Many of the women I work with are vegan vegetarians. Which means when it comes to increasing omega-3 intake, they tend to want to go heavy on flax, hoping it will make up for not eating fish. It simply doesn't work this way…in ways that are very important to PCOS.
When different groups of rats are given ALA (the primary omega-3 in flax), EPA and DHA (the primary omega-3's in fish oil), EPA and DHA lowered glucose and insulin levels about 35-38% greater than did ALA. Insulin sensitivy improved by 60% in the fish oil groups compared to the ALA groups.
Bottom line, if you really, really want to get better, and you're not currently eating fish, or using a fish or marine algae supplement, you may want to seriously consider adding one of those to what you're doing. It's pretty non-negotiable, we need DHA and EPA to properly function as human beings.
Andersen G, Harnack K, Erbersdobler HF, Somoza V. Dietary eicosapentaenoic acid and docosahexaenoic acid are more effective than alpha-linolenic acid in improving insulin sensitivity in rats. Ann Nutr Metab. 2008;52(3):250-6. Epub 2008 Jun 19.