U/sound Results. PCOS or not?

I had an external U'sound before conceiving DD and was told I had PCO's. I went for an U'sound the other day (For something else) and the lady said internal U'sounds were better for diagnosing PCO's. Here are my results -


FINDINGS: Both ovaries are normal. There is no adnexal mass or collection. No other pelvic abnormality.

IMPRESSION: Normal examination. The appearance of the ovaries is not particularly suggestive of PCOS.

My periods are a bit irregular (See below) and it took us 15 cycles to conceive DD and we have been TTC # 2 for 15 cycles now. I did have blood tests before DD, but I can't remember what the results were?

I would have thought internal U'sounds would be conclusive?

Hi Ella's Mum.

Internal ultra sounds are better for viewing the ovaries and would give a better idea of whether your ovaries are polycystic or not.

BUT... It is possible to have PCOS and still have normal looking ovaries, just as it is possible to have ovaries that appear polycystic but not have PCOS.

PCOS needs more than just PCO to be diagnosed, and blood tests are going to be the better indicator of whether you have PCOS or not. Elevated testosterone and other androgenic hormones would be a big indicator. Along with a wonky LH/FSH ratio (and I would need to look up how all that works). Other signs and symptoms would include excess weight that is difficult to lose and primarily distributed over the abdomen, acne, excess body hair that follows a typically male pattern, as well as hair (the hair on your head this time) thinning or loss.

I know this is probably not much help to you, but it is impossible to diagnose PCOS just on the appearance of the ovaries alone.

BW

Thanks BW.

I guess when I get my referal to the FS or GYN I'll have some more blood tests then.

Looking at the actual u'sound films I can actually see at least 6 'cysts' in one ovary and about 10 in the other.

I've found quite a few doctors who are really cautious about using the term 'PCOS'. I don't think I've ever met or heard of anyone who has had all of the symptoms for PCOS. I've got the cysts, weight gain, pimples but because hair growth is not unusual, one doctor told me that I was not PCOS, another one did. If you are being told one thing and you are unsure of it then get a second opinion. Keep asking the questions and pushing for answers.

I think that even with Doctor's theere is still much not understood about PCOS. The GP that diagnosed me, did so on my suggestion and I was the first he had diagnosed. He rang an expert in that area and sent my results over, also my symptoms who confirmed it for him. HE had no idea about how to treat, but researched it all for me and put me on metformin. A previous doctor had told me I was normal, even though the blood tests came back at menopausal female hormones and excessive testosterone, and other out of wack hormones, the androgen ones. Then the ultrasound confirmed it, as well as my symptoms. I didn't have the hair problem too bad, but had weight gain despite my heavy physical labour job, inability to lose weight, acne after not having it since my teens, weight gain, and complete loss of periods for many months.

I would personally get another opinion and definately get some bloods done. Take your U/S with you, or maybe ask for a referral to a specialist? Do you have the symptoms of PCOS besides possible fertility issues? Internal ultrasounds are supposed to be accurate, and many places don't even offer the external ones for pelvic examinations in my area (non pregnancy)

I think from Dr Eden's Book on Polycystic ovaries (PCO) the statistics are around 1 in 4 women have PCO and it doesnt cause any issues at all in terms of them falling pregnant. Its concerned with the pattern of the follicles and how they are arranged in the ovary. They use the term a pearl necklace in terms of how the follicles are arranged. (i should be mature and still not giggle at this term!)

Ultra sounds can not be used alone in terms of diagnosing PCOS.
There needs to be 2 out of the 3 symptoms found for it to be assessed as PCOS. The 3 things are:

1. Periods which are irregular (less than around 6 each year)
2. Blood Tests which show high male hormones
3. Polycystic ovaries

They side the effects are things such as bad skin, excess hair but they are usually a result of the high male hormones.

Thanks for picking up my slack, Summer. You found the exact bit from that book that I was thinking of - cursed staff meetings keeping me at school hideously late! Looks like I have taught you well! :p

BW

ROFL Oh between you and Eden's book, Im all ready to receive my PhD in knowledge on PCOS

I have -

Irregular periods (Are they considered that? See below)

Pimples mostly around chin and neck areas and

The scan definatley has the 'pearl neclace' (he he) effect.

(I'm within the normal weight range)

I once read that a symptom could be 'skin tags' in the arm pits. I have them too, but don't get how that is connected?

If I rang my Dr would she give me my previous blood results over the phone?

Ella's mum, it would be impossible to say yes or no to PCOS with the information that we have so far. You really need to consult your doctor about this.

Just to give you a bit of an example, I have really quite severe PCOS, yet I've always been within a healthy weight range, I've never ever in my life had an acne problem, and I just don't have the hair issues to any noticable or distressing extent. The only obvious sign I had regarding PCOS was my complete and utter lack of a menstrual cycle - we're talking 70+ days as a matter of course. So for me it's really only through blood tests and scans that it's possible to give me a diagnosis (although the severe menstrual irregularities I have just scream that there is a hormonal problem of some sort).

Now, to my mind I wouldn't consider your cycles to be irregular, but I'm not entirely sure of what the medical definition is. Skin tags are often listed as one of the symptoms of PCOS, but there are also many other causes for acne, skin tags, etc that are not PCOS.

Basically, all I can say, even with the extensive knowledge I have gathered is that it's possible, but if you do have PCOS, it would appear to me to be fairly mild. Have you ever charted? Do you know whether you are ovulating each cycle? That could be a big indicator of whether you need help with this or not. Many women with PCOS need absolutely no assistance with conceiving at all.

Ella's mum, it's a possible diagnosis, but I really couldn't give any indication of how likely it would be at all.

BW

I would say your cycles are irregular.

This is one of the biggest problems I had with getting a PCOS diagnosis - healthy weight and I thought my cycles weren't too bad - if a doc asked, I said they were regular, because I didn't understand what they meant by "regular"! Apparently, when they ask if you are regular, they mean if they are the same length most months, with perhaps a day or two out either way (ie. shorter or longer) every now and then - but essentially, the same length to the day for most months. When I first asked a health care professional what they meant by regular... I exclaimed, well, I have never been regular then!! This is after telling numerous doctors that I was indeed "regular", since I assumed if it came around every month, that was regular enough!

I also had doctors and specialists arguing over whether I really had PCOS or not... they seem to not be in a hurry to give out a diagnosis - especially when you may not fit the PCOS stereotype they seem to have in their minds...

All the best with seeing a FS - they should know what they are looking for!
Love,
Michelle :)

Thanks ladies, I suppose I will wait and see what the FS says when we get there in about 3 months, but until then I think I probably should give temping a go to try and see if I am actually ovulating.

Thanks again and good luck to all you lovely ladies!