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Trans Vaginal Ultrasound Scan Shows Multiple Small Follicles. Have PCOS. Could I Conceive Naturally?

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Posted on Wed, 20 Nov 2013
Question: I have pcos can I conceive naturally? I currently weigh 17 stone if I lose weight will I conceive? I have a regular cycle every 28-30 days but I have bleeding mid cycle. Trans vaginal ultrasound scan shows multiple small follicles. I am out of my mind that I wont conceive cos I bleed around ovulation which means I cant have intercourse. Clearblue fertility monitor shows ovulation some months but not every month. Is conceiving naturally possible please?
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Answered by Dr. Aarti Abraham (2 hours later)
Brief Answer: LINE OF TREATMENT OUTLINED BELOW Detailed Answer: Hello XXXXXXX Thanks for writing to us with your health concern. Please mention your height so that I can know your BMI, and guide you accordingly. about the necessary weight loss. In addition to a tranvaginal ultrasound scan , the following tests need to be done to establish PCOS - FSH LH Prolactin TSH DHEAS Serum free testosterone Oral glucose tolerance test Fasting serum insulin. Please have these done to conclusively establish the diagnosis, as well as to know how severe the condition is. Also, normally mid cycle there is small amount of spotting, barely lasting for a day or two. This can be because of ovulation. If you are having a proper mid cycle bleed, that needs to be investigated - a per vaginum and per speculum examination and a pelvic ultrasound scan, at the very least needs to be done. If it is only ovulatory spotting, then you can definitely have intercourse during those days. Women with PCOS often have difficulty in conceiving naturally, because there is difficulty in ovulating each month. Given your age, I would like to enquire for how long have you tried to conceive naturally ? If it has been over a year, please seek the help of an Infertility specialist. Go through a cycle of follicular monitoring ( observing the growth of ovarian follicle with serial ultrasound throughout the month ). If ovulation is documented, you can then go for further attempts at natural conception, but with the aid of follicular monitoring to target the ovulatory period. If ovulation is not observed, as I suspect would be the case, because of PCOS, then it is advisable to undergo ovarian stimulation with agents like clomiphene citrate which will induce egg formation, in conjunction with follicular study again. If 3 - 6 such attempts fail, go for further testing of the patency of the fallopian tubes. If they are blocked, then you would need ART ( assisted reproductive techniques ) to achieve conception. Meanwhile, take regular folic acid supplements, and maintain a healthy lifestyle to maximize chances of pregnancy. All the best. Please feel free to ask for further clarifications.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Aarti Abraham

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Trans Vaginal Ultrasound Scan Shows Multiple Small Follicles. Have PCOS. Could I Conceive Naturally?

Brief Answer: LINE OF TREATMENT OUTLINED BELOW Detailed Answer: Hello XXXXXXX Thanks for writing to us with your health concern. Please mention your height so that I can know your BMI, and guide you accordingly. about the necessary weight loss. In addition to a tranvaginal ultrasound scan , the following tests need to be done to establish PCOS - FSH LH Prolactin TSH DHEAS Serum free testosterone Oral glucose tolerance test Fasting serum insulin. Please have these done to conclusively establish the diagnosis, as well as to know how severe the condition is. Also, normally mid cycle there is small amount of spotting, barely lasting for a day or two. This can be because of ovulation. If you are having a proper mid cycle bleed, that needs to be investigated - a per vaginum and per speculum examination and a pelvic ultrasound scan, at the very least needs to be done. If it is only ovulatory spotting, then you can definitely have intercourse during those days. Women with PCOS often have difficulty in conceiving naturally, because there is difficulty in ovulating each month. Given your age, I would like to enquire for how long have you tried to conceive naturally ? If it has been over a year, please seek the help of an Infertility specialist. Go through a cycle of follicular monitoring ( observing the growth of ovarian follicle with serial ultrasound throughout the month ). If ovulation is documented, you can then go for further attempts at natural conception, but with the aid of follicular monitoring to target the ovulatory period. If ovulation is not observed, as I suspect would be the case, because of PCOS, then it is advisable to undergo ovarian stimulation with agents like clomiphene citrate which will induce egg formation, in conjunction with follicular study again. If 3 - 6 such attempts fail, go for further testing of the patency of the fallopian tubes. If they are blocked, then you would need ART ( assisted reproductive techniques ) to achieve conception. Meanwhile, take regular folic acid supplements, and maintain a healthy lifestyle to maximize chances of pregnancy. All the best. Please feel free to ask for further clarifications.