Hello anonymous,
The Rotterdam criteria for the Diagnosis of PCOS require that a patient meet 2 of 3 features, which include irregular cycles, clinical or laboratory signs of hyperandrogenism (elevated androgens) which include excessive hair growth and acne, and PCOS ovaries on ultrasound. There are some women with stress or low body fat related hypothalamic dysfunction which can appear like PCOS, but are less likely to respond to Clomid or Femara and may require injectable gonadotropins (FSH and LH).
Some women with PCOS will not respond to 50 mg of Clomid, and can respond to Femara. Depending on your age, a trial of Femara may be a really good idea. If you do not respond to Femara, then a visit with a reproductive endocrinologist to discuss injectable gonadotropins or other options is a good idea. Unless your own physician is comfortable using injectable gonadotropins.
Best of luck with your fertility journey.
L. April Gago MD
Sunday, April 5, 2009
Friday, March 7, 2008
Do I have PCOS?
Are you experiencing problems with fertility or abnormal menstrual cycles, or very irregular cycles.
It is possible that you have polycystic ovarian syndrome (PCOS).
Classically, women with PCOS are described as having irregular menstrual cycles, excessive hair growth, especially on face and chest and problems with being overweight. However, many women with PCOS do not experience all or any of these symptoms. They still may have trouble conceiving, and certain lifestyle modifications like high protein, low carb diet and moderate excercise, and sometimes with the additon of well as medical treatments can restore fertility.
When I see patients with fertility problems or menstrual irregularities, I do a complete hormonal evaluation and an evaulation of the uterine cavity, and if fertility is desired usually the fallopian tubes and the semen parameters. If PCOS seems to be the diagnosis, we start with lifestyle modifications, and also discuss the desire for medications and fertility treatments.
I have had good success with many PCOS patients in restoring ovulation and fertility with this approach.
If you have questions or comments please post, and I will do my best to get back with you.
L. April Gago MD
It is possible that you have polycystic ovarian syndrome (PCOS).
Classically, women with PCOS are described as having irregular menstrual cycles, excessive hair growth, especially on face and chest and problems with being overweight. However, many women with PCOS do not experience all or any of these symptoms. They still may have trouble conceiving, and certain lifestyle modifications like high protein, low carb diet and moderate excercise, and sometimes with the additon of well as medical treatments can restore fertility.
When I see patients with fertility problems or menstrual irregularities, I do a complete hormonal evaluation and an evaulation of the uterine cavity, and if fertility is desired usually the fallopian tubes and the semen parameters. If PCOS seems to be the diagnosis, we start with lifestyle modifications, and also discuss the desire for medications and fertility treatments.
I have had good success with many PCOS patients in restoring ovulation and fertility with this approach.
If you have questions or comments please post, and I will do my best to get back with you.
L. April Gago MD
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