# anyone understand this?



## SARAH1942 (May 10, 2012)

Hi, my daughter, 29, is currently in Australia and coming home in 2 months due to off the scale stress/worrying about a recent I R  result and blood test for ovulation. She is not allowed to google - an order from her mum - as she's making herself more stressed so i've joined this forum in the hope i will be able to help her by understanding one or two things.

Her main goals in life were to get a degree and her Masters - which she has - and then to have a baby. She is tcc and had an ultrasound to ascertain her tubes were ok. they were fine. her periods are every 28 days so very lucky but pcos was seen on the ultrasound - 15 on each ovary. Blood tests were taken which showed I R (she hasn't an ounce of surplus fat on her!)  so you can imagine the tears!!    Neither condition runs in my family but her father was adopted and is no longer around.

Blood tests on "day 21" showed she HAD ovulated - a doctor told her the ultrasound showed she hadn't, the hospital said she had( ) so hence the 21-day blood test. (also the follicle on the ultrasound had "gone in on itself" which proved she had). But this doctor still said she hadn't....she has no bedside manner at all. getting info out of her is hopeless. so i've come on here to ask if anyone can understand the following figures...Thank you so much if you can. 

progesterone levels were 39nmol/L
fsh ratio was FSH4: LH10
Fasting insulin 27mUL
oest 2:607
DHEAS:4.4umo/L
free testosterone 1.0pmo/L

all the above was taken AFTER ovulation.


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## Betty-Boo (Oct 14, 2007)

Hello and welcome to Fertility Friends   

I've included some forum boards that may help answer some of you questions   

*Diagnosis ~ *CLICK HERE

*PCOS ~ *CLICK HERE

*Fertility Investigations ~ *CLICK HERE

Have a look round the site and if you get a little stuck with the navigation side of things - please shout!

We also have a chat room - which is a fabulous place to 'meet' and chat with others. Our newbie chat is every Wednesday. A great chance to meet other new members and find out a little more about how the site works.

*Newbie chat ~ *CLICK HERE

All the best - our paths may cross again in other areas of the site.
Good luck,

  

Tis xx


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## DINKIN82 (May 15, 2012)

Hi Sarah
Im new to this too.
Your daughters FSH level is good at just 4 then that is ideal.  The NHS want it to be under 10 for treatment.  Im also 29 and have been ttc for 3 years.  Just started my first IVF.  All my tests so far have been pretty much clear so its classed as unexplained infertility 
All the best


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## SARAH1942 (May 10, 2012)

Thank you but when you say the nhs want it to be under 10 for treatment do you mean treatment as in to help her conceive?? Because a 4 wouldn't be good if she needed help?? Sorry I'm a bit confused......


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## Betty-Boo (Oct 14, 2007)

Sarah - first step would be for her to have the tests from day 1-3 of her cycle. The NHS will look at her day 3 results and judge her response to medication from there.
Might be worth having her AMH tested (this is the hormone that our dormant eggs transmit and gives an indication of ovarian reserve). An AFC which is where you are scanned (vaginally) to see how many 'dormant' follicles you have in your cycle. Again another indicator of response.
Once she has those tests, the clinic / consultant will have more of an idea of which treatment is suitable for her.

Her progesterone levels do indicate that she did ovulate that month.

Hope that makes sense.

Zita West has a wonderful book explaining everything:

http://www.zitawest.com/buy/books/fertility-and-conception/fertility-and-conception.htm

I ordered mine for my mum via Amazon. The library may have a copy. Also have a look through the boards I've linked to below - again lots of info in there too 

All the best

Tis x

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites


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## Audiprincess (May 7, 2012)

Hi sarah1942

Is your daughter taking any medication for her pcos? There is metformin and clomid everyone that I have spoken to with pcos (with no other fertility issues per couple) has conceived, might be worth asking a clinician? 

If you/your daughter wants a chat feel free to drop me a personal message xx


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## SARAH1942 (May 10, 2012)

thank you thank you thank you!!   brilliant - have passed all the replies onto her in Australia. Yes she IS on Metformin now - but vomiting a lot  ......And she says she is starving!! (she misses her carbs soo much). Its quite sad really as she is quite skinny build  - but normal weight!


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## catie_s (Jul 24, 2011)

Hi Sarah,
Drs often look at the FSH/LH ratio; if the LH is higher then that is an indication of PCOS and I see that for your daughter the LH is about double. However, tests done on day 3 might give slightly different results. Her FSH level is absolutely normal, I'm also 29 and mine is also a 4 which the Dr said is perfect - we did actually need icsi to concieve because of problems with my husband but I am currently 30 weeks pregnant   You want the FSH to be lower rather than higher.
Metformin and Clomid would probably be the drugs that the Dr would give to start off with. Clomid should be effective if there are no problems with her partner. The fact that she is ovulating is brilliant news and very positive. She should definitely get day 3 tests done as it will give the Dr a clearer idea of dosage etc.
My dad is diabetic and takes metformin, he said it made him sick at first but the dr changed the dose slightly so it might be worth her having a chat with her GP about it.
Wishing her lots of luck!
Catie x


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## SARAH1942 (May 10, 2012)

hi, did you mean to say the LH should be lower than the FSH? Cos you wrote the other way round......??

SO pleased about your baby - well done both of you!! thanks for nice reply - have posted all that onto my daughter in Australia xx


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## catie_s (Jul 24, 2011)

Hi Sarah,
FSH and LH levels should be more or less equal. FSH is the hormone that tells the follicules on the ovary to grow every month then the LH hormone tells the biggest follicule when its time to release its egg for ovulation. What happens is that on around day 14 of your cycle there is a big surge in the LH hormone to let the follicule know that its time for ovulation. The problem is that if the LH is always high then the follicules get confused and dont know when it is time to release their egg. If the LH:FSH ratio is 2:1 or 3:1 then this is seen as a sign of PCOS. They also count the number of follicules on each ovary ( my Dr counts over 12 on each ovary as being PCOS) Apologies if you knew all that already!! 
To reassure you though I have mild PCOS - my bloods came back as normak (my fsh was 4 and the Lh was 4,5 ) but I have about 15 follicules on each ovary. I have none of the other symptoms and it was only when the Dr did a scan that she saw I had so many follicules. Im not sure if your daughters LH is so high because the bloods were done on day 21 (therefore after the LH surge) the best thing is to test them on day 3 before ovulation has taken place.
The good news is that Clomid has an amazing success rate especially if her partner has no problems. We had the additional worry of my husband who has low count, low motility and lots of dodgy shaped sperm   and yet....
I think your daughter has every chance of being a mummy!! I will keep fingers crossed she has good news soon, tell her to keep positive - it really does help!
Catie x


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## SARAH1942 (May 10, 2012)

fantastic catie - thank you sooo much.     x


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## SARAH1942 (May 10, 2012)

Hello-my mum has given me her logi n details so I can firstly thank you all so much for replying, and secondly so I can give my point of view across in the situation! Also please excuse any typo's-imcurrently in Australia (only for another 4 weeks! ) and my only means of communicating is my iphone! 
So, as my lovely mum  has said, I was told 2 weeks ago that I have 14 cysts on one ovary and15 on the other...this was done 3dpo and she said she could see where I had ovulated fromthe left side (I did not know an u/s could show this-but I had indeed ovulated as far as I was concerned 3 days earler as I get ov pains every month around day 12, and ewcm before. I've also used opk's and bbt charting for a couple of months to self-confirm these signs andthey have corresponded as they should-annd opk's only +ive on 2 days out of the whole month.

So I had blood tests done to check levels as I was ovulating, had no other signs of pcos aside to multiple follicles and the results were all normal (done on day 21/doc said this wouldnt take a difference to comparing results for a pcos diagnosis-but next time when im back in England I'll get them done on day 3) apart from lh:fsh ration (10:4)  and IR was 27mU/l which completely scared the hell out of me!! Im size 10, 5ft 10 and yes I admit I could do.more exercise and eat less pasta but couldnt everyone?! The last 4 months have been sedentry +++ , extremely stressful and ice eaten mainly carbs...so as IR causes pcos (I think) then imhoping this has plated a part in my results.

Im exercising 5-6 times a week (started last week and it will ve easier once im back in England at home as I can go to my gym classes again-admittedly I'd only go once a week before!) and Im eating about 100g carbs a day and thats without bread, pasta, floyr, cakes etc so its wuite hard. My stress levels will reduce once im home too. Im on 750mg metformin-tolerating that now just about, and doc wants me on 1000mg and thinks I wont need any.more due to my size. I will get re-tested when im home..and in 3 months to give meds and exercuse a chance to show. My blood sugars im.testing at work as im a nurse and was just curious...they are about 4.7  2 hours after breakfast...and 5.7 after lunch/dinner (low carb ie kippers on one sluce of multigrsin bread) and after 2 hoursyesterday they wete still 5.5....so I believe the fact that it's taking a long time for them to come back down.is a bad thing? 

Finally! Sorry for waffle-is there anyone that can shed any light with my updated post here? I have read that IR reduces egg quality...and so by me now makibg every eeffort to reduce IR, including stress levels (although hard when news is still quite new, im coming to tetms with eating foods that bore me and im away from home) im hoping with.a new production of eggs happening every three months approx, by the 4 month mark I should be in a better egg condition.to conceive...and hopefully my IR levels by then will reflect this? 
Many thanks for reading my essay  xxx


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## DINKIN82 (May 15, 2012)

Hi Sarah
who told you that you get new eggs every 3 months  thats news to me   If you have an AMH test then that tells you what your egg reserves and quality are.  the test can be performed anytime of the monthly cycle and is far more accurate than FSH tests.  My consultant told me something interesting which I never knew, apparently when a baby girl is in the womb at 6 months old she has approx 7million eggs, when she is born she has an average of 2 million, and once she has her first period that drops to 1 million.  He told me this to explain that new eggs can never be made.  we get what we are born with and in each individual woman the eggs diminish with age (some of us more quickly than others).  I had an AMH test which came back as 7.7, which isnt great for my age but could be worse.  When I did my first ivf my left ovary didnt respond at all and all my eggs came from the right, they seem to think that I have less eggs that side and thats why I didnt respond. I would look into getting that test done on your return to UK.  The nhs dont offer the test, we did it via the hospital but there was a charge of £60.  At least if you get it done then you'll know what your dealing with   good luck all the best.


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