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Ultrasound showed subserosal fibroid. Suspected for PCOS. Any complication in conceiving?

Mar 2013
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Hi I am 26 and recently had a ultrasound they have found that I have- 20mm subserosal fibroid present, the endometrium measures 2mm and is even throughout . The right ovary volume is 11cc and the left ovary volume is 5cc, in both ovaries there are multiple small follicles arranged at the periphery in the appearance suggestive of PCOS- I have no children but do want some! is this very bad? From this can you tell if I will be able?? Anything you could tell me would help thanks XXXXXXX .
Posted Fri, 29 Mar 2013 in Women's Health
Answered by Dr. Aarti Abraham 1 hour later
Thanks for your query.

Firstly the 20 mm subserosal fibroid is nothing to worry about. Subserosal means it is present on the outer surface of the uterus, and hence will not interfere with pregnancy.

Also the endometrial thickness is slightly less, but it depends on when the ultrasound was done. If done during the first or second day of your menstrual cycle, it is acceptable.

The problematic area here is the ovarian appearance suggestive of PCOS - that is polycystic ovarian syndrome.

PCOS is a condition where multiple ovarian follicles are present in the ovary, and they grow every cycle, but none of them succeeds in maturing and presenting as a mature oocyte, hence there is problem in ovulation ( rupture of mature egg ). This generally results in irregular periods/ delayed periods / scanty menstrual bleeding.
Alongwith this, there are abnormalities in reproductive hormones like FSH, LH, androgen hormone levels, deranged blood sugars etc.

As you can understand, problems in ovulation would lead to problems in conception.
Hence you might need to take help of medications to improve PCOS and help in ovulation.

THe mainstay of treatment of PCOS is weight loss. A healthy lifestyle with regular exercise and a sensible nutritious diet would lead to great improvement. ALongside, doctors often prescribe medications like Metformin which correct the associated abnormalities. Clomiphene citrate is required in case the patient does not ovulate spontaneously.

For starters, if your periods are irregular, or if you have acne, hirsutism, darkening of skin in the nape of the neck , groin, armpits etc - then consult a Fertility specialist > Do so even if you have been trying to conceive and not succeeding for a year or more. Get the various tests mentioned above done. ALso check your thyroid hormones and have a cycle of follicular monitoring with ultrasound to check if you need ovulation inducing drugs like Clomiphene.

Meanwhile, maintain a healthy BMI.
PCOS in no way means that you will never have children, it just means you MIGHT need medical aid in conceiving.
Many PCOS patients conceive on their own also without any treatment.
Its just a disease which needs lifestyle alteration and positive thinking, and early investigation, diagnosis and treatment.
ALso, PCOS is not diagnosed merely on ultrasound, if you have none of the other symptoms described.
Take regular folic acid supplements.

Take care, and please feel free to ask any further follow up questions.
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