Do I have polycystic ovarian syndrome (PCOS)?
Q: I am a 26 years old female facing the problem of secondary infertility. I am ToRCH IgG and under its treatment for the last five years. Four months back, on the advice of a gynaecologist, I underwent a scan on the third day of my period, which showed that I have PCOS. The doctor gave me some medicines which I didn't take as those were contraceptive pills. This month, I consulted another gynaecologist and she also asked for scan. This time I went for the scan on the 8th day of menses. The report states that my ovaries are normal in size and shape. But, there are multiple nabothian cysts in the cervix, the largest measuring 14x14mm,11x19mm. Can this cause infertility? Which scan reports should I believe?
A:The diagnosis of PCOS is best made with a transvaginal scan, and usually, it is difficult to diagnose nabothian cysts by ultrasound, they can be seen when a speculum examination is done through the vagina. Please have a proper complete check in correct order- history, followed by a physical check up with positive findings listed and then the ultrasonography (USG). If there is some confusion, there is no harm in getting another transvaginal scan from a reliable place. If PCOS is diagnosed, you would need to take tab clomiphene citrate (50 mg/day) for 5 days from the 3rd day of the menses to help egg formation, along with ultrasound testing for egg development from the 9th day of the period. You may also need to check for abnormal sugar values and then see if Tab Metformin is needed. Clomiphene alone, or with metformin helps egg formation, makes periods regular and also improves the chances of pregnancy. Pregnancy chance in PCOS on clomid, is about 60-70%. You will need to recheck your TORCH test as well, and if still positive, and rising titre, will need to take medicine, like Spiramycin. In case there is no PCOS, but only nabothian follicles, the treatment is for infection and the follicles can be cauterised/ burned with electric current if big, for quick results for pregnancy. Please understand, that the first step is in clarifying the diagnosis, maybe through another transvaginal scan.