PCOS can make pregnancy harder to achieve, but not impossible, and this chapter looks at fertility in practical terms. It covers research on the overall chances of becoming pregnant, the role of lifestyle changes such as weight management and nutrition, and ovulation induction treatments for those who need support. Higher risks during pregnancy, including gestational diabetes, pre-eclampsia and miscarriage, are discussed alongside the need for close monitoring. The chapter also explains ways to track ovulation, such as ovulation predictor kits, supplements such as myo-inositol and vitamin D that may help, and when IVF might be considered.