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Re: ovarian reserve and PCOS From: Steve & Eryl Raymond (eryl@intekom.co.za) Thu Aug 14 15:48:11 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steve & Eryl Raymond: "Re: query" Previous message: Steve & Eryl Raymond: "Re: GYN: Vaginal Stenosis after repairs" Maybe in reply to: ivan valencia: "ovarian reserve and PCOS" Next in thread: Mark Perloe: "Re: ovarian reserve and PCOS" Reply: Mark Perloe: "Re: ovarian reserve and PCOS" Reply: ivan valencia: "Re: ovarian reserve and PCOS" You would find it helpful to do a day 21 progesterone with LH and FSH. If she has an anovulatory PRG and the LH is greater than the FSH by a factor of 2:1 or more then you can start thinking about PCO, but nothing else that you have posted is really indicative of PCO. On day 3 her FSH would be elevated as it is still within the menstruation. In the end you may find it easier to give her Clomiphene or Tamoxifen and see what her response is on a day 21 Progesterone. Steve ivan valencia wrote: >I have a case I want to share with you and I will appreciate some >comments. She is a latinamerican 34 years old lady who comes to the >office because of primary infertility of 6 years duration and very >irregular menstrual cycles (every 15, 30 and 60 days). Her partner had >a vasectomy (second marriage)and they are willing to have a PESA-ICSI >cycle. She have mild hirsutism and no acne complaints. BMI 26. Vaginal >ultrasound and saline enhanced vaginal ultrasound normal. No PCO >ultrasound morphology. Ovaries normal size. Her day 3 labs are as >follows: >TSH 5,2 (normal less than 4) >Testosterone 130 (normal less than 60) >Prolactin 18 (normal less than 25) >Glucose tolerance challenge test normal. >FSH 16,5. Because this result was not expected we repeated it and came >18.5 the same day. (normal less than 12). >Clinically we diagnosed PCOS and mild thyroid failure. However, the >elevated FSH levels suggest incipient ovarian failure. Now, the >irregular menstrual cycle is because PCOS or she is experiencing >premature ovarian failure? Would she benefit instead of oocyte donation? >Are ovarian reserve testing realible in PCOS? >Your comments will be greatly appreciated. >Ivan Valencia MD >CEMEFES >Portete 600 y Abascal >Quito Ecuador > -- S.H. Raymond FRCOG Principal Specialist Department of Obstetrics & Gynaecology Empangeni Hospital Private Bag X20005 Empangeni SOUTH AFRICA 3880 Phone: (+27)-35-9028560 Fax: (+27)-35-7922596 "The greatest derangement of the mind is to believe in something because one wishes it to be so". René Dubos 1876. Next message: Steve & Eryl Raymond: "Re: query" Previous message: Steve & Eryl Raymond: "Re: GYN: Vaginal Stenosis after repairs" Maybe in reply to: ivan valencia: "ovarian reserve and PCOS" Next in thread: Mark Perloe: "Re: ovarian reserve and PCOS" Reply: Mark Perloe: "Re: ovarian reserve and PCOS" Reply: ivan valencia: "Re: ovarian reserve and PCOS"

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