your body needs to keep stress hormones low, support insulin sensitivity, and reduce inflammation.

Here’s a cheat sheet: 

Regular exercise can be helpful in improving fertility and treating PCOS symptoms, as losing even 5% to 10% of body weight can help to lower insulin resistance, improve hormones, and ovulation.

There is no single exercise that’s “best” for PCOS, because it really depends on your root cause as well as your fitness level. 

What you find enjoyable and sustainable is also a huge factor, as working out can also be a way for you to enjoy moving your body and reduce stress.

If you want variety, for example, you may find that a combination of different exercises works better for you than lifting weights five days a week. 

This can look like doing three 20-minute resistance and high intensity interval training (HIIT) weekly, and doing low-intensity movements like pilates or yoga the rest of the week.

Stress can raise inflammation levels, and long-term stress is especially detrimental to hormones and fertility. 

Cortisol, the stress hormone, triggers increases in insulin—and can thus worsen PCOS symptoms. 

Proper stress management through talk therapy, meditation, exercise, and engaging in hobbies is, therefore, helpful in improving health among women with PCOS.

You can also incorporate stress-lowering habits into your routine, like stress-lowering morning rituals where you can just sit and enjoy a cup of tea, or do breathing exercises. 

Here are some ideas:

Women with PCOS may also benefit from natural supplementation to support health and fertility. 

Nourished Natural Health has designed a supplement line for women with PCOS to address each unique root cause.

PCOS patients may also be prescribed medications and procedures like the following to help them get pregnant: