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Overweight. Trying to conceive. Pelvic scan shows normal uterus with thickness 6.4mm and ovary volume 10cc. Meaning?

Mar 2013
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Hi , I have been trying to conceive for the past 6 months. I am 37 years of age and overweight. My Doctor sent me for an ultrasound scan and is quite happy that I should conceive naturally but I am worried to death that something is wrong. I will type what the report says:

US Pelvis transabdominal & transvaginal
Poor quality image with limited resolution due to patient body habitus.
The uterus appears normal in size and echotexture with an endometrial thickness of 6.4mm LMP - day 27.
The right ovary has a volume of 10cc, the left ovary has a volume of 11cc. Both ovaries contain numerous small follicles. PCO cannot be excluded, suggest correlation with clinical biochemistry. No free fluid seen.

Do you see that I should be able to conceive naturally with the above report? What should my endometrial thickness be and my ovary volume?
FSH and LH was normal
Posted Sun, 18 Aug 2013 in Infertility Problem
Answered by Dr. Aarti Abraham 19 minutes later

Thanks for writing to us.

You have not mentioned the normal cycle length you have.
On day 27, I would assume you are pre menstrual, and hence the endometrial thickness should be more, around 12 - 13 mm.
Also, ovarian volume more than 10 cc on each side with multiple small follicles means that you are mostly have PCO ( polycystic ovarian syndrome ).

In this condition, the patient has hormonal imbalance, due to which the ovary contains multiple small eggs, but none of them form mature ovum , and there is difficulty in ovulation and conception. Women also typically have delayed and scant periods.

Being overweight is a risk factor, and maintaining an ideal BMI will go a long way in controlling this condition.

As suggested in the ultrasound, confirmation is by blood tests. The following need to be done - FSH, LH ratio on day 2 of periods, Serum free testosterone, Serum DHEAS, TSH, Prolactin, Serum fasting insuling, C peptide and Oral glucose tolerance test.
Even though unrelated to PCO, please get your AMH (anti mullerian hormone) levels done, as it indicates ovarian reserve, that is , capacity of ovaries to form eggs, which is also impaired with advancing age.

Once PCOD is diagnosed, there are medications to control it, such as Metformin.
Also, you need to have a cycle of follicular monitoring to see if you ovulate naturally.
If you do not, you might need help of ovulation inducing agents like Clomiphene citrate to induce ovulation.

Do not lose hope, as women with PCOD do have difficulty in conceiving, but they also respond very well to treatment.

At 37, I would ask you not to wait anymore. Consult an Infertility specialist right away.
Along with the PCOD workup that I have outlined, also have other tests done simultaneously, such as the semen analysis of your partner, and checking of the patency of your fallopian tubes.
This is because, with advancing age, fertility tends to decline, so it is better to speed up the process.

Take regular folic acid supplements, eat healthy and have regular exercise.

All the best, and feel free to discuss further.
Above answer was peer-reviewed by
Follow-up: Overweight. Trying to conceive. Pelvic scan shows normal uterus with thickness 6.4mm and ovary volume 10cc. Meaning? 1 hour later
I want to get pregnant naturally. I dont want any kind of tablets or treatment. I have all blood works done and they are all normal. I have regular 28-29 day cycles. My own Doctor doesnt think I should have any problems to conceive naturally
Answered by Dr. Aarti Abraham 1 hour later
If no problem so far has been found, then please continue with natural planning for pregnancy.
If you fail to conceive within 6 months, I would ask you to consider seeking treatment, only because of your age factor.
IF all suggested blood tests are normal, then do not worry.
Consider taking up the line of treatment outlined above, if you fail in conceiving naturally.
Above answer was peer-reviewed by
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