Hello,
Thanks for your query at DoctorSpring.com
Can you please upload the images ( pictures ) so that I can go through them.
And a few more details please.
Since how long have you been trying to conceive ?
Do you have regular cycles ?
Have you been pregnant earlier ?
Looking forward to hearing from you.
Take care.
Patient replied :
Hi,
Thanks for getting back to me.
I have not been pregnant before and I have been trying to conceive for over a year. My cycles are pretty regular and are normally 28-29 days. I have attached the scan images for your review.
Many thanks. Kerry.
Hello
Thank you for the update.
I have gone through the images.
The cysts could be haemorrhagic or simple follicular cysts.
If you are having regular cycles, generally they are not a deterrent for fertility.
However, after one year, more intensive workup is needed.
Let me outline a plan for you.
First take birth control pills for 2 months, they would generally cause the cysts to regress.
If this does not work, and the cysts persist / increase in size, you would need a laparoscopy to deal with them surgically.
Next get the following workup done -
Semen analysis of your partner / husband.
FSH, LH, TSH, OGTT, Prolactin , AMH - for yourself.
3 cycles of follicular monitoring ( tracking growth of the egg follicle via serial ultrasound scanning ) to check if you are ovulating ( obviously this comes after the cysts have been dealt with ).
Then please revert to me, if follicular monitoring shows no ovulation, or the laparoscopy shows blocked tubes, you might need to consider assisted reproduction.
Take daily folic acid supplements, and maintain a healthy body weight.
All the best
Please feel free to discuss further.
Patient replied :
Hi,
Thank you for your advice,
I will speak with my GP and request some more of the pill.
I had already had my husbands sperm tested and the results were normal. I also had my AMH checked and it was 33.51 which I understood to be satisfactory?
I visited my GP a couple of months ago and blood was taken to test the following- Oestradiol (E2), FSH (F), FSH/LH, and Testosterone. I will told that all my bloods were normal.
So do I just need tests for TSH, OGTT and Prolactin?
Many thanks.
Kerry.
HI Kerry
33.5 is too high.
It supports a diagnosis of PCOD - polycystic ovarian disease.
IT is consistent with the cysts seen on the ovaries too.
Yes, please get those tests done.
What is your height and weigh t?
Patient replied :
Hi,
If I do have PCOD, is it still worth going back on the pill to try and reduce the cysts or will I need other treatment?
I will make an appointment with my GP to get the other tests done as soon as possible.
I am just over 5 foot 9 inches tall and weigh 11 stone 7 pounds. I am currently trying to lose a stone in weight.
Many thanks.
Kerry.
Yes you need to work on the weight loss.
It is worthwhile to get on the pill to reduce the cysts, because you will not ovulate as long as these cysts are present.
Take care.