Could I have PCOS?

[CanadianMaple]

I'm going to talk to my RE tomorrow, but when I read about what's going on with my hormones, combined with the ultrasound I had last week, I'm really wondering.

My LH/FSH ratio is elevated. I'm not sure what they are for this cycle, but in the spring they were 5:12 and then 7:15, so about 1:2. When he did my CD3 baseline scan, I had 30 antral follicles on my right and 10 on my left. I've had a bit of weight gain which is unusual for me in the past 3 years, skin tags on my neck and a few stray little hairs on my chin which seemed to have slowed down when I was on the pill.

I was put on the BCP for 3 months, with one cycle off in Aug/Sept. It was supposed to lower my high LH so we could do IUI this cycle. It was still elevated on CD3, just 0.5 of a point below the max they will allow, and I am positive it was too high on CD8 because of the wet CM/EWCM I was seeing, combined with an almost positive OPK. I find out tomorrow if it was and if my cycle is canceled.

Since I am not insulin resistant, it seems like they are just watching me this cycle. I go in tomorrow to see what the Clomid last week did. He made a comment when he saw 30 follicles on my right side about how he hoped too many don't respond too much and seemed surprised at how many were over there.

Is there anything I can ask for if they cancel this cycle? Does this mean I will need injectables like they warned me about to get pregnant? I'm feeling so frustrated, we finally resolved our MFI side of things and to now worry about my fertility is hitting me harder than I had expected.

 

[CanadianMaple]

No one?

 

[Smiler82]

Sorry hun I can't offer much advice, just didn't want to read and run.

I have got PCOS but I've got no idea what LH/FSH ratios etc should be. I just wondered, since you had a scan to check your follicles did they not see if your ovaries are covered in cysts? I had my first scan for clomid the other week and was devastated to see the mess my ovaries are in. They had huge, dark circles all over them, which are the cysts.

I only had 2 follicles, one on each ovary. So purely based on my experience, seeing lots of follicles wouldn't necessarily indicate PCOS.

How did you get on today? I hope your cycle wasn't cancelled x

 

[CanadianMaple]

They said something about how many follicles I had, especially on my right so I think that's an indicator? The nurse today said something about how the guidelines seem to change everytime they go to a conference about it. She thinks I definitely have PCO indicators.

My cycle is all but canceled. My LH:FSH is still 2:1 and now my progesterone is too high. They are giving me 2 more days and then I'll go in again and they'll probably cancel me.

 

[lisap2008]

When I was diagnosed years ago it was by ultrasound I was told there were lots of cysts in my ovaries.

 

[foquita]

I thought anything over 12 indicated PCOS, and anything over 2:1 LH/FSH ratio. have you asked them if they think you've got PCOS? I think you can have polycystic ovaries but not have PCOS, PCOS is the hormonal imbalance.

smiler82, follicles and cysts are the same thing the 'cysts' on your ovaries are actually follicles that have tried to mature and failed.

 

[foquita]

I like this page, it explains it really well

https://www.sensible-alternative.com.au/female-hormones/polycystic-ovarian-syndrome

 

[lisap2008]

I thought anything over 12 indicated PCOS, and anything over 2:1 LH/FSH ratio. have you asked them if they think you've got PCOS? I think you can have polycystic ovaries but not have PCOS, PCOS is the hormonal imbalance.

smiler82, follicles and cysts are the same thing the 'cysts' on your ovaries are actually follicles that have tried to mature and failed.

This is a good article that explains the difference between follicle and cyst.
https://fertilityfile.com/2007/12/18/cyst-vs-egg-vs-follicle-clearing-up-the-confusion/

 

[foquita]

thanks a cyst is still a follicle though...

 

[foquita]

The syndrome acquired its most widely used name due to the common sign on ultrasound examination of multiple (poly) ovarian cysts. These "cysts" are actually immature follicles, not cysts ("polyfollicular ovary syndrome" would have been a more accurate name). The follicles have developed from primordial follicles, but the development has stopped ("arrested") at an early antral stage due to the disturbed ovarian function.

https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome

 

[Smiler82]

They're not quite the same thing.... I know the word cyst is a bit of a misnomer when it comes to PCOS but there is a clear difference. When I had my scan yes,the 'cysts' were failed follicles, but the two follicles I had that were heading towards releasing an egg look very different. You can see a little white,area, the egg getting ready. All the big, black marks on the rest of my ovaries are failed follicles.

But the thing is, PCOS still isn't understood that well, as that nurse said the guidelines for diagnosis keep changing. Makes it hard sometimes, depending how up to date your doc is...

 

[foquita]

i think as well they like to just stick everyone in that category to make it easier for them (where's the rolling eyes smiley?! )

mine just looked the exact same on my scan, wee black holes and one large 23mm black hole and that's the one i ovulated out of. my pretty ovaries all dressed up with their string of pearls round each one

 

[CanadianMaple]

Thanks!

I find out tomorrow if my IUI is canceled. I'm really nervous. I had always wondered if I had PCOS from some of the weight gain I had (always thin, then weight gain over past 3 years and no change in diet), the LH:FSH, when he saw all of those follicles and seemed surprised...

 

[foquita]

good luck, I'll keep my fingers crossed for you let us know!

 

[CanadianMaple]

I'm here. I only have one follie at 17.5mm and my other 2 quit growing. I have a ton of small ones.

They are talking about cancelling since I don't have a good chance with only one?

 

[Smiler82]

Foquita - I totally agree. Any probs with cycles they can't figure out they lump you in the PCOS box. Similar to how if you have undiagnosed digestive problems they just tell you you've got IBS. Just so many variables between each patient I guess makes it hard to really know.

Haha pretty ovaries That's a positive way to look at it!!

CanandianMaple - I'm so sorry they are talking about cancelling I don't get it though. If you were ovulating normally, your ovary only releases one egg anyway? When I had my CD13 scan, my two follies were only measuring 10mm each but I did ovulate. Took a while yeah, but it still happened. Did they say how many follicles they'd want to see?

 

[donna noble]

yes I had a doctor actually tell me they lump everyone into pcos now whether or not you have cystic ovaries or present with other symptoms! They are just too dang lazy to actually figure out what may be your real problem. Too many expensive tests and insurance companies don't like that is the reason. So sad in our day and age with the technology we have this is how they treat women. Some doctors are really good, but I am finding my experiences are not unique in how I was treated.