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

[emeraldgirl1]

Said it all above, really! But has anyone has this done and what should I expect? Will the hospital automatically assign a female technician to do the job or will I have to request that? Don't know if I fancy having a random bloke rummaging around!! And I'm presuming it's not actually painful, but all info would be much appreciated thank you!

I'm also scheduled for a blood test for what they call LH and (I think) FSH - are there any other tests I should be having done?

AND... if it comes up negative for PCOS what should I do next? (Irregular periods are worrying me) Ask for a referral to Gynae or Endocrinologist perhaps?

Ah, you are referring to dildocam!

It's about the size of a dildo and erm... it's a camera. It isn't actually painful just hugely embarassing although at the same time completely and utterly fascinating.

Good luck with everything else!

Oh and the worst bit is the little condom they ceremoniously attach to it!

It's normally a woman because it's normally the same person who does the scans for pregnancy IME but when I had it done the consultant (male) did it - he was much more gentle than the sonographer who did one when I was pregnant

This sounds like something out of a bad romantic comedy!!! Well, something to look forward to I suppose...

I've had a few of these and they don't hurt - they do try to do it as gently as possible, there is lubricant involved, and your modesty will be preserved with some paper sheeting!

If they are looking at your ovaries they will be moving the probe from side to side, which feels a little weird, but not painful. Everytime I have had one it was with a female sonographer.

The LH/FSH tests are standard too - the key thing is the ratio of these to each other. The results can be a bit variable though, so if your levels are a bit off, you might want to get your doctor to repeat them a month later.

Good luck with it x

Hi Emerald

How are you about having a smear?

If it is an ok experience for you - something you have to do to check all is well - then go with the same attitude for the ultrasound. The person doing it will have done a zillion before and will be more interested id trying to diagnosise what't going on rather than embarrased.
It may be a bloke - you can ask for a woman - you can also take a firend / partner in with you.

Whether neg or positive for PCOS you should discuss the findings and next steps with a gynae.

I've had a shed load of these done as they are part of the IVF procedure too - they are really no that bad - just try to relax.

good luck xxx

I've had a few of these (annual check ups on my remaining bits after having one ovary removed). Always the same, very nice female sonographer, they do preserve your dignity as far as possible.

I always felt a bit grotty after them so used to try to go straight home for a nice bath and not go back to work if possible. I really don't like hospitals though, specially the one this was at, so I think that added to the grottiness. Doesn't hurt, just feels weird.

Best of luck.

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.

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

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!

Thanks everyone!!

Mrstittlemouse - actually we haven't started TTC yet - we are preparing to start TTC, if you know what I mean!! I'm 32 (almost 33, feels the long march of time weighing heavy on bones) and have only just realised that I probablly need to work out the reason for my constantly erratic periods if we're ever going to have the chance to get pregnant. And because I'm a control freak and have to have my house in order before I even start - possibly not the kind of personality that's going to enjoy TTC (!)

Chocolatedays - actually I don't mind smear tests at all, really. Never painful, just undignified. And I'm an old hand at brazilian waxing so nothing should embarrass me really. I might just ask beforehand if it'll be a woman doing the scan though as the least I want is to be prepared... That'll be the control freak thing again...

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.

hmmm.... actually, the issue is that I'm not mentally ready at all!! Hoping that getting physically ready will kick-start the whole getting-mentally-ready thing...

I have stopped taking the pill, though. But not stepped away from the condoms yet...

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.

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).

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

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

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

Thanks namechanger, glad to hear things are working out for you (I hope??)

And yes you're right, I will definitely pursue further investigations etc if the results come back positive OR negative. Always good to know what you're dealing with, I think.

PortBlacksandresident - you made me lol

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!

Hi RunLyraRun - love your name...

Yes, you sound in a v similar position to me! I was told I might well have PCOS ten years ago when being treated for an eating disorder, even though I didn't have any external symptoms. I still think I don't have any external symptoms, though I have had 2 outbreaks of adult acne in my life (though both coincided with massive stress so could have been that) and as for this "do you have excess hair?' question, well, I don't know!! I mean, I don't think I have any worse than any of my other friends, but who's to say what is 'excess' for Pete's sake??!

Well, I'm having to wait for the tests another 6 weeks or so because GP wants to be certain my body has readjusted to having come off the pill about 6 weeks ago. Something to do with the follicles apparently. If nothing helpful comes from those, I will certainly pursue the other test you mention re progesterone... Thanks so much for the tip! GPs seem to want to give the minimum info possible sometimes. I think I would struggle with the test though as at the moment my cycle is anything between around 35 and 55 days.

I'm still not convinced it is PCOS but I think this is a good place to start!

V glad to hear you at least got some answers - and maybe that mental readiness will suddenly kick in... Am starting to think the best way is just to say hang it all and see what happens!!

Though that's a lie, of course

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.

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.

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.

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?

Thanks so much Attila, that's great info!

Seeing as it sounds like you're a PCOS old hand (!) can you give me any info on what can be done if I do have it? Would docs just advise starting to TTC, or would they be advising drugs (are there even any??) Bit of a novice here, sorry!

I didn't realise you can have periods without ovulating. I was on mini-pill (Progesterone only) so I don't know if that makes a difference as (correct me if I'm wrong) I thought only the traditional pill gave you that 'fake' period...?