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PCOD, irregular cycles and obesity causing infertility - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Infertility Problem
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2585 Questions
User :   hello dr, iam XXXXX 27yrs, and iam married since 4yrs i have pcod problem, due to irregular cycle but now without any tablets my cycle bacame regular my husband had varicoscele surgery april 2010. my question is i was obese b4 but now i took treatment and reduced 10 my wt is 60 kg. my ht is 155cm
User :   hi
User :   Dr. XXXXXXXX here.
User :   let me read what you have typed
User :   ok. please proceed with your query further.
User :   i think i hv typed my problems and query very clearly?
User :   after the varicocele surgery was his semen analysis done to see if he is having normal quality and quantity of sperms?
User :   no thats not yet done still
User :   you have informed me about your current height and weight and about your obesity earlier. your query is not clear what you want to ask. please review it.
User :   for my only ultrasound scan and 2nd day of cycle all hormone test has been done
User :   ok. when was the ultrasound scan done? what did it show?
User :   pcod problem jan 2010.
User :   ok. are you trying to conceive now?
User :   after that my cycle became regular without taking tablets.but dr, told me to take duphaston tablet but i did not take
User :   if yes then i would advise you to go ahead with these further tests for yourself: User :   1) take the hormonal tests for FSH, LH, Prolactin and TSH levels
User :   wat is the next step of test to be taken?? guide me
User :   2) a repeat ultrasound scan to see of PCOD changes have become better or corrected
User :   iam planning now since 4yrs happened na
User :   3) get the semen analysis for your husband done
User :   see what the results show at present.
User :   further treatment will be decided based on the test reports.
User :   at first we need to be clear that your PCOD changes have reversed, and that there is no hormonal abnormalities
User :   actually in my hormone test pcod problem dr. told me one of my hormone is raised and they gave me tablet named caberlin 0.25
User :   and also we need to see that your husband is not having any problems with the sperms after his surgery
User :   once we have the results we can proceed further
User :   Caberlin is given to control increased Prolactin levels, which does causes the PCOD changes in ovary. continue taking that, it will help
User :   you might get pregnant while being on this tablet.
User :   if you miss your periods while being on this tablet, it might suggest pregnancy.
User :   i always have this urinary infection problem and vaginal infection sumtimes. due to this will i have anyother problem in my ovary?
User :   repeat hormonal tests will tell if the medication given is working, and whether it should be continued
User :   no, the repeated urine infection and vaginal infection will not cause problems in ovary, but will alter the vaginal pH, making it difficult for sperms to penetrate and travel inside
User :   caberlin tablet was supposed to take for 12 weeks 12 tablets weekly once . its over now? you want me to continue the same tablet./??
User :   so wat am i supposed to get rid of this infections????
User :   if any infection is still present, or suspected, get a vaginal swab test done to identify the infection, and get both yourself and your husband treated simultaneously, to avoid re-infection(avoid having unprotected intercourse while being on the treatment).
User :   yes, it should be continued, get repeat tests to see if the tablet is needed to be continued.
User :   proceed with further treatment based on the results of your investigations.
User :   vaginal swab test means - it has to be get done only by visiting a lab right?
User :   no, not a lab, your gynecologist when examining you will take the swab from vaginal area and send it to lab for test
User :   have you followed what I have said?
User :   please get back to me if you are having any doubts.
User :   other changes that could be helpful in getting pregnant and getting rid of infection include: 1) drinking plenty of water
User :   2) including 3 servings of fruits and 3 of vegetables in diet in form of salads and juices
User :   3) being in regular follow-up with doctor to detect hormonal changes.
User :   4) discuss with your treating gynecologist about getting tests done to see if you are ovulating (having egg release from ovaries). If you are not ovulating, then treatment will be given to help you to ovulate/release eggs and get pregnant
User :   5) sometimes varicocele surgeries can lead to few blocks which affect sperm quantity, get your husbands semen analysis done, if it shows low sperm count, get him investigated to look for blocks
User :   and get them corrected by the urologist such that he can have normal sperm counts.
User :   wen am i supposed to do a ultrasound scan to chk whether i hv pcod problem my next cycle is 4th august?
User :   6) stick to foods rich in zinc like sea food (if you are non vegetarian) and beans group (if you are vegetarian)
User :   if your next period date is 4th august, I would suggest you to wait for the next periods, and get the ultrasound done after 8-10 days after your first day of bleeding
User :   to look for changes in ovary with the eggs
User :   repeat the scan every 2 days (known as follicular study) to see if eggs are growing fine and are getting released
User :   this month i got 4 july now i can do the ultra sound ??
User :   it will also help you to time out your intercourse to have a fruitful outcome
User :   yes you can do the scan now if your first day of periods was 4th July, but in case you have already ovulated, then changes will be missed
User :   hence I suggested the next cycle
User :   in the meantime, get your husband evaluated for the sperm quality and quantity
User :   have you followed what I have said?
User :   so can u tell me wen am i supoosed to plan wat days? from which day to ahich day?this mnth i got 4th july my cycle 1st day?
User :   what is the usual period cycle length? i mean to ask in how many days gap do you usually get your periods now?
User :   so u mean to say that 13 august i can do my ultra sound scan
User :   if your Day1 of bleeding is July 4th, your ovulation dates will be anytime between 11-21st July, when you should have your egg released from ovaries.
User :   28 - 30 days
User :   so having intercourse now should benefit if your husband is having normal sperm count and quality (assuming you are having normal egg release)
User :   if you fail to concieve in this cycle
User :   then?
User :   then wait for your next periods in August
User :   and start with investigation with hormonal tests and serial scans to time your ovulation
User :   start with scans after 7th August
User :   hysterosalpingogram - wat is this? am i supposed to undergo this?
User :   hysterosalpingogram is a test done using dyes to look for blocks in the normal anatomy (like tubes, uterus). has it been advised for you?
User :   no
User :   since i have lot of infections in my vagina and urinal part so i asked uuu?
User :   it is a part of infertility work-up. it can be done if blocks are suspected
User :   the repeated urine and vaginal infections can lead to PID (pelvic inflammatory disease)
User :   the ultrasound scan picks it up by showing fluid in POD (pouch of douglas)
User :   it is treated with antibiotics
User :   if vaginal infections are found, even your partner/husband should be treated simultaneously
User :   my pt is i dnt want to waste time in waiting more bcos we want a kid very badly as such bcos of tat we hv lot of issues in the family wen i explain to dr.s in general they r not understanding. dnt mistake me
User :   i can understand, hence I suggested you tests to be done for both of you to get to underlying problems soon
User :   i hv to go for ivf directly iam asking?
User :   such that treatment can be initiated and help can be provided to you to get pregnant
User :   not needed, first try the normal process, IVF even if needed will require your husband to have normal semen quality and quantity
User :   so it is anyways necessary to be done
User :   along with that the repeat tests done for you, will help to know if pregnancy can proceed normally.
User :   if you have vaginal infections continuing, the pregnancy will be at risk
User :   as the process done will also introduce infection inside, which will lead to miscarriage
User :   and further delay in successful pregnancy.
User :   go ahead step by step as suggested above
User :   so vaginal swab test has to be initiated immediately? any particular day i hv to do or normal??
User :   it can be done anytime.
User :   the vaginal swab test and your husband's semen analysis can be done anytime
User :   semen analysis after 2-3 days abstinence, and early morning sample is better.
User :   it gives accurate results
User :   so next step i hv to get all my hormones tested and ultrasound scan tats it na then for my husband semen test
User :   yes these should be done after making sure that there is no ongoing vaginal infection.
User :   i will detail out the steps again for you
User :   1) Vaginal swab, treatment based on results for both of you.
User :   for my husband also vaginal swab test has to be done??
User :   2) semen analysis for your husband, treatment based on results, if low, then cause to be identified, if normal, proceed with plan for pregnancy
User :   5) lastly if these do not work out even with ovulation induction, and normal semen test for your husband.],
User :   go in for HSG and then decide on IVF
User :   have you followed what I have said?
Doctor :   Hi
Doctor :   Are you back?
User :   hello dr
User :   yes
Doctor :   Please proceed with your query. Have you followed what i said uptil now?
User :   wat is hsg dr?'
Doctor :   Histosalpingogram
User :   s i follwed till now wat u hv said
Doctor :   Is there anything else i can help you with?
User :   nothing much dr.
User :   all my hormones test on 2nd day of my cycle
User :   can u tell me wat all test to be done on 2 nd day ather than ultra sound?
Doctor :   It can be done at the same time when you start the serial scan that is from Day 8 to 16 counting from day 1 of your period
Doctor :   The tests done include complete blood counts, TSH, LSH.
User :   only this much
Doctor :   FSH, LH and Prolactin
User :   all this test on my 2nd day of my cycle or wen bcos all these days i was giving on my 2nd of my cycle/
Doctor :   I have already told earlier they are to be done between Day 8 to 16 counting from day 1 of your period
Doctor :   Have you followed now?
User :   ok
Doctor :   Anything else would you like to know?
User :   nothing thank you
Doctor :   Thanks for consulting me, bye for now
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