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Re: PCOS: Infertility - PCOS correct diagnosis????
From: Walter Futterweit, MD, FACE,FACP (anonymous@obgyn.net)
Tue, 27 May 2008 21:59:57 -0500 (CDT)
At Tue, 27 May 2008, anonymous@obgyn.net wrote:
>Dr. Futterweit:
There appear to be multifactorial causes of the infertility:
1) anovulation. PCOS is likely with that and irregular menses (80%).
2) Any evidence of elevated insulin levels or a look at prolactin, and
non-classic congenital adrenal hyperplasia? The diagnosis of PCOS is
probably correct but the above studies and testosterone and free T is
lacking.
3) A male factor may also play a role.
4) The need for a reproductive endocrinologist is pressing and more
studies are needed.
5) ?Lap. Not yet in my view.
Good luck
Dr. Futterweit
>Are you also on Metformin ? It is an insulin sensitizer that helps to
>improve how your cells use insulin. Have you been seeing a Reproductive
>Endocrinologist ? They usually are up on the current management of PCOS.
>It sounds like you have several factors affecting your fertility. The
>best treatment is to get everything into as normal a balance as possible
>and that improves the use of Clomid and other medications. ...
>
>At Tue, 27 May 2008, TK wrote:
>>
>>For a few years now I have been living with the diagnosis of PCOS. I am
>>now 29 and my partner and myself have been actively trying to conceive
>>for 2 years now and have had unprotected encounters for 6 years before
>>that without the use of birth control, etc. During that time I was
>>monitored by a gynecologist for ovarian cysts, anovulation and abnormal
>>cycles. A few years ago I was finally told that I had PCOS. My
>>progesterone levels where low and my FSH:LH levels are 1:4. No other
>>hormone levels are outside of the normal range and my weight is in the
>>middle of the normal range(5'5", 125lbs). I had a tubal X-ray and
>>everything presented itself as normal aside from the fact that I have a
>>retroverted uterus. I have undergone a 6 month treatment of Clomid with
>>IUI, as my partner has also been diagnosis with low sperm count and low
>>mobility(smoker and 1 undescended testicle operated on at 12 years of
>>age). During that time the ultrasounds showed I was ovulating each
>>month but pregnancy was never acheived. We are now moving to a short
>>course of superovulation with IUI(1 month on 1 month off for 6 months).
>>If ovulation was acheived is it possible there was some underlying issue
>>of egg quality? Is it possible PCOS is the wrong diagnosis? Should we be
>>scheduling a laproscopy before starting the new treatment? Any insight
>>that can be provided given our history would be greatly appreciated.
>>
>>--
>>TK
>>
>--
>Pat Sonnenstuhl, CNM, CPPI, CHt
>Peace on Earth Begins with Birth
>Birth Counseling and Fertility Therapy
>http://home.comcast.net/~prebirthhealth/birthcounseling.htm
>Hypnosis for Healing
>http://home.comcast.net/~prebirthhealth/hypnosisforhealing.htm
>Peaceful Birthing
>http://www.peacefulbirthing.org
>
--
Walter Futterweit, MD, FACP, FACE
Clinical Professor of Medicine, Division of Endocrinology
Mount Sinai School of Medicine, New York, NY 10029
http://www.aacehost.com/pages/page.php?r=716
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