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Have PCO. Chances of conceiving naturally?

Mar 2013
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Practicing since : 1998
Answered : 5620 Questions
I have pco but not the syndrome and I am 37 years of age do you think I have a chance of conceiving naturally please?

I have uploaded my US scan report
Posted Fri, 27 Sep 2013 in Getting Pregnant
Answered by Dr. Aarti Abraham 6 hours later
Brief Answer:

Detailed Answer:
Thanks for trusting us with your health query.

I am happy to be able to assist you. I have gone through your ultrasound report. PCOS (PolyCystic Ovarian Syndrome) is a syndrome that is defined when 2 of the following 3 features are present in a patient -

1. Ultrasound characteristics of polycystic ovaries ( PCO ) - which as you rightly mentioned, are present in your case.
2. Symptoms of irregular cycles, such as irregular cycles, delayed cycles, scanty bleeding during cycles . Please do let me know if you suffer from any of these conditions.
3. Symptoms of hormonal imbalance - acne, hirsutism, diabetes or pre diabetic state, insulin resistance, black pigmentation on the nape of the neck etc.

Since you state that you have ONLY polycystic ovaries (not the syndrome) - please let me know if you have undergone evaluation for PCOS.

For a patient with PCO on ultrasound, the following investigations are warranted -
1. LH, FSH on day 2 of the menstrual cycle.
2. Androgen hormone levels - DHEA level, Serum free testosterone
3. Thyroid hormone profile - T3, T4, TSH and prolactin measurement
4. Oral glucose tolerance test and Fasting Serum Insulin
These would confirm if you indeed have PCOS. If these are done, please let me know.

Now, regarding your chances of conception. There are 2 factors here - First is your age, second is PCO or PCOS. Women with PCO only are much better off than women with PCOS ( the whole syndrome).

Along with the investigations done so far, I would also like to know how long you have been trying to conceive naturally.
The symptoms of PCOS can be managed with weight loss and lifestyle modification.
Even a 5 % weight loss would help to regulate cycles.
You could also let me know your current weight and BMI.
Metformin and other drugs are often prescribed to correct hormonal imbalance.
Since women with PCOS often have problems with the menstrual cycle, invariably there is difficulty in ovulation and hence conception too.
What is good news is that normally with advancing age, the ovarian reserve ( capacity of ovaries to form mature eggs ) declines.
In women with PCOS, the ovarian reserve is good, as there are multiple follicles inside the ovary.
Hence, they respond well to therapy given for ovulation induction. You could go in for a cycle of follicular monitoring, wherein , if it is observed that you do not ovulate on your own, agents like Clomiphene Citrate are given to induce ovulation.
More than 80 % of women with PCOS respond favourably to clomiphene therapy.
Also, if you have been trying to conceive unsuccessfully for more than a year, then you need to consult an Infertility specialist.
Apart form the workup detailed for PCOS, the following workup needs to be done -
1. Assessment of ovarian reserve - measurement of AMH ( anti Mullerian hormone ) and follicullar count on ultrasound.
2. Your partner / husband 's semen analysis should be done.
3. If ovulation status and semen analysis is normal, then assessment of the patency of the fallopian tubes should be done, this is best done via laparoscopy.
Once these factors are assessed, then an objective opinion can be formed regarding your chances of conception.
As a general statement, if you indeed have been investigated for PCOS, and do NOT have the syndrome ( all investigations are normal, and your periods are fine ), then you have a good chance at spontaneous natural conception.
37 is an age, where you should hasten the process and try actively for conception, because as age advances, the unfavorable factors increase.
Please do write back with further details as I suggested.
I hope this answer helped you.
I would be happy to address any further follow up questions.
All the best, XXXXXXX
Looking forward to hearing from you.
Above answer was peer-reviewed by
Follow-up: Have PCO. Chances of conceiving naturally? 35 minutes later
Hi all my blood work is good so my GP says.

I have regular cycles varying from 28-33 days all I get is a bit extra hair growth on my chin. My GP is confident I will conceive naturally, he says I need to lose weight to help. I am currently 17stone 4 pound and 5 foot 3. So I am obese.

I am trying to lose weight have regular contact with my husband and reavalue the situation in 6 months time.

Do you think this is a good place to start? Husband semen analysis is fine also

A clearblue fertility monitor shows ovulation but actual ovulation strips don't, my GP said rely more on the fertility monitor and forget the ovulation strips
Answered by Dr. Aarti Abraham 34 minutes later
Brief Answer:

Detailed Answer:

I would have liked to review all the printouts of your bloodwork if you have access to them.
In the scenario that you dont have access to it, I can take the word of your GP that you do not have PCOS.
If you do not have PCOS, then the chances for spontaneous conception are quite good.
You have not mentioned since how long you have been trying to conceive.

Right now, the steps to follow briefly would be -
1. You DO need to lose weight. A dedicated fitness regime and diet programme would help.
2. You should try to conceive sincerely for 6 months. This would mean ensuring that you are sexually active atleast around the peri ovulatory period. You could rely on the fertility monitor, and then go for ultrasound monitoring of ovulation after months. A better way is to start being sexually active every alternate day for 2 weeks, 10 days after your period begins. That way you would cover the ovulation period, without stressing out about actual ovulation.

Do not worry, as with or without medication for ovulation, you still have a pretty good chance at conception as long as you manage to curb your weight .
DO not forget to take regular folic acid supplements ( pre natal vitamins ) daily.
All the best.
Above answer was peer-reviewed by
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