Follicle Size and Hemorrhagic Cysts

[kriola]

Hi, new to the board and would really appreciate some feedback. I am 37 and on second round of Clomid. My MD did a Day 21 progesterone and sonogram today. I am currently 5 DPO. There was one follicle @ 1.5 cm (15mm) on left ovary and two 1.5 cm(15mm) as well as a 3 cm (30 mm) "hemorrhagic" cyst on my right ovary.

This is my question; Did I actually ovulate (won't get progesterone results for a couple of days) since it seems that 3 of the follicles are rather small and could the hemorrhagic cyst have actually produced an egg?

I have searched all over the internet but keep coming up empty. My MD just wants me to go back in two weeks to look at the cyst again. He didn't seem too concerned. I am a bit frustrated and not sure what's going on. I had a miscarriage in August and found out I have PCOS. I have had LH surges/positive OPKs every month but still nothing.

If nothing happens this month, I will go to an RE, I am worried that I may have a blocked tube,etc.

 

[Mrs. Bear]

Hi kriola

It sounds like we have a lot in common - I am also 37 with pcos. Clomid didn't work for me, even at 150mg, so my RE put me on Femara/Letrazole which seems to be working. I had a 3.7cm cyst last week so I go in next Tuesday for another ultrasound to see if it has reduced in size. If it is small enough I hope to start my second round of Femara next week.

Are you charting? The post-ovul temp surge is generally a good indicator of ovulation. From what I understand a cyst can form from the follicle that released the egg as well as from follicles that didn't so I don't think having one is conclusive either way.

Has your MD put you on metformin yet? It not only is supposed to help with pcos but my RE says I would need to stay on it through 1st trimester too. Since pcos also increases risk of miscarriage the metformin is supposed to help reduce that risk as well.

I would definitely recommend that you go to an RE. They know so much more and have so many other options. Mine does ultrasounds to monitor if you are responding to the medications and even started me on femara as soon as they saw the clomid wasn't working so we didn't have to wait for the cycle to end before trying another option. I kick myself thinking of the months I wasted before going to mine (my ob/gyn never even picked up on the pcos). They will check your tubes, etc and check out his status too so you definitely know where you stand and what your options are. A lot of insurance covers the testing even if they don't cover the procedures like IUI or IVF.

If you plan to see an RE after this cycle you should probably go ahead and call for an appointment now in case there is a wait (I had to wait 2 weeks for mine and some people wait much longer) - you can always cancel if you get your BFP before then.

Good luck and lots of

 

[kriola]

Thank you so much for responding! MY MD actually referred me to an RE after I told him if it didn't work this month, I wanted to have the full battery of tests. These last couple of months have been an eye opener, PCOS can lead to so many things later in life including heart disease and diabetes! I will be calling to make an appointment tomorrow.
I have been on Metformin since the miscarriage. Thank you so much for the info on the cysts. I guess I can still hope for this month. Have been having slight cramping today at 5 DPO

 

[Mrs. Bear]

No problem. I'm happy to share any info I have. PCOS is hard enough on its own - adding the age issue on top of that and the stress of TTC can get crazy. I've been through a lot of the tests so if you have any questions feel free to ask.

I think a lot of the health risks are related to the insulin resistance/hormones stuff so hopefully knowing early will help us avoid those issues.

I think pcos is way underdiagnosed. There are so many stories on these boards that just scream pcos to me.

Here is hoping you get your BFP this month and can have the fun of calling to cancel your RE appointment