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What Does This Pelvic Ultrasound Inspite Of Trying To Conceive Indicate?
Question: hi
TTC and pelvic ultrasound showed asymmetrical thickening of posterior myometrium, likely to represent adenomyosis, small sized – will this be a problem? Also,
Sagittal are 10cm2 and Volume 15cc – is this enough room to conceive? And lastly, RT Ovary (Volume 7cc) showed 17mm dominant follicle – no mention of other follicles, is this normal and LT Ovary (Volume 11c) showed 5 small follicles – At 45 years old, am I normal range?
Thanks.
TTC and pelvic ultrasound showed asymmetrical thickening of posterior myometrium, likely to represent adenomyosis, small sized – will this be a problem? Also,
Sagittal are 10cm2 and Volume 15cc – is this enough room to conceive? And lastly, RT Ovary (Volume 7cc) showed 17mm dominant follicle – no mention of other follicles, is this normal and LT Ovary (Volume 11c) showed 5 small follicles – At 45 years old, am I normal range?
Thanks.
Brief Answer:
It depends on EMI...
Detailed Answer:
Hi,
Thanks for writing to us.
I presume that you are trying for pregnancy for the first time and going by the criteria, your values stand as follows-
-right ovary--volume normal, the follicle is mature enough to rupture.
-left ovary--induction of ovulation may have led to the activation of several follicles or if it is not so, the ovary could be polycystic. The volume is slightly higher.
-uterus appears to be almost normal in size.
The impact of adenomyosis on the possible pregnancy depends on the invasion of the endometrial-myometrial interface or EMI. If the EMI is intact, there would be negligible effect on a pregnancy. Also, the increased vascularity in pregnancy leads to growth of the tumor and if it lies more toward the outer wall, there is less harm.
Medical and conservative management should be planned when pregnancy is contemplated so as to avoid any difficulties with implantation and progression of pregnancy.
So, in the current scenario, I would ask you to discuss with your consultant on the need for managing the adenomyosis before planning a pregnancy. At your age, there is no room for risk approach.
Hope I have answered your query. Please feel free to contact for further clarifications. I will be happy to help.
regards,
Shanti.V.
It depends on EMI...
Detailed Answer:
Hi,
Thanks for writing to us.
I presume that you are trying for pregnancy for the first time and going by the criteria, your values stand as follows-
-right ovary--volume normal, the follicle is mature enough to rupture.
-left ovary--induction of ovulation may have led to the activation of several follicles or if it is not so, the ovary could be polycystic. The volume is slightly higher.
-uterus appears to be almost normal in size.
The impact of adenomyosis on the possible pregnancy depends on the invasion of the endometrial-myometrial interface or EMI. If the EMI is intact, there would be negligible effect on a pregnancy. Also, the increased vascularity in pregnancy leads to growth of the tumor and if it lies more toward the outer wall, there is less harm.
Medical and conservative management should be planned when pregnancy is contemplated so as to avoid any difficulties with implantation and progression of pregnancy.
So, in the current scenario, I would ask you to discuss with your consultant on the need for managing the adenomyosis before planning a pregnancy. At your age, there is no room for risk approach.
Hope I have answered your query. Please feel free to contact for further clarifications. I will be happy to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you XXXXXXX really appreciate your response. I just wanted to also ask: after ovulation, do follicles reduce in size dramatically or slowly? I am wondering if the 17mm could be after ovulation, especially as I have irregular menstrual cycle and am spotting quite a bit two weeks after period? Also, with the 5 smaller follicles - does this mean i only have 5 or can more develop each cycle?
Thanks for your help.
Thanks for your help.
Brief Answer:
Detailed below.
Detailed Answer:
Hi,
Thanks for writing back.
After ovulation, follicles reduce in size immediately and become irregular in outline. If the follicle fails to rupture, a cyst forms and such a follicle retains its size.
If you are spotting two weeks after a period, it could mean anything from a breakthrough bleed to ovulation spotting. Follicular monitoring should clarify the issue.
Usually, 3-11 follicles begin to develop in each cycle and this number dwindles with increasing age. Out of these, only one develops completely to release the ovum and the rest atrophy. If you are taking treatment for induction, more follicles are expected to develop to maturity.
Hope I have clarified your query. Please get back for any more clarifications. I will be ready to help.
regards,
Shanti.V.
Detailed below.
Detailed Answer:
Hi,
Thanks for writing back.
After ovulation, follicles reduce in size immediately and become irregular in outline. If the follicle fails to rupture, a cyst forms and such a follicle retains its size.
If you are spotting two weeks after a period, it could mean anything from a breakthrough bleed to ovulation spotting. Follicular monitoring should clarify the issue.
Usually, 3-11 follicles begin to develop in each cycle and this number dwindles with increasing age. Out of these, only one develops completely to release the ovum and the rest atrophy. If you are taking treatment for induction, more follicles are expected to develop to maturity.
Hope I have clarified your query. Please get back for any more clarifications. I will be ready to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr XXXXXXX
Thank you once again.
Just one more question: as we haven't started any IVF yet - the recent tests are my first tests to see which direction we will go in - could the five small follicles in my RT ovary be the start of my next ovulation cycle? So far, I have been taking 25mg DHEA twice per day and have been having Chinese acupuncture and drinking Chinese herbs since March, but that is all the intervention I have had.
This journey to motherhood is so special and is teaching me so much about myself, for which I am eternally grateful. Thanks again for your time, I think this service is really great and will be recommending it to my friends.
Regards, XXXXXXX
Thank you once again.
Just one more question: as we haven't started any IVF yet - the recent tests are my first tests to see which direction we will go in - could the five small follicles in my RT ovary be the start of my next ovulation cycle? So far, I have been taking 25mg DHEA twice per day and have been having Chinese acupuncture and drinking Chinese herbs since March, but that is all the intervention I have had.
This journey to motherhood is so special and is teaching me so much about myself, for which I am eternally grateful. Thanks again for your time, I think this service is really great and will be recommending it to my friends.
Regards, XXXXXXX
Brief Answer:
Answered below.
Detailed Answer:
Hi,
Thanks for your feedback.
As I have mentioned earlier, in each menstrual cycle, several follicles develop, but only one of them matures to release the ovum while the rest atrophy. So, in each cycle you find a fresh set of follicles developing. Please note, the follicles do not occur after birth, they are present at birth and they are shed throughout the reproductive life without any replacement. Once they are over, menopause occurs.
I do not have any idea about the Chinese techniques and hence cannot comment on them. I would like to say, based on your age, that if you are anxious to conceive, you should not waste any more time experimenting. With each passing menstrual cycle, you have lesser ova remaining and the fertility status gets lower. So, please see an infertility expert at the earliest instance.
Hope I have clarified all your queries. Please contact if you need any more information. I will be available to help.
Wish you good health.
regards,
Shanti.V.
Answered below.
Detailed Answer:
Hi,
Thanks for your feedback.
As I have mentioned earlier, in each menstrual cycle, several follicles develop, but only one of them matures to release the ovum while the rest atrophy. So, in each cycle you find a fresh set of follicles developing. Please note, the follicles do not occur after birth, they are present at birth and they are shed throughout the reproductive life without any replacement. Once they are over, menopause occurs.
I do not have any idea about the Chinese techniques and hence cannot comment on them. I would like to say, based on your age, that if you are anxious to conceive, you should not waste any more time experimenting. With each passing menstrual cycle, you have lesser ova remaining and the fertility status gets lower. So, please see an infertility expert at the earliest instance.
Hope I have clarified all your queries. Please contact if you need any more information. I will be available to help.
Wish you good health.
regards,
Shanti.V.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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