Polycystic Ovaries (PCOS) - can you help my friend out???

[looneytune]

Hi

A good friend of mine has been TTC for 2 years and I really feel for her (doesn't help that I have a 5 week old baby and of course he has to come with me when I see her).

Anyway......a while back her dh's sperm was tested and they were told he had slow swimmers so they thought that was causing it to take a long time but then in May, she got a positive test result but pretty much immediately followed a really heavy, clotty & painful period which she is pretty sure much have been a miscarriage (I've had one and what she described definitely sounded like it)

She was scanned recently to see what's going on as it's been a long tim TTC. One ovary was looking like was about to release an egg according to the scanner, nice big folicle I believe is what was said? Then the other side shows lots of little folicles (I think this is what she said) in a sort of necklace shape and the person who spoke to my friend after about the results explained that it look like a Polycystic ovary.

She's got to wait until Sept to see the specialist at the fertility clinic so I'm trying to find out what I can for her (she has no internet) in the meantime.

She doesn't have any of the usual signs i.e. funny period, ache, overweight, hairy etc.

Oh, another thing, she was told not to use a monitor like persona as not realiable yet she said her cycles are regular 30 days and that she's been getting an egg symbol and it's been around the right time she'd expect etc. Funny enough though, this month she didn't get the egg showing - any idea what this is all about?

Basically, is there anything my friend can do to help her chances? I know they have things like clomid etc. but aren't these to regulate the cycles? If so, there's no point for my friend.

TIA

I have PCOS and had clomid to get preggers

IIRC you start on day 2 of cycle so it doesn't matter what cycle is doing

BUT this was 13 years ago so ideas have prob changed now

Hi. Your friend may or may not have PCOS - there is a dispute over diagnositc criteria, and many women without PCOS have ovaries with cysts.

She would need a blood test to measure hormone levels to get a diagnosis. And some women with PCOS ovulate, so will not need clomid in any case (this might explain why the Persona is showing egg symbols. And even healthy women with out PCOS have some months when they don't ovulate.)

I think that I would wait to see the specialist - the results of the blood test are key to establishing whether she has PCOS, whether or not she is ovulating, whether there are hormone issues that predispose her to early miscarriage, and if she has any of this, what to do about it.

Are they doing anything at all about her dh's fertility issues?

Hi Looneytune,

It is nice of you to be so concerned for your friend in such a manner.

You can have a condition called polycystic ovaries without any of the other symptoms associated with the syndrome (PCOS) itself. The polycystic ovary is often described as having a "ring of pearls" appearance which seems also to tie in with that the sonographer said.

PCOS though is a very individualistic disorder and affects each woman with it very differently. The commonality though between PCO and PCOS are the cystic follicles associated with the condition. These can and do disappear but only to be replaced by further cystic follicles.

PCOS is the cystic follicles with also one or more symptoms associated with the condition e.g irregular periods to name but one.

Raised LH levels as well have been implimented in miscarrying, some women with PCO/PCOS can run a higher than average risk of miscarrying. Careful management of this condition therefore is essential.

Any test results over six months should be discounted and up to date test results should be sought asap particularly with regards to her husband. I would agree with Firepile's point that both these people should be treated in tandem. It is little point in trying to treat her fertility problem alone if he has an ongoing male factor problem. He should have more semen analyses done as a matter of course. Both of these people as well should attend the appointment in September if at all possible.

It is quite possible also to have periods without ovulating. Her persona monitor is not worth using in these circumstances - these kits measure levels of LH. As many women with PCO have an excess of LH to start with these kits can give false positive readings - the kit reads the excess LH. Also mutliple positive results can happen too - it is not correct to assume that there is only one rise in LH every month.

Clomid is designed to make the ovaries work harder (regulating cycles is not its job). It is not always suitable for all PCO/PCOS patients to take (it can increase LH levels) so it should always be given with a degree of caution. Monitoring should be done as a matter of course whilst on this drug treatment.

Verity's website is good for information and would suggest also that your friend contacts them www.verity-pcos.org.uk.

There is not much at all your friend can do in the meantime except wait for the appointment with the cons. Your friend should also not self medicate with Agnus Castus as this can make some hormonal problems worse. Would also refrain from using the Persona due to the above.

If your friend can remain with the correct weight range for her height so much the better. Excess pounds can excerbate symptoms and there is a fine line between PCO and PCOS anyway.

HTH, any other questions just ask

Attila

Thanks for that. She's having blood tests shortly, they need to be done on a set day.

I'll ask her about dh as that wasn't mentioned this time (he was there). I believe they were left to it after he was told that and I came on here months and months ago to ask about it and was advised on certain diet/vitamins etc.

What she'll likely have done initially re blood tests is a day 3 which will measure LH and FSH levels (these MUST be compared against one another otherwise the test is meaningless) and day 21 (to measure progesterone). She will also likely have more internal ultrasound scans done to see what the ovaries look like, polycystic ovaries can also appear larger than normal (walnut) size.