QuestionHI doctor, I have irregular perdiods. I am 24 y/o going 25. I recently had a Trans vaginal ultrasound.It said I have immature follices which is called Polycsytic ovaries. I'm not sure if I should take metformin or femera. My ob is hesitant ot give me clomid because I have a tiny ovarian cyst.
I usually have a delayed period during cold months and currently it's a cold month.
AnswerHello Jannahmaeil,
PCOS is not defined by ultrasound appearance but it can be one of the components. The first required component is an ovarian dysfunction, usually manifest by irregular menstrual cycles. You then need a second component and your ultrasound gives you that. Therefore, I would give you the diagnosis of PCOS eventhough you are thin.
If you are trying for pregnancy, then the ovary needs to be induced to ovulate (give off an egg). This is done by various medications such as Clomiphene, Femara or injectables. In some patients, weight can be an issue and decreasing weight to normal can lead to normal ovarian function. Also, in some patients there is insulin resistance and medications such as Metformin (glucophage) can block the insulin and ovulation will occur. However, these different treatments have to be tailored to each patient because there is lots of variation. I would recommend that you review my blog where I have written extensively regarding PCO.
I would also recommend that you seek the care of an infertility specialist, called a reproductive endocrinologist, who is the expert in these types of disorders. Most general Ob/Gyn's do not treat this well and do not have the expertise or knowledge to do a good job.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
