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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why Am I Not Conceiving?

Hello Doctor, My age is 33 yrs. I have a 25 day cycle. I'm trying to conceive since 4 months. I underwent a series of ultrasound to study my follicles.
Details of the ultrasound:
1. Day 11th of my Last Monthly Period : Right Ovary- Only 1 follicle @ 20mm, Left Ovary- Small Follicles, Endometrium- 9mm
2. Day 12th of LMP: Right Ovary- Only 1 follicle @ 24*21mm, Endometrium- 9.1mm
3. Day 13th of LMP: Right Ovary- Only 1 follicle @ 25*21mm, Endometrium- 9.1mm
4. Day 14th of LMP: Right Ovary- 2 Follicles, 1 follicle @ 32*25mm + 2nd follicle @ 16*14mm Endometrium- 9.2mm
5. Day 15th of LMP: Right Ovary- 2 Follicles, 1 follicle @ 37*28mm + 2nd follicle @ 18*17mm Endometrium- 9.5mm.
On the day 15th of my LMP, the radiologist wrote a comment that "Both follicles show internal Hemorrhage". He also said orally that some blood is seen, but both the follicle have not ruptured yet.
Please help me interpret all this data. Does it mean that both the follicles have ruptured and filled with fluid. Or is it something else. Please tell.
Thu, 22 May 2014
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General Surgeon,  's  Response
Hi,

Thanks for writing to HCM .

Let me explain you what is happening in you and what should happen normally in a female.

Normally the follicles start growing and reach a size of 20 to 22mm and rupture. This is called ovulation. After rupture the size of follicle reduces significantly and also there won't be any blood inside.

In your case your follicles have grown more then normal and have not ruptured and have become a cyst. Since the follicle has reached such a size, the blood vessel will stretch and break leading to blood inside it.

The treatment for this is initially conservative with antibiotics . If don't reduce then puncture it. I suggest you to discuss with your gynac .

I assume you are not taking any ovulation inducing drugs.

In future to avoid such complication I advice you to get your follicular study on day 12 andonce size is more then 20mm take hcg injection. This will rupture the follicle .

Hope I have been helpful .

Regards
Dr.Deepika Patil
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Why Am I Not Conceiving?

Hi, Thanks for writing to HCM . Let me explain you what is happening in you and what should happen normally in a female. Normally the follicles start growing and reach a size of 20 to 22mm and rupture. This is called ovulation. After rupture the size of follicle reduces significantly and also there won t be any blood inside. In your case your follicles have grown more then normal and have not ruptured and have become a cyst. Since the follicle has reached such a size, the blood vessel will stretch and break leading to blood inside it. The treatment for this is initially conservative with antibiotics . If don t reduce then puncture it. I suggest you to discuss with your gynac . I assume you are not taking any ovulation inducing drugs. In future to avoid such complication I advice you to get your follicular study on day 12 andonce size is more then 20mm take hcg injection. This will rupture the follicle . Hope I have been helpful . Regards Dr.Deepika Patil