What does this ultra sonography of pelvis indicate inspite of having PCOS?

Posted on Wed, 14 May 2014 in Women's Health
Question: hello doctor ,
I am 25 years old and married for 2 years. I am having irregular periods since my periods started and also used to have abdominal pain. From the past one year i am getting my periods after 2 months and we are also trying for a baby. we consulted doctor and she gave the following medicines
susten 200 for 5 days
folivite for 3 months
chrominac for 3 months
after using these medicines , walking and dieting i got my periods , this month i got my period after 18 days.
A ultra sonography of pelvis on my 5th day was done she found that there are PCOS in both ovaries
My utereus size is 7.5x3.4x4.9cms
Endometrial thickness 6mm rght ovary 3.6x2.4 cms lft ovary 3.4x2 cms
both ovaries are enlarged,multiple small follicies each measuring not more than 6-8mm rght and lft adnexa appeared normal
tsh is 2.18 uIU/ml

On my 10th day my cycle transvaginal sonography of pelvis done and the result is endomet thk -7.5 mm,MSF seen in rght ovarian follicle, lft ovarian follicle-rght shows a dominant follicle measuring 12x13mm and doc prescribed inj hmg 75 iu im stat

on my 12th day my cycle transvaginal sonography of pelvis done and the result is endomet thk -11 mm,MSF seen in rght ovarian follicle, lft ovarian follicle-lft ovary shows a dominant follicle measuring 18x14mm and doc prescribed inj hcg 5000 units im stat

On my 13th day ovulation test was done and the result was positive

The medicines she prescribed are folivite, chrominac and susten 200

My last period date was 3rd april and now i am getting a slight abdominal and vaginal pain.
Are the above, symptoms of pregnancy? and are these reports are normal?

Answered by Dr. Madhuri N Bagde 43 minutes later
Brief Answer:
Too early to comment upon pregnancy

Detailed Answer:
Hello and welcome,

You have provided a detailed history which is a big help.

It seems that you had ovulation on 16th april and today on day 20 you are having abdominal pain.

The symptoms of pregnancy are mostly nausea, vomiting, sometimes pain and increased urinary frequency. They appear about a week after the missed period. They may come a bit early but never come before the missed period. The only condition when there are symptoms before the missed period are twins and a special condition called molar pregnancy where the hormone levels are very high. Still even for them this is too early.

Usually the baby attaches to the mother 5-7 days after ovulation and then the pregnancy hormones begin to increase and lead to symptoms. This takes at least 1-2 weeks after attchement. So it may be possible that even if there is a pregnancy then the baby is just attched to the mother and unlikely that it will cause symptoms so early.

Other causes of pain may be infections, blood pooling in pelvis [ congestion], endometriosis [ collection of uterine lining inside the abdomen leading to pain ], pain from other organs like urinary bledder and intestine.

As of now, I suggest that you observe the pain. If it decreases, get a urine pregnancy test done 3 weeks from the date of ovulation or a blood pregnancy test done 2 weeks after ovulation date to look for pregnancy. If it is negative then you will need further investigations like a hormonal evaluation on day 2-3 of period and drugs like metformin to help control the PCOD.

If the pain increases, then you will need to see your doctor for ruling out other causes.

All my good wishes are with you.
Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Madhuri N Bagde 15 hours later
thank you madam are my results are normal?
Answered by Dr. Madhuri N Bagde 14 minutes later
Brief Answer:
Reports indicate PCOS

Detailed Answer:

Your reports indicate that you have PCOS. This is caused by hormonal imbalances and leads to trapping of the ova [ female eggs] inside the ovary [ they are the multiple follicles seen on scan] so that they are not available to cause pregnancy.

Despite the PCOS, you had an ovulation which is a good sign as ovulation is the main problem preventing conception in PCOS. The HMG and HCG have helped in ovulation. So I guess that drugs like clomiphene will be useful in your case.

I also suggest that if you have been trying for a pregnancy for the past 1 year and have not succeeded then it is better if you and your husband are both investigated for causes other than PCOS. A husbands semen analysis and your tubal patency test are the basic tests needed and can be done after consulting a infertility specialist. If they are normal an IUI procedure at the time of ovulation will be helpful in case there is no pregnancy in this cycle.

Your thyroid report is normal.

Please do not worry as PCOS is a very common problem but it can be treated.
Weight loss, regular exercise, yoga and a diet low in sugar and fat are very helpful in treating PCOS.

Hope that this was helpful.
Please feel free for any further queries.

Take care.
Dr Madhuri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Madhuri N Bagde 5 hours later
thank you maam
Answered by Dr. Madhuri N Bagde 1 hour later
Brief Answer:
You are welcome!

Detailed Answer:
You are most welcome, it was a pleasure answering your query.

Dr Madhuri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Madhuri N Bagde


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