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Have Poly Cyst Ovaries, Taken Medicine. Follicular Scan Showed Follicle In Large Size. Suggest?

Posted on Tue, 17 Sep 2013

Question: Doctor,
I herewith attached my wife s follicular scan Reports.As per the first Scan Report she has poly syst ovaries.As per the second Scan Report after taking Medicines And Injuctions,the follicle are in larger size.Also showing utreus as subseptate.Is there any chance for pregnancy and Ovulation?What is subseptate utreus?Please explain.

Regards XXXXXXX XXXXXXX

Answered by Dr. Dattaprasad (11 hours later)

Brief Answer:
Ovulation probably already ocured.

Detailed Answer:
Hi,
Welcome to XXXXXXX
For pregnancy to occur, apart from ovulation, normal semen analysis & patent (open) tubes are required. Kindly upload the semen analysis & tubal patency test results (hysterosalpingogram/sonosalpingogram/laparoscopy) if already done.

Regarding ovulation, in second scan done in August, it appears that ovulation has already occurred.

Subseptate uterus: Normally two half of uterus fuse to form single cavity before a girl's birth. If upper half fails to fuse properly, it appears as small growth in uterine cavity as septum/subseptum (if septum is very small). Subseptate uterus doesn't cause infertility, but may sometimes be responsible for abortion if embryo attaches to septum.

To know chance of pregnancy, following information is needed;
1. Duration of marriage, how many months/years you are trying for pregnancy?
2. Are wife's menses regular? What is the length of menstrual cycle?
3. Was semen analysis performed? If yes, what was the result?
4. Was any tubal patency test performed? If yes, what was the result?
5. What treatment you have received till now.

Awaiting reply.

Regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dattaprasad (7 hours later)

Doctor,

Our marriage was on XXXXXXX 2012. But we are trying for pregnancy from XXXXXXX 2013 onwards. Means we are trying for pregnancy last 8 months. But it was not successful. So I had done Semen Analysis first. As per the analysis report, it is normal. I here with attached that report for your reference.

Then we consult with an infertility specialist. After checking my wife 's first scan report, he said that she has PCOS. He prescribed medicines like Bigomet and F gam tabs. Also prescribed injection Ivfm 150 for 2,4,6,8 days of period. Then scanned on 11th day. This month we are intercoused on 12,13& 14th day. Now waiting for the result.

Our Doctor suggest that laproscopy is best for this.

Doctor what is your opinion? Please explain.

Regards XXXXXXX XXXXXXX

Answered by Dr. Dattaprasad (8 hours later)

Brief Answer:
Laparoscopy can be done later.

Detailed Answer:
Hi,

I still don't know whether wife's menstrual cycles are regular or not, because further treatment will depend on that factor. Also whether any other tubal patency test was performed?

If wife's menstrual cycles are not regular, you have to try at least 6 ovulatory cycles (Cycles with egg formation & rupture) before going for invasive treatment. Last month in July, there was no growing follicle seen on scan. So you have effectively tried probably for 7 months. As previous details about egg formation I don't know, if wife had ovulation for at least 6 months, you can go straight for laparoscopy. If If ovulation has not occurred in all cycles, you can wait for 2-3 more cycles before going for laparoscopy.

If cycles are absolutely regular with ovulation in all previous cycles, you can still wait for 3-4 months before going for laparoscopy.

If you have not done any tubal patency test, its time to get at least some noninvasive test like hysterosalpingogram/sonosalpingogram done.

On general advice for conception is not to restrict intercourse around ovulation, you can have 3-4 times per week. It will take away stress & increase chances of conception.

Let me know if you have other concerns.

Awaiting reply.

Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dattaprasad (40 minutes later)

Doctor,

My wife's last 7 month Cycle details given below.

24-DEC-12 38 DAYS
31-JAN-13 33 DAYS
05-MAR-13 29 DAYS
03-APR-13 33 DAYS
06-MAY-13 38 DAYS
13-JUN-13 29 DAYS
13-AUG-13 IN PROGRESS

Avg.Cycle length- 34 Days
Longest Cycle - 38 Days
Shortest Cycle - 29 Days

We will done tubal patency test soon and inform you.
Our doctor suggests IUI also.Is it sucessful in this case?

Regards XXXXXXX XXXXXXX

Answered by Dr. Dattaprasad (38 minutes later)

Brief Answer:
IUI will increase chance of pregnancy.

Detailed Answer:
Hi,
Welcome back.
Wife's menstrual cycles appear fairly regular. You can do tubal patency test as advised, if she doesn't conceive in this cycle.
Regarding IUI, if done with superovulation with Inj FSH (what you had done in this cycle), it will triple the chance of pregnancy. So you can go for it after confirming tubal patency.
Let me know if you have other concerns.

Regards.

Above answer was peer-reviewed by : Dr. Prasad