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Unable to conceive, report shows bulky ovaries, multiple tiny cysts. Cause for not conceiving?

hello I am 26 years old n married for 3 n 1/2 yrs. i wish to have a kid. have done USG PELVIS . report says: both ovaries are minimally bulky. Multiple tiny peripherally situated cysts noted in both ovaries.No dominant follicle seen. Stromal echogenicity is raised( PCOD features ). right ovary measures:- 3.99 cm x 3.05 cm approx left ovary measures:- 3.82 cm x 2.65 cm approx my husbands sperm count :- 90 million/ml please suggest what would be my treatment
Asked On : Sat, 2 Feb 2013
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OBGYN 's  Response
Mar 2013
Thanks for writing to us with your health concern.
Your husband's semen count is normal.
Your ultrasound report is highly suggestive of PCOD, polycystic ovarian disease.
In this condition, there is baseline hormonal disturbance.
Due to this, the ovaries get studded with multiple small follicles.
None of them mature properly to form a dominant follicle, and none of them ovulates in time.
Hence, there are irregular cycles, and erratic ovulation.
Please consult an Infertility specialist.
Get the investigations done - LH, FSH, TSh, prolactin, OGTT, serum insulin, DHEAS, free testosterone, lipid profile.
Also, you can start ovulation induction with clomiphene citrate if follicular monitoring reveals problems in ovulation.
If 3 - 6 cycles of clomiphene / gonadotropins fail, you should have a laparoscopy to check if tubes are open or not.
For blocked tubes, or failure of induction, IVF is the last option.
Weight loss is a must for PCOD control.
Take care.
Answered: Thu, 28 Nov 2013
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