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Dr. Andrew Rynne

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What causes irregular menstrual bleeding when diagnosed with PCOS?

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Dr. Nishikant Shrotri

OBGYN

Practicing since :1968

Answered : 2916 Questions

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Posted on Fri, 3 Mar 2017 in Women's Health
Question: Hi, I am about to go through a miscarriage as my hcg levels only went up from 494 to 714, what are my chances of having a miscarriage again and when am I able to start trying to conceive again? My menstral cycles are very irregular and only happen maybe 3/4 times a year, usually only happening because of an ovarian cyst and then I have my bleed after a rupture, I don't normally ovulate so what could I do to help get my body to ovulate? Before this miscarriage my progesterone was 18.2 and my uterine lining was 9.81 so thickening up as it should. I read most miscarriages happen because of abnormal chromosomes, but I didn't know if my levels above had anything to do with it? My doctor doesn't seemed to be concerned, but I feel like my absent menstral cycle along with my ovulation problems could have something to do with this. I am only 23, and my doctor doesn't want to help put me on anything because he feels I am still young and should just keep trying, but without a cycle i don't feel I'll ever get anywhere. This pregnancy took 2 years to conceive. Miscarriaging at 5 weeks now.

Thanks in advance!
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Answered by Dr. Nishikant Shrotri 54 minutes later
Brief Answer:
Please provide investigation reports, images and focused hystory

Detailed Answer:
Dear xxxxxxxxxxxxxxxxx,

I hope I have spelt your name correctly; if not you may correct me.

You seem to have some confusion about the diagnosis and the investigations.

When it is a miscarriage, the hCG levels should drop and not rise. What was the period of gestation when the hCG levels rose? Was there any other evidence to prove that you were pregnant and then aborted? On what basis, you were diagnosed as pregnant and what made the diagnosis of abortion?

Your menstrual pattern suggests that you could be a case of Polycystic ovarian syndrome (PCOS). Do you have your abdominal ultrasonography images and reports? If so please upload them for my review. What is your height, weight and BMI?

To find out whether the miscarriage was due to chromosomal abnormalities in the child, you should have submitted the products of conception for chromosomal study. Now before you attempt for any pregnancy, you may get your and your husbands chromosomal testing done.

Once a miscarriage increases the possibility of a repeat miscarriage; though it is not a rule. However, during your next pregnancy, you should be under close monitoring by an Obstetrician.

I agree with you; you should not be neglected only because you are just 23 years of age.

Please provide me with your detailed menstrual history, marital history and all the investigation reports including the above mentioned ones. Please get your blood examined for FSH, LH, Oestrogen, Progesterone and Prolactin. After seeing the reports, I might suggest you some more investigations.

If you have any more query, you may ask me anytime; I am always available for you, xxxxxxxxxxxxxxxxxxx

Dr. Nishikant Shrotri
Above answer was peer-reviewed by : Dr. Prasad
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