First Ultrasound - question about results

[LadyLucinda]

I had my first ultrasound today, (TTC 28 months with no results), AF is due tomorrow, the ultrasound was a baseline scan and they did measurements and counted my follicles.

I didn’t get much info as it will all be sent to the clinic (along with the HSG results) but radiographer said I had 18 follicles on one side and 12 on the other. Is this normal? It seems quite high.

I’m 33, low BMI, regular 25 day cycle (that has only been late once in 5 years), I do have painful periods and hormonal acne.

TIA

Its a good count, fingers crossed they get to the right size for you.

I had 18 on my 1st round but got ohss however i know some people with pcos get a huge amount of eggs. Different people react differently to the drugs but you have a very good number there xx

Hi @LadyLucinda I had 17 follicles on each ovary so a total AFC of 34 on my baseline scan. In some cases having a high AFC can mean PCOS but only if you meet the other diagnostic criteria: having less than 6-9 periods per year and/or high levels of testosterone.

In my case it was just high, the good news is people with a high AFC respond well to stims in Ivf, however it does increase the risk of ovarian hyperstimulation syndrome. In my cycle they gave me low dose stims, I got 12 eggs all were mature and I ended up with 9 blastocytes (I’m 35).

Hopefully mine are just high as well. I don’t think I have PCOS although it’s not something I’ve ever considered, mainly because I have very regular cycles but I do have very heavy painful periods. They happen every 25 days and last about 7 days - I feel like I’m on more than I’m off!

The GP put me on the pill when I was about 15 because I was passing out and missing school. I guess in hindsight my mum or I should have asked them to look into it more than just take the pill but it fixed the problem at the time.

We should have our appointment in a month or so to get all the results and discuss the next stage.

Apologies i didnt mean to imply you had PCOS i was told i had pcos at 1st for no reason other than i had been trying for a while without result which was later confirmed that i didnt. (Ovaries and periods were completely fine) i just had a good reserve.

I just meant some people who have pcos have loads of eggs with stimms. If this is just your reserve scan it is very good and sounds like you have great egg reserve.

Both of you should be tested.

Given your history of painful periods I would be wondering if endometriosis is infact the root cause. It is both very common and very much diagnosed mainly because the surest way to detect it is through a keyhole surgery op called a laparoscopy. The pill would merely mask the symptoms of any underlying issues.

An ultrasound scan will not detect endometriosis if it is there. I would suggest in the meantime that you keep a pain and symptom diary if you do not already do this.

It is both very common and very much UNDER diagnosed mainly because the surest way to detect it is through a keyhole surgery op called a laparoscopy

Thanks @AttilaTheMeerkat I thought I might have endometriosis, I also have bad acne which I think is a symptom of endometriosis. I don’t think the hospital really care though, my problem is infertility and the solution is probably IVF. I suspect I will have an unexplained fertility diagnosis and offered one course of IVF.
I was told you have to have been trying for over 2 years with no MC or anything (which we have) before they will do IVF but they said at my last appointment if it’s unexplained we will have to try another 12 months on top of the 2 years. It’s so frustrating, with everything being over the phone it feels like you are on a conveyor belt and you don’t really get answers.

Do you still have a lot of follicles with endometriosis?

No, acne is not a symptom of endometriosis but can be indeed linked to PCOS. There is a very fine line between polycystic ovaries and it’s related syndrome of PCOS. The polycystic ovary can appear to be larger than its usual size (about the size of a walnut) and has a string of pearls appearance with lots of follicles. These follicles can disappear, only to be replaced by further cystic follicles. The polycystic ovary has follicles that release hormones that affect ovulation or are dormant. One may contain an egg.

You should not receive a diagnosis of unexplained because it is no diagnosis at all. All this means is that they have failed to find out what is wrong. Sometimes too it is given to couples when they have not been adequately investigated. Do not ever accept an unexplained diagnosis!.

If you are in the UK read the NICE guidelines and highlight those.
I would seriously consider going to another hospital in the nearest large city to you if this is how you’ve been treated and otherwise fobbed off to date. I personally would not want to return to the unit you’ve been seen at. It is fair to say too that some sub fertility units are far better than others. It’s vital that you two as a couple and the staff in the unit can work as a team.

It may well be that IVF is not ultimately necessary. It should ideally only be tried after all other treatment options have failed. As previously mentioned as well both of you need to be tested further.

You need a diagnosis first and foremost and you will need to be persistent in order to get answers. Educate yourself on PCOS and endometriosis, this could help you when it comes to making treatment decisions.

I had an AFC of 34 (I believe they saw more follicles during stims though) and I was fine :)
I have had a couple of suggestions if PCOS maybe but never been tested or mentioned until I had my day 5 update but I have no other symptoms of it so I'm unsure.
I was on the lowest dose of stims and also a high OHSS risk. I had egg collection two days early as I responded well. Had to have a freeze all though due to OHSS and also as I had fluid in my lining so a fresh was ruled out. I was given a different trigger to avoid OHSS also.
Everything they did worked! As other than feeling a tad tender when walking the following day I had zero symptoms of OHSS and felt completely fine after! Must have been the litres of lucozade sport I was drinking haha

I'm also 'unexplained' although all tests done. IVF is sort of a 'test' for us so we can see how far/which stages we get to and if anything comes up. My clinic have been amazing so far at keeping me right