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Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS?

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I had a pelvic ultrasound done today and i noticed that on the screen there were all these black dots on my ovaries. I will attach a picture. I was wondering if this means i have pcos or if these could just be healthy follicles. I dont get to see my dr until friday and its causing me to have anxiety. Also what is the difference between cysts, follicles and eggs. And whats normal and what isnt? I know these pictures arent clear but i would appreciate any kind of input you could possibly give me please.
Posted Mon, 23 Sep 2013 in Women's Health
 
 
Answered by Dr. Kulsoom Qureshi 2 hours later
Brief Answer:
Most pictures are normal wait for final report

Detailed Answer:
Hi,
Thanks for sharing your concerns with us.
Normal ultrasound picture of ovaries contain white areas which represent ovarian stroma & black areas which are follicles.
If black areas are very large then we call them cysts. These are abnormal.
Strictly speaking, egg is the end product, when an ovum & a sperm get fertilized. You can't see an egg on ultrasound. But, sometimes, just to make it simple for the patients to understand, doctors use the term eggs for follicles.
At the beginning of a woman's cycles many follicles begin to appear on the ovaries. Usually, at mid-cycle one or two of them grow to become mature. This disappear after ovulation.
So, to interpret the ultrasound pictures of ovaries it is important to know the timing of ultrasound with regard to a woman's cycle & also these pictures need to have some labeling of side & size etc.
Polycystic appearance of ovaries is quite common in women of reproductive age. This appearance alone is not sufficient to label a woman to be suffering from PCOS, which is a clinical diagnosis made after considering clinical history, lab tests & ultrasound pictures into one diagnosis.
I have seen your ultrasound pictures. Some are not very clear & others are without any labeling of size & side. So, It is quite difficult for me to make any impression.
Most pictures seem to be normal, but, I can see few pictures which resemble polycystic ovaries. I will stress again that please don't take it as final as there is no labeling of size or volume of ovaries & follicles.
So, my final advise is to be patient & wait for the final report of ultrasound in which the doctor must have made comment on the size of follicles & ovaries.
Till then hope for the best.
please write back if you have any question. I will be glad to respond.
Best wishes.

Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 4 minutes later
I will have the reasults on friday. I was just wondering if its normal to have all those black dots on my ovaries. I will also have my lab results on friday as well. I was just hoping to get some insight. How many follicles are considered normal?
 
 
Answered by Dr. Kulsoom Qureshi 7 minutes later
Brief Answer:
Usually follicles are less than ten

Detailed Answer:
Welcome back & thanks for your response.
Yes, having follicles or black spots is perfectly normal.
Usually these follicles are less than ten.
If there are many small follicle arranged around the periphery of the ovary, which is enlarged & unusually white then this is called polycystic ovary in ultrasound appearance.
However, diagnosis is never complete without a supportive clinical history & lab results.
You may write back once your full reports are ready.
Take care.
Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 2 minutes later
Thank you for your help
 
 
Answered by Dr. Kulsoom Qureshi 7 minutes later
Brief Answer:
We are here to help you, whenever you need.

Detailed Answer:
You are welcome here with all your questions & concerns.
Best regards.
Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 22 minutes later
I have one more question. My doctor said if i had pcos he would put me on metformin 500mg three times a day to restore my menstrual cycles and restore ovulation. Is this a common treatment?
 
 
Answered by Dr. Kulsoom Qureshi 19 minutes later
Brief Answer:
Yes, this is a very common treatment

Detailed Answer:
Welcome back.
PCOS patients who are overweight, often get this treatment. This medicine helps them loose weight, restore menstrual regularity & fertility.
One should also undertake other measures to loose weight like dietary & lifestyle modification coupled with regular exercise. These measures alone may have effects similar to metformin if undertaken in an efficient way.
Best wishes.
Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 3 minutes later
My doctor suggested this although i am not overweight. My weight is normal and doesnt fluctuate. Would this medication still help?
 
 
Answered by Dr. Kulsoom Qureshi 11 minutes later
Brief Answer:
Weight reduction will help if your BMI is high

Detailed Answer:
Hi,
Welcome back.
Actually, we doctors classify obesity on the basis of BMI ( Body mass index) & not the weight alone. It is actually a relation of our height & weight.
Some people are of normal weight but come under overweight category if we calculate their BMI. So, This may the reason of your doctors advise.
You can write back with your current height & weight & I can calculate it for you.
Metformin may still be helpful even if you are of normal weight.
Warm regards.
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Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 2 minutes later
My height is 5 feet tall and i weigh 128 pounds
 
 
Answered by Dr. Kulsoom Qureshi 11 hours later
Brief Answer:
You are overweight!

Detailed Answer:
Hi,
Thanks for your response & sorry for a late reply.
I have calculated your BMI, it is 25.85. This is borderline high & comes in overweight category. Therefore, weight reduction is recommended & likely to be helpful in your case.
Best wishes.
Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 17 minutes later
Thank you for all of your helo. You have really eased my mind. I will begin to lose weight to see if that would help me. Again i want to thank you for being so responsive and helping me through this
 
 
Answered by Dr. Kulsoom Qureshi 13 hours later
Brief Answer:
You are always welcome.

Detailed Answer:
Thanks for your appreciation & feedback.
You may contact back with your final reports.
Wish you best of luck.
Take care.
Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 38 hours later
Hello. I got my bloodwork results back and my doctor said that all of my hormones were PERFECT! That i had absolutely nothing wrong with any of my hormones. He tested TSH, FSH, Progesterone, estradiol, LH, insulin, blood sugar, lipids, teiglycerides and basically a CBC. All was normal. My ovaries are polycystic but my ovaries are not enlarged. He said there were more than normal amounts of cysts on both ovaries. The left ovary had 14 cysts and the right obary had about 10-12. His advice to me was to take clomid because he said he doesnt know whats causing the cysts since there arent any hormonal imbalances and therefore he cant tell why my periods are irregular and why i am not ovulating. What is your take on this?
 
 
Answered by Dr. Kulsoom Qureshi 9 hours later
Brief Answer:
Please send me actual reports.

Detailed Answer:
Hi,
Good to have you back.
I am glad to know your hormonal work up is normal but I want to see actual reports & want to know actual levels before giving my opinion.
Also please also mention on which day of the cycle your hormone test was done?
Please also write back, have your doctor tested your tubal patency & your partner's semen analysis. What are the reports?
What is your current frequency of intercourse? do you experience any sexual problem?
I cannot make any comment about your doctors advise for Clomid, as I am (at present) not aware of many significant details of your history.
I will be waiting for your reply to guide you further.
Wish you best of luck.
Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 4 hours later
The tests were done mid cycle and i will have to get a copy of the reports and get back with you. I do not experience any sexual problems. My husbands semen analysis was normal. My fertility doctor said my hormone levels were normal for mid cycle. Current frequency of intercourse is every other day and sometimes every day but most of the time its every other dat .
 
 
Answered by Dr. Kulsoom Qureshi 15 hours later
Brief Answer:
Get your serum prolactin checked

Detailed Answer:
Hi,
Thanks for your response.
I will be eagerly waiting for your reports.
Best time to have hormonal profile is day 2-3 of cycle ( specially FSH, LH, & estradiol). Best time to check serum progesterone is day 21 of cycle. Otherwise, information could be misleading.
One very important test which is lacking among hormones is serum prolactin. High levels of this is an important cause of an-ovulation. Get it checked.
I think male factor & sexual problems can be ruled out in your case, but, tubal patency should have been checked, before starting any fertility treatment.
Wish you all the best.
Take care.
Above answer was peer-reviewed by
 
Follow-up: Noticed small dots on ovaries during ultrasound. Could this be healthy follicles or do I have PCOS? 2 minutes later
I did get my prolactin checked and it was normal as well
 
 
Answered by Dr. Kulsoom Qureshi 4 minutes later
Brief Answer:
That's great

Detailed Answer:
That's great. Now please send me the actual reports & have your tubal patency test done, to complete fertility work up.
Have a nice day.
Above answer was peer-reviewed by
 
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