PCOS investigations - anyone had the transvaginal ultrasound and what to expect?

I have my ultrasound this Saturday... at least I know what to expect now, ta folks!

I've had the internal and can tell you that it doesn't hurt at all. They do lob on the old lube quite liberally!

I had a female tecnicial and then when having a consultant's appointment with Bupa my male consultant did it with a female nurse present.

Not a problem for me, more worried about needles dand blood, give me an internal anyday of the week!

RunLyraRun

Please follow up these blood test results! Its your body you deserve to know what is going on and as for describing them to you as "nearly normal" that is shameful for a doctor! on your behalf! As soon as you get a diagnosis then you can start treatment options.

I am now a parent too after a long hard fertility battle but it was worth it.

Emeraldgirl, Atilla is correct in saying you can have a bleed without ovulating so it is important to make sure you are ovulating before TTC, please check out the verity website. It really helped me as I was given practically no information from my initial consultant, just told to take clomid, get blood work done regularly and wait and see. In hindsight I should have pushed for more. I am angry now that I didnt so please dont follow my path and get things sorted as soon as you can. It took me 8 years to conceive, although eneded up conceiving naturally after lots of treatments from gynae and assisted conception.

There are many knowledgeable people on here with regards to PCOS so please dont be afraid to ask anything or for support. You will get answers ans help without hesitation.

Hope all is well with you

x

Thanks Attila. I didn't think that was a very helpful comment from the gynae!

Fortunately I saw a different one last time, who was lovely, so hopefully I will be able to stick with her. I will ask her about the bloods next time I see her.

I suppose I am an old hand!. I was diagnosed with PCOS some years ago now and am a parent.

I would look into getting a gynae referral asap as longstanding irregular periods are certainly problematic to have when ttc. PCOS as well is a condition that should not be messed around with by GPS. Its a problem that is generally outside their general remit of understanding, it often needs specialist help from a gynae in order to conceive.

Clomid is usually prescribed initially but a person should be monitored whilst on it. No monitoring whilst on this is a no-no as it can markedly affect hormone levels. Some PCOSers as well can become clomid resistant; it is certainly not suitable for all PCOSers to take. It can increase LH levels which is something that many PCOSers have an excess of to start with. This is why monitoring is adviseable throughout the time you're on it.

A course of clomid lasts for six months after which time other treatments should be tried (these include injectible drugs and ovarian diathermy surgery).

A person is less likely to be ovulating regularly if at all if periods are irregular.

The pill can mask symptoms of the underlying problem regardless of what type of pill that has been taken. A withdrawal bleed is not an ovulatory one.

namechangerforareason has mentioned Verity. Its a very good UK based website for PCOSers.

www.verity-pcos.org.uk

Hi RunLyraRun

I would certainly ask why the bloodwork results were described as "nearly normal". That means they were not and it should be properly explained to you by the gynaecologist (presumably this was the person who requested the tests in the first instance).

Thanks for that clarification Attila. Sorry to hijack, but when I had my initial bloods and ultrasound, the letter from my gynae to my GP just said that my bloods were "nearly normal"!! - do you think it's reasonable to ask what they were?

There is no evidence to suggest that the pill is responsible for failure to ovulate but what the pill can do is mask symptoms of any underlying problem. The pill leaves your system very quickly after taking the last tablet.

emeraldgirl,

The internal ultrasound is truly as has been described - have had more of those than I could count honestly and they are not awful at all. They are very useful and a good sonographer can tell how cystic the ovaries are.

You need a diagnosis first and foremost.
I think PCOS could well be a strong possibility for the irregular periods in your case. They're going to be looking at your LH and FSH levels as well (which is a common test to see if PCOS is present). Re that LH/FSH blood test you MUST ensure that the LH level is compared against that of FSH. Usually with PCOS, the level of LH exceeds that of FSH consistently.

LH and FSH are important hormones as these kickstart the ovulation process. If these are awry then ovulation is affected. It is also quite possible to have periods without ovulating (which is likely in your case as well as your periods are irregular).

If your LH and FSH levels are awry then your progesterone level will be low as well.

PCOS is a very individualistic disorder and affects each woman with it very differently. I was diagnosed with this based on my bloodwork and a few stray hairs.

Asking for a referral to a gynae post these tests is certainly not an unreasonable request particularly if PCOS is confirmed.

I'm no expert but I believe it could even take a while longer than that for everything to settle down?

I stopped taking the pill nearly 2 years ago, and during the first year my shortest cycle was 33 days, longest 62, with the rest in the 40's. During this second year they have reduced to anywhere between 28 and 38 - not exactly regular but a lot better.

I haven't had any other lifestyle changes to make (weight, diet, exercise all in good nick), so I believe it might have taken my body a good number of months to get back in the swing of things. Everyone's different, of course.

Re: the definition of PCOS, I believe you have to have at least 2 out of 3 of a) irregular periods, b) external signs, and c) signs on ultrasound (ie lots of immature follicles).

I don't think you HAVE to be either spotty or hairy! Another indicator a lot of people have is struggling to maintain their preferred weight.

Hello emeraldgirl, I'm in a very similar position to you (as it were!) I'm 33-going-on-34, not yet mentally ready to TTC, so trying to get physically ready first as that seems easier somehow

I chucked out the pill a while ago but am clinging to the condoms. I thought I probably had PCOS (had acne for 20 years ) so came off the pill so that I could get diagnosed (I was right, by the way I do have PCOS). I had a male ultrasound practitioner BUT I had an external ultrasound so that didn't matter. I wonder why i didn't have transvaginal - anyone know?

My GP recommended that I also have blood test on CD21 to measure progesterone, that tells you whether you've ovulated. That's a pretty standard test too, but of course you have to have your blood taken on day 21 or thereabouts - has anyone mentioned that to you?

NB day 21 is when they test progesterone in a "normal" cycle, if yours is shorter or longer they will need to adjust that day accordingly - my gynae has asked me to get my tests done on day 21, 24, 27 to be sure!

Sorry forgot to mention, whether the results come back pos or neg for PCOS make sure you discuss all treatment options and referral to specialist gynae who can deal with your case be it PCOS or something else.

Dont be afraid to ask for this referral.
x

Hello,

Hope that all goes well for you.
I have PCOS, diagnosed quite a few years ago now.

The transvaginal ultrasound isnt that bad, the sonographer will have done it loads before and you are within your rights to ask for a female to perform this test. Usually is a female though. I had it done loads as I needed fertility treatment and to be honest after a few times it doesnt even phase you, just another test. Easy to say but try to relax. The sonographer will move probe about to scan your ovaries and its not painful, just not very comfortable.

The bloods are routine as someone has mentioned its to get your LH/FSH ratio, mine was way off the charts! LH 4x my FSH where they shoud be realatively similar but if they are off please get rechecked at GP a month or so down the line.

I had a laparoscopy done too, have the teeniest scar ever! Doc put dye through my fallopian tubes to check they werent blocked.

I dont have any other PCOS symptoms other than the irregular heavy painful periods.

great website verity

Hope it all works out for you and good luck x

Did make me wonder if you need to tell the blood service if you put anything else up there though .

I posted something similar about a year ago and got much the same reassurance. Edging your bum to the end of the bed and getting your feet in the right place is the hardest bit.

Didn't hurt at all and less invasive than a smear as they don't use a speculum.

Oh, and you can't give blood for 6 months afterwards. Something about it being inserted into the body (only found this out when i turned up to give blood).

Actually, I think that most of us aren't mentally ready - and it works out alright. If there's any concern about your age then I personally would go for it now - or at least when you see your DH next.

Ah I see! "Hello!", from a fellow control freak.

But if you're mentally ready to have children then there's nothing stopping you from throwing away the contraception now. Here's hoping that you're announcing a very unplanned pregnancy on MN next month.

I've had these as part of normal gynae check ups.

It's as others have said like a large white dildo attached to a cable. When I've had it done you remove your trousers and pants in the bathroom and come out wrapped in a paper sheet. Hop onto the bed and either put legs in stirrups or bring knees up to your bum like for a smear.

They squirt a load of lubricant on the probe, put a really baggy condom on it and then gently insert it. With me the sonographer has always been really gentle, easing it in from side to side. Once it's in they then move it around from side to side gently, so they can see each ovary. This part may be a little uncomfortable, but definitely not painful. And in my experience the sonographer always explains what he/she's about to do so you aren't taken by surprise.

Just try to relax and even have a laugh with the nurse or sonographer - in my last one the nurse was a hoot!

I found it much easier than a smear, by the way. No speculum and no scraping.

It was the least bothersome of all my investigations, to be honest. The technician was very gentle. If the ultrasound and blood tests come up normal then the other test that they could do it an HSG (dye in the uterus and Fallopian tubes). That's more expensive and takes longer to arrange, normally. How long have you been TTC? How old are you? They might suggest that if these tests are normal that you try naturally for a while before going for more tests. Your DH/DP is getting tested as well I hope. Male factor infertility is as common as female factor.