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Suggest Treatment For PCOS

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Posted on Thu, 13 Mar 2014
Question: HELLO Dr. XXXX here. Age 31. Want to conceive. Got pelvic Ultra Sound Scan done..showed Multi Cysts in both the ovaries. Using Thyronorm 12.5 coz TSH showed 4.5. NO PROBLEM with my Husband.
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Answered by Dr. Dr. ARIF N K (20 minutes later)
Brief Answer: Kindly reply few questions. Detailed Answer: Hello XXXX, Thank you for choosing Healthcaremagic. I have analyzed your query, but I need some more information to come to a conclusion: Since how many years of married life? Does you and your husband have any coital (sexual intercourse) problems? does your husband have erectile or ejaculatory dysfunction? How are your periods? are they regular or irregular? if irregular, how irregular are they (let me know the exact frequency and duration of your periods). HAve you undergone hormonal evaluation for FSH, LH (follicular stimulating and leutinizing hormone) and prolactin levels? Have you checked for fallopian tubal patency? Please ask if you have more questions, and do write back with the answers so that I can guide you further. Awaiting your response. Regards Arif
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. ARIF N K (18 minutes later)
3 years of married life but only from last 1 year, we are trying for pregnancy. No intercourse problems. My periods are irregular, once in 2 months. Yes, Hormonal evaluation showed FSH 5.51mIu/mL, LH 9.97mIu/mL, Prolactin 21.7ng/mL. No idea about Fallopian tubal patency. My Dr. prescribed progeten tablets but I didn't use till now. I'm afraid about my pregnancy. Will I be able to be a Mother or not ?? Plz advise me.
doctor
Answered by Dr. Dr. ARIF N K (2 hours later)
Brief Answer: It could be due to PCOS. Detailed Answer: Hi XXXX Thank you for the reply. After analyzing your reports, I think you are suffering from PCOS(poly cystic ovarian syndrome), this is due to change in hormonal levels, irregularity in periods and also scan showing poly cystic pattern. Your prolactin level is normal. Considering all these reports your main problem is PCOS which is causing ANOVULATION i.e no proper ovulation occurring (no cyclical egg releasing). Your doctor might have given you progestin to get withdrawal bleeding, so that further treatment can be planned. According to me you need further evaluation of fallopian tubes. I personally feel its better to go for Diagnostic Laparoscopy (for checking fallopian tube patency) and OVARIAN DRILLING (as you are having PCOS). If that is normal then you need ovulation induction with Clomiphene citrate and IUI(intra uterine insemination). KINDLY DO NOT WORRY. YOU WILL DEFINITELY BE A MOTHER IF YOU FOLLOW THE STEPWISE FERTILITY TREATMENT. Please ask if you have more questions. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. ARIF N K (50 minutes later)
Thank u very much for ur advise. The tablets are Progeten 200 & not progestin. Should I have to undergo a painful treatment. Will there be side effects for PCOD treatment. I'm a banker by profession. Will I be able to do my job normally, while undergoing treatment. Approximately, How long will it take to conceive in these cases like mine. Is this type of treatment expensive?? Is there any alternate & easy method?? Tha names Ovarian Drilling & Ovulation induction, sounds to be frightening. I'm taking Thyronorm daily. Shall I take Progeten 200 also. Dr. said that these tablets have side effects like dizzyness, etc. From yesterday, I got periods but flow is not there. It is very scantily bleeding. Not even 1 diper was completly wet. Should I visit the Doctor again. I'm afraid that my Dr. would scold me for not taking Progeten 200 till now. I didn't take coz I got fever last week. With Progeten 200 tablet, Dr. said that I would get periods & also told me to visit her on the SECOND DAY of the period. Now, without taking that tablets, I got period. What to do now???..Plzz advise...
doctor
Answered by Dr. Dr. ARIF N K (41 minutes later)
Brief Answer: laproscopy is safe.. Detailed Answer: Hi, Thank you for choosing Healthcaremagic. Hello XXXX I can understnad your concerns, coming back to your questions: Progestin are natural progesterone tablets, they are given for withdrawal bleeding. Even if you get pregnant when you are on this drug it wont affect the growing baby. Hence I feel your doctor suggested you this medication. Diagnostic laparoscopy is my personal opinion, considering your PCOS. Bo the PCOS and checking fallopian tube patency both can be dealt simultaneously with this procedure. Diagnostic laparoscopy is not a painful procedure, it is done under general anaesthesia, most of my patients withstand this procedure without any problems. Within 5 to 7 days you can resume your normal actvities. It is almost like a day care procedure. Kindly do not get frightened, it is a safe procedure if done under expert hands. Coming back to your other questions: Approximately, How long will it take to conceive in these cases like mine? It depends, each individual is different. Some of my patients conceive within 2 to 3 cycles after the laparoscopy procedure. Is this type of treatment expensive?? No too much. In my center it costs around 15,000 indian rupees. Is there any alternate & easy method?? You can go for HSG (hystero salpingogram) where X-ray is taken to confirm fallopian tube patency and same ovulation induction with drugs. I'm taking Thyronorm daily. Shall I take Progeten 200 also? You need to continue thyronorm. I personally feel there is no need to take progeten as you ahve already got your periods. Light bleeding could be due to hypothyroidism. Kindly do not worry, and do visit your doctor on day 2 of period. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept my answer so that I receive credit. Thank you, Wish you good health. Regards, Dr Arif You can consult me again directly through my profile WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. ARIF N K

OB & GYN Specialist

Practicing since :2007

Answered : 1303 Questions

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Suggest Treatment For PCOS

Brief Answer: Kindly reply few questions. Detailed Answer: Hello XXXX, Thank you for choosing Healthcaremagic. I have analyzed your query, but I need some more information to come to a conclusion: Since how many years of married life? Does you and your husband have any coital (sexual intercourse) problems? does your husband have erectile or ejaculatory dysfunction? How are your periods? are they regular or irregular? if irregular, how irregular are they (let me know the exact frequency and duration of your periods). HAve you undergone hormonal evaluation for FSH, LH (follicular stimulating and leutinizing hormone) and prolactin levels? Have you checked for fallopian tubal patency? Please ask if you have more questions, and do write back with the answers so that I can guide you further. Awaiting your response. Regards Arif