-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: ovarian reserve and PCOS From: Mark Perloe (mperloe@ivf.com) Sat Aug 16 09:07:39 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Incompetent cervix at 6 weeks" Previous message: Mark Perloe: "Re: ovarian reserve and PCOS" In reply to: ivan valencia: "ovarian reserve and PCOS" Next in thread: ivan valencia: "Re: ovarian reserve and PCOS" Reply: ivan valencia: "Re: ovarian reserve and PCOS" PCOS and diminished reserve would be independent conditions, although androgens drop as ovarian function diminishes. In the absence of PCO appearance, I would check a 17hyrdroxyprogesterone in the follicular phase to rule out adrenal hyperplasia. Observation at intervals may reveal increasing androgen levels suspicious of a tumor. An insulin glucose tolerance test may show relative hyperinsulinemia and merit diet and metformin treatment. Implantation may be reduced due to elevated androgens. SO that this would need to be normalized before oocyte donation is considered. At 11:39 PM 8/13/2003 -0500, you 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 -- Mark Perloe, M.D. <http://www.ivf.com/>Georgia Reproductive Specialists IVF.com "no president since Herbert Hoover has actually lost jobs over the course of his term." Yet Bush has his eyes on that record. <http://www.georgiaforwesleyclark.com>Draft General Wesley Clark, a necessary voice of common sense and moderation on the foreign policy front. Next message: Richard Chudacoff, MD: "Incompetent cervix at 6 weeks" Previous message: Mark Perloe: "Re: ovarian reserve and PCOS" In reply to: ivan valencia: "ovarian reserve and PCOS" Next in thread: ivan valencia: "Re: ovarian reserve and PCOS" Reply: ivan valencia: "Re: ovarian reserve and PCOS"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Jul 2 04:36:05 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.