May have PCOS..Doctor seems unconcerned.

[Anonymous]

I went to my OBGYN yesterday for an ultrasound and check up as I'm on cycle day 65 and have had no period and tests have been negative. I got an ultrasound done first and the ultrasound tech asked me if I have ever been checked for PCOS as she can see the "string of pearls" in my left ovary. I told her no and she said my doctor would probably discuss it with me next. Once my doctor met with me 20 minutes later, she told me that my endometrium lining looks perfect. I asked about PCOS and said what the ultrasound tech said and her response was "yes I can see some of those and it wouldn't surprise me if you did have PCOS due to your irregular cycles." That's all she said about it and didn't go into more detail. She's know I'm trying to conceive and told me the only things I need to do is start taking folic acid and to go back on a progesterone pill but to make sure I take a pregnancy test every month, 10 days before starting the progesterone. I'm so confused as I know how serious PCOS can be and how hard it can be to get pregnant if you have it. She just seemed happy that my lining was good and thin and didn't act like anything else was an issue. She said I just want to make sure I'm having a cycle at least every 3 months. I feel like I need to find a new doctor as none of this makes sense to me. I asked her to check my thyroid levels and am waiting for that to come back but otherwise, that's all I got from her. I'm slightly irritated and upset that I didn't get more answers. Should I find a new doctor who actually will take the time to discuss all this with me and actually act concerned considering we are trying to have a baby?

[Anonymous]

Ask for Metformin. I have PCOS and had no trouble conceiving when I took it.

[Anonymous]

When my OB/GYN diagnosed me with PCOS at the age of 33, he ordered bloodwork that included testosterone/androgen levels, AMH, prolactin level, and fasting glucose. He also did the routine "day 3" bloodwork. I was also checked for insulin resistance. Turns out I am not insulin-resistant (some PCOS ladies aren't), so neither he nor the RE I ended up seeing would prescribe metformin for me.
Hallmarks of PCOS, in addition to the "string of pearls" visible on ultrasound, include irregular cycles and elevated testosterone levels.
Don't mess around with this. I'd ask for further testing to confirm a diagnosis, and then proceed from there. I'm surprised your OBGYN brushed this off. My dr was very proactive about it and insisted that I see an RE to handle the infertility side of things (we had been TTC for 8 months by that point, and I was anovulatory). Women with PCOS may eventually have other health issues, aside from just difficulty getting pregnant.

[Anonymous]

Find a new OB. It's possible your OB wants you to try longer before doing anything about it (how long trying and how old are you?) which could be reasonable or there could be other reasons she is not concerned but the bottom line is that you don't feel comfortable and you don't feel like she was listening to you or attending to your needs. And fertility/pregnancy consultations get very personal so it's important to have and OB you trust who you feel like you are on the same page with.

[Anonymous]

Hi OP, I also had PCOS (having my second baby fixed it), and used to never get a cycle. First, get a new doctor. I went to a reproductive endocrinologist. Had first child with help of metformin. Second baby with a natural remedy - D Chiro Inositol. It worked, and worked quickly. Second baby was a total surprise. Look into natural way first. I didnt' like taking diabetes medication through the first trimester.

[Anonymous]

Anonymous wrote:Find a new OB. It's possible your OB wants you to try longer before doing anything about it (how long trying and how old are you?) which could be reasonable or there could be other reasons she is not concerned but the bottom line is that you don't feel comfortable and you don't feel like she was listening to you or attending to your needs. And fertility/pregnancy consultations get very personal so it's important to have and OB you trust who you feel like you are on the same page with.

Op here- I'm almost 28 and we've only been trying for about 3 months now. I know it could technically happen on its own as we have "only" been trying for about three months but I'm just concerned about her lack of caring about me possibly having PCOS and that she didn't offer any additional testing to confirm so I'm left wondering.

[Anonymous]

My mild PCOS was missed by my OB and picked up instantly by my RE. If in doubt, I reccomend seeing an RE right away. Think about how many other things an OB/GYN does - pregnancy, baby deliveries, menopause, cancer screenings etc.

Even AFTER my diagnosis, my (new) OB was barely managing my PCOS on the second pregnancy.

[Anonymous]

The string of pearls can mean you aren't ovulating. If you aren't ovulating, you won't get pregnant. I was in a similar boat at about the same age while trying for my first. It took metformin, very minor surgery to remove a polyp, and femara to eventually get pregnant. None of this would have been discovered if I didn't see an RE; my OB/gyn was also pretty dismissive. I don't say this to scare you, but to encourage you to be proactive!

[Anonymous]

switch doctors.

[Anonymous]

How likely is it that you have PCOS IF there is no string of pearls, but you very rarely menstruate? We are not TTC now, but will soon. The doctor said that I do not have PCOS since I do not have the string of pearls, but we are unsure as to why I do not have periods.

[Anonymous]

Get a new OB seriously. That's so bad. Also, OB's don't know about making babies, they deal with their gestation and delivery. If you are having trouble TTC, see and RE.

[Anonymous]

Go straight to an RE. Seriously, you're wasting time with an OB. They are not experts in getting you pregnant.

I have PCOS. Get maybe 4-6 periods a year. Got pregnant easily twice with Clomid and timed intercourse monitored by an RE.

[Anonymous]

Anonymous wrote:How likely is it that you have PCOS IF there is no string of pearls, but you very rarely menstruate? We are not TTC now, but will soon. The doctor said that I do not have PCOS since I do not have the string of pearls, but we are unsure as to why I do not have periods.

It's possible. Have you had any bloodwork done to check hormone levels? Ask your OB to do "day 3" bloodwork (you can Google this to see what's involved, it is very common, and part of a standard workup when diagnosing TTC issues/infertility). Typically, they look at FSH, LH, estrogen levels. My OB and RE were both interested in my AMH, which was very high. Also, elevated androgen/testosterone levels can indicate PCOS.

Diagnosis of PCOS doesn't just rely on the "string of pearls" sign. A diagnosis may be made if a patient has two of the three following symptoms: irregular cycles, excess androgens, polycystic ovaries. http://www.mayoclinic.org/diseases-conditions/pcos/basics/symptoms/con-20028841

[Anonymous]

Anonymous wrote:How likely is it that you have PCOS IF there is no string of pearls, but you very rarely menstruate? We are not TTC now, but will soon. The doctor said that I do not have PCOS since I do not have the string of pearls, but we are unsure as to why I do not have periods.

PP from 9:38 here again. Also, get your prolactin level checked. In addition to having PCOS, I have elevated prolactin due to a small, benign tumor on my pituitary gland. This also contributes to irregular/anovulatory cycles. Elevated prolactin can be easily treated with medication.

[Anonymous]

OP Here-
I heard from my doctor today regardin my blood work for my thyroid and she told me it came back at a 5.2. She said she considers "normal" up to a 5 so its only slightly above normal but recommended that I see a RE.