Help understanding my Transabdominal & Transvaginal results

[Naddy]

Hi there peeps,

I was wondering if there is anybody on this forum that could help me understand the results of my ultrasounds that I had done last week? It was sent to my medical records last night online, so I'm not sure whether these results mean my obgyn will be in touch regarding these findings. Thank you

FINDINGS:

With transabdominal images the uterus measures 7.1 x 2.7 x 3.8 cm. The RIGHT ovary measures 2.2 x 1.0 x 1.9 cm. The LEFT ovary measures 3.9 x 3.2 x 3.8 cm with a dominant follicle/cyst.

With transvaginal imaging, the endometrial stripe is normal at 0.3 cm. A few tiny cervical nabothian cysts are present. There are 2 myometrial cysts seen near the fundus, measuring 0.3 cm in size. The RIGHT ovary measures 1.7 x 0.8 x 1.0 cm and is
unremarkable. The LEFT ovary measures 2.6 x 2.6 x 2.4 cm with a 2.7 cm dominant follicle. No pelvic free fluid.

IMPRESSION:
1. Two small myometrial cysts are present, measuring up to 0.3 cm. This is of uncertain significance. With a normal endometrial stripe, adenomyosis is thought to be unlikely.
2. LEFT ovary contains a dominant follicle.
3. RIGHT ovary is unremarkable..

 

[Naddy]

Well, I posted this on here hoping someone would get back to me and they haven't I did call my obgyn to ask what these result meant but they haven't got back to me. I sometimes wish I still lived in England where healthcare is a single payer system , because the health care system over here in America sucks and you pay a fortune for it...

 

[RubyRainbows]

Have they gotten back to you yet? What cycle day were you at the time of this ultrasound?

 

[Naddy]

Have they gotten back to you yet? What cycle day were you at the time of this ultrasound?

Hi RubyRainbows

Thank you kindly for responding, I do appreciate it.

My obgyn nurse called me to set an appointment date for an endometrial biopsy, which I'm having done this Wednesday. I did ask her what my ultrasound results meant, but unfortunately she was very vague and said they were 'fine'! Didn't help ease my mind at all.

When I had the ultrasound done I was on cycle day 50. Right now I'm on cycle day 62 and still no AF I really don't understand what's going on.

Out of interest I did take an opk on Control day 52 and it came out positive. Don't understand that, unless I ovulated late....

My cycle days vary from, 26 days to 32, 38, 46, 48 & 60....

 

[Naddy]

Well, I've just returned from my appointment with my obgyn. I failed to have the endometrial biopsy done She couldn't get the implement through my cervical canal because it was too narrow. I've never felt so much pain in my life. I deliberately took some pain killers beforehand because of the horror stories.
Anyway, she said it wasn't of great importance right now. She said my ultrasound results were good, that the lining of my uterus was thin, which she was happy about. And that it showed a dominant follicle, so she thinks my hormones are all over the place.
After my appointment I went and had bloods taken to check my FSH and Estradiol levels.

All in all, I feel like a complete and utter failure for not being able to go through with the biopsy. She did say that woman who haven't ever given birth tend to feel more pain than those that have, but that still didn't make me feel any better

 

[cupcake23]

Hi, sorry your appt didn't go well. You are not a failure, after having my first child they tried inserting an iud, it was impossible! Had about 4 GPs have a go, oh the pain! There's really not much you can do, if they really wants biopsy then next time ask for local anaesthetic.

I'm hoping your blood results come back soon, and you can figure out what's going on x

 

[Naddy]

Thank you for your response cupcake I'm glad I'm not the only one that has gone through this. I'm more annoyed with myself!! I really am trying everything I can to find out why I can't conceive, so failing to have this biopsy done has made me feel really down That is why I demanded to have my fsh and estradiol tested. She wasn't going to, but then she agreed.

Because I'm in my 40's I always feel like the doctors are judging me because of my age. Until I'm told I'm going through menopause I will do all I can to get pregnant with #1.

I'm now on CD64 and I just want to know what's going on.....

Hi, sorry your appt didn't go well. You are not a failure, after having my first child they tried inserting an iud, it was impossible! Had about 4 GPs have a go, oh the pain! There's really not much you can do, if they really wants biopsy then next time ask for local anaesthetic.

I'm hoping your blood results come back soon, and you can figure out what's going on x

 

[ttc bubby no2]

If you have had your FSH taken on cd64 it may not be very accurate. I had a very long cycle (over 200 days) when ttc #1 and they took my FSH late in the cycle and it was borderline high (I was only 28 then) but I have since had it taken a couple of times on cd3 and it was normal. Just be weary if you get told it is high, I would suggest requesting a retest at cd3.

Have you tried any fertility meds? When I had my crazy long cycle I was given provera to bring on AF and then clomid.

 

[Naddy]

Hi ttc buddy no2

Thank you for your advice regarding the FSH level, it's funny you mentioned being weary of the results. Well I did receive them this morning and I would like your view on the result and what my obgyn said, if you don't mind of course...

FSH (Follicle Stimulating Hormone) - Result - 19.5 mIU/mL

Follicle Stimulating Hormone Reference Range
Adult Females:
Follicular Phase 3.9 - 8.8 mIU/mL
Mid-Cycle Peak 4.5 - 22.5 mIU/mL
Luteal Phase 1.8 - 5.1 mIU/mL
Postmenopausal 16.7 - 113.6 mIU/mL

Estradiol - Result - 92 pg/mL

Estradiol Reference Ranges
Ovulating Females:
mid-follicular phase 27 - 122 pg/mL
periovulatory 95 - 433 pg/mL
mid-luteal phase 49 - 291 pg/mL
Post Menopausal Females: <20 - 40 pg/mL

This is what my obgyn said about the results -

Your FSH level, which is used as marker of ovarian function, is quite high (19) - because this level can change, the use of this level to determine menopause is not accurate, and I do not think you are in menopause though you have not had a cycle in 63 days.

However, as I mentioned earlier, a level greater than 10 is discouraging for those who want to consider pregnancy. This being said, it does not mean that egg donor would not be an option. Again these and more options being available to you with the help of a Reproductive endocrinology and infertility specialist.

So what do you think?

If you have had your FSH taken on cd64 it may not be very accurate. I had a very long cycle (over 200 days) when ttc #1 and they took my FSH late in the cycle and it was borderline high (I was only 28 then) but I have since had it taken a couple of times on cd3 and it was normal. Just be weary if you get told it is high, I would suggest requesting a retest at cd3.

Have you tried any fertility meds? When I had my crazy long cycle I was given provera to bring on AF and then clomid.

 

[ttc bubby no2]

It is high but it is in the range for the mid-cycle peak so it is hard to know. I would ask to be tested again on cd3 whenever that comes.

You could ask about an AMH test which can be done any day and it is supposed to be a more accurate measurement of your ovarian reserve. I'm not sure if the test is expensive though.

Have you had irregular cycles before or is it new? Do you think you could have polycystic ovarian syndome (pcos).

You said you got an OPK+ on Cd52 so you may well have ovulated and could expect AF in the next few days (or a BFP?). It is possible to ovulate that late. I ovulated cd47 one cycle last year.

 

[Naddy]

I can't thank you enough for responding to my queries ttc buddy no2 I often sit here running all these issues through my mind and do nothing but worry, so your advice is really helping me

I would have the fsh test done again, but my monthly hasn't appeared so I don't know what to do. The initial reason I went to see my obgyn was to find out why my cycles are irregular and she doesn't seem that interested in helping me, just suggests I see a reproductive endocrinologist.

Regarding my cycles, this is a list of my cycle days -

(2016)
16th Mar - 19th Marc- Now
19th Feb - 22nd Feb - 26 days
4th Jan -7th Jan - 46 days

(2015)
17th Nov - 24th Nov - 48 days
10th Oct - 17th Oct - 38 days
2nd Sept - 9th Sept -38 days

This is the longest I've gone without a period, I just don't know what's going on. I could have PCOS and that's what I went to the doctor for, to find out what's going on, but she's so vague. I have looked at the symptoms for PCOS but I don't have many of them, so not sure.

I have contacted the nurse for my obgyn to find out if they can prescribe me medication to induce my monthly but I am yet to hear back. When I was talking with her, she did say it's a good sign that I had a dominant follicle showing on my ultrasound plus my uterine lining was perfect. So one minute she seems optimistic and the next she's saying I egg donor is an option. Just so confused and down about everything.

I did take a pregnancy test yesterday and it was negative. I would be 14dpo. I don't know, all these numbers etc confuse me lol...


....thank you once again

 

[PearlD]

Naddy, I hope you don't mind me jumping in, but I think the best advice would be to go see a reproductive endocrinologist. Most OB/GYN's don't have a clue about fertility issues, and it seems pretty clear that yours doesn't given that she's trying to judge your fertility level and whether you're in menopause by looking at FSH and E2 numbers that were clearly taken either midcycle or during your luteal phase. Those numbers don't mean anything if they aren't taken some time on either cycle day 2, 3 or 4. The RE will be able to help you get your cycle started up again, and then do a measurement of your FSH and E2 on the correct cycle day. And they'll check your AMH, which will give them the best idea of your ovarian reserve. REs are used to working with woman in their 40s and are generally much more helpful (I started working with an RE at almost 40 and finally gave birth to my son at 42 and my RE was awesome the entire time). Good luck.

 

[ttc bubby no2]

It sounds like going to an RE is the way to go as they will be much more helpful.

My cycles are averaging around 42 days when I'm not on meds. They have always been a bit irregular even when I was a teenager and I had that really long cycle and had no idea why. I only just got diagnosed with PCOS last year. I think because I am not overweight it was overlooked. My main symptoms other than the irregular cycles are acne and polycystic ovaries. I think you only need 3 to be classed as PCOS.

 

[Naddy]

Of course I don't mind you jumping in, I appreciate your point of view.
You are right, I need to see a RE regarding my fertility issues. I'm just somewhat annoyed my obgyn didn't even suggest helping kick start my cycle, because that's what I initially went there for. She did say she couldn't help me regarding fertility issues because she works at a catholic hospital.....

I am a bit dubious about seeing the RE due to being 44. I'm so worried I will get the 'your too old' spiel.

It's great to hear that your RE was so helpful, it's fab that you were able to have a little one.....

Naddy, I hope you don't mind me jumping in, but I think the best advice would be to go see a reproductive endocrinologist. Most OB/GYN's don't have a clue about fertility issues, and it seems pretty clear that yours doesn't given that she's trying to judge your fertility level and whether you're in menopause by looking at FSH and E2 numbers that were clearly taken either midcycle or during your luteal phase. Those numbers don't mean anything if they aren't taken some time on either cycle day 2, 3 or 4. The RE will be able to help you get your cycle started up again, and then do a measurement of your FSH and E2 on the correct cycle day. And they'll check your AMH, which will give them the best idea of your ovarian reserve. REs are used to working with woman in their 40s and are generally much more helpful (I started working with an RE at almost 40 and finally gave birth to my son at 42 and my RE was awesome the entire time). Good luck.

Hi, ttc buddy no2 Can you tell me what tests they do to diagnose PCOS? I too am not overweight, have irregular cycles, and do you think the two 0.3 cysts would mean I have PCOS? The obgyn seemed to believe that cysts that small aren't an issue.

Do you take any supplements for your PCOS? Is there anything you can suggest for me to take?

It sounds like going to an RE is the way to go as they will be much more helpful.

My cycles are averaging around 42 days when I'm not on meds. They have always been a bit irregular even when I was a teenager and I had that really long cycle and had no idea why. I only just got diagnosed with PCOS last year. I think because I am not overweight it was overlooked. My main symptoms other than the irregular cycles are acne and polycystic ovaries. I think you only need 3 to be classed as PCOS.

 

[ttc bubby no2]

I think the cysts from polycystic ovaries are different to what you have. I have lots of little cysts from follicles that have formed but then don't ovulate. They can clear up I think but take a while.

It really varies how they diagnose it. You can get some hormone tests done although mine were all normal last time they were checked.

I would just wait and see what an RE says. Unfortunately it could just be age related but at least they would do the tests to give you more of an idea of what you are dealing with.

 

[Naddy]

Thanks The obgyn did say the cysts I have don't affect me at all.

Thankfully my monthly appeared after 66 days without one. Longest ever!!

I'm religiously taking my bbt every morning, doing opk's here and there. It's a start at least.

I think the cysts from polycystic ovaries are different to what you have. I have lots of little cysts from follicles that have formed but then don't ovulate. They can clear up I think but take a while.

It really varies how they diagnose it. You can get some hormone tests done although mine were all normal last time they were checked.

I would just wait and see what an RE says. Unfortunately it could just be age related but at least they would do the tests to give you more of an idea of what you are dealing with.