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Why do I have long irregular cycles? Ultrasound showed ovarian cysts. Pregnancy not likely?

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My partner and I have been ttc for six months. I'm 29, healthy weight, day 3 bloods all came back normal... but I have long, irregular cycles (35 to 49 days) and an ultrasound showed ovarian cysts. My doc says there's nothing she can do until we've been trying unsuccessfully for a year - is this true? Or might I be a contender for Clomid? Thanks.
Posted Thu, 19 Apr 2012 in Getting Pregnant
 
 
Answered by Dr. Chakravarthy Mazumdar 8 hours later
Hello TK,

It seems from your history that you have been detected with multiple cysts by your doctor. This is a common condition where there are multiple peripheral cysts on the ovaries and most times they are functional cysts (yet to mature and release eggs).

There is another condition called PCOS (Poly cystic Ovarian Syndrome), which has potential cause for infertility. Due to these cysts, the ovary functions abnormally and there is no ovulation. By that I mean, that no eggs are released for fertilization to occur. Right now your doctor is not thinking about this.

I believe your doctor is doing the right thing by asking you couple to wait for 6 more months. According to the current guidelines, a couple would be investigated and treated for infertility only after one year of regular and unprotected intercourse.


Hope I answered your query. I will be available to reply if you have follow up queries.




Disclaimer: The Expert’s advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
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Follow-up: Why do I have long irregular cycles? Ultrasound showed ovarian cysts. Pregnancy not likely? 12 hours later
Thanks for your response. Is it not true that very long cycles (ie., such as the 42-day ones that I have) are usually annovulatory, though? I've also suffered serious acne breakouts around my neck and jawline since coming off the pill, which suggests to me that there may be a hormonal imbalance later in my cycle.

I suppose I suspect PCOS, even though my day 3 bloods showed normal. Is this possible?
 
 
Answered by Dr. Chakravarthy Mazumdar 1 hour later
Hi,

Thank you for the reply.

I guess Day 3 blood tests are Serum LH and FSH levels, Is it? If they are normal I do not jump into the conclusion of PCOD. Perhaps the best investigation of choice for PCOD is reversal of LH/FSH ratio. It is good to know what are the tests and their results.

I am wondering about the symptoms of irregular periods and prolonged cycles, acne break outs. You have to repeat this tests once again next cycle. Were your periods regular during contraceptive pill use?

Prolonged periods necessarily do not mean anovulation. You need a serial ultrasounds to check for the growth of follicles and egg release.

Interestingly the treatment is started only after six months and goes with Metformin, Clomid ( if you are not ovulating) etc. So you should not stress out with the thoughts and increase the reasons for prolonged periods and non ovulation.

Stay calm, increase the frequency of intercourse, regular exercise, adopt relaxation techniques, build relationship with your partner till then.

Wish you Good Health.



Disclaimer: The Expert’s advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.

Above answer was peer-reviewed by
 
Follow-up: Why do I have long irregular cycles? Ultrasound showed ovarian cysts. Pregnancy not likely? 18 minutes later
Thanks for that.

Yes, the blood levels were 5.1 (FSH), 6.1 (LH) and 1.1 (testosterone).

My periods were normal while I was on the pill.

The ultrasound report reads: "Appearances are consistent with PCOS. The uterus is anteverted and normal in size, shape and echopattern measuring AP dia 33mm uterine length 77 mm. The endometrium appears smooth and regular. The right ovary measures enlarged 55mm x 17mm x 29 mm. The left ovary measures enlarged 44m, 16mm, 28 mm. Bilateral multiple cystic lesions 2-3mm diffused throughout ovarian tissue. However NB larger 8.4mm follicle noticed in LT ovary ?developing follicle."

This test was done halfway through my cycle; the sonographer said that she would would have expected the follicle to be more developed by then. Should I be worried about the fact that it wasn't? Or is that normal if I had a long cycle?














 
 
Answered by Dr. Chakravarthy Mazumdar 23 hours later
Hi
Thanks for your reports.

On reading your day 3 blood reports and the scan reports as well, I would want to tell you that , we cannot exclude the chances of PCOD here , since you have symptoms of acne , irregular cycles and ultrasound findings going in favor of PCOD.

Doctors are usually happy to see a follicle size of more than 12mm at the time of ovulation as this is usually expected to give fruitful results. According to many studies it was found that 80% of the follicles which were more than 17mm in size, were successful for ovulation & fertilisation later.

Regarding the growth of the follicles with prolonged menstrual cycles, one may not be able to predict the same , as it is purely hormonal and changes are expected accordingly.

Hence I feel CLOMID would help in ovulatory cycles as well as good growth of the follicles , to help in a successful pregnancy.

I hope I answered all your questions .

Wish you all the best for the pregnancy .




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