Question
(03/02/2011):
My name
is Nasreen and I am planning for a baby.
From
recent months I am experiencing few health problems.
Need
your medical advice.
From
03-Jan-11 I found it was slight bleeding and blood spotting and went
to Gynec doctor she told that it may be Implantation is happening
so you are facing this issue just wait for sometime if you don't get
periods do the pregnancy test.
1-Feb-11
I did the pregnancy UPT test the result was positive later.
We went
to doctor for further advice and later we did Beta HCG test on 1-Feb-11
and result was 362 ml
and on 03-Feb-11 Beta HCG was 261 and showed the reports to doctor.
Doctor
said it's getting aborted automatically and later we did the ultra
sound we didn't find gestational sack.
Later
after 15 days again I did pregnancy UPT test on 25-Feb-11 and test
was negative.
The concern
is that still I am facing bleeding and spotting (Brown/ sometime it
will be little red mix) whenever I pass urine.
When
the Test is negative then it would be aborted completely right.
One more
Gynec she said I have Polycystic ovaries so I am facing this pregnancy
problem.
I am
really confused and tensed what really happening in my stomach or
in my body.
It would
be great help if you kindly help me what is the real issue in my health
or in my pregnancy.
Whether
I am pregnant or not or what is the other issue for bleeding.
Thanks
in advance for your quick help and support.
Regards,
Nasreen
Answer:
Dear
Nasreen,
The hormone
human chorionic gonadotropin (better known as hCG) is produced during
pregnancy. It is made by cells that form the placenta, which nourishes
the egg after it has been fertilized and becomes attached to the uterine
wall.
Levels
can first be detected by a blood test about 11 days after conception
and about 12 - 14 days after conception by a urine test. In general
the hCG levels will double every 72 hours.
The level
will reach its peak in the first 8 - 11 weeks of pregnancy and then
will decline and level off for the remainder of the pregnancy.
Women
who have PCOS appear to have an increased risk of miscarriage.
Treatment
for PCOS depends largely on an individual woman's fertility desires.
For those
women not desiring immediate pregnancy, there are basically
two options to help regulate menstrual cyclicity and prevent endometrial
hiperplasia.
For women
with PCOS who desire pregnancy, ovulation induction is often
necessary.
This
involves medical treatment in order to help the ovaries release an
egg each month in a reliable fashion. For many women this involves
simple and relatively inexpensive oral medication.
Others
may require more intensive and expensive therapies utilizing injectable
medications.
Diagnosis
of PCOS can be difficult since a specific test can't be performed
nor is there a set list of symptoms that doctors can look for. Each
woman's experience of PCOS is unique because no two women have the
exact same symptoms.
However,
a diagnosis is usually made when a woman has irregular or absent periods,
in addition to signs of hyperandrogenism without another medical cause.
When
a woman has infrequent, absent or irregular periods, it is a sign
that ovulation may not be occurring. The doctor will try to rule out
other conditions that could cause irregular periods, such as thyroid
disease, hyperprolactinemia, Cushings syndrome or congenital adrenal
hyperplasia.
PCOS is often suspected when a patient has irregular periods or fertility
problems. These symptoms signal a disruption in the reproductive cycle,
which normally culminates each month with ovulation (the release of
an egg from an ovary).
Many
women with PCOS, though not all, have enlarged ovaries with numerous
ovarian cysts.
Other
PCOS symptoms include:
- Excessive
production of androgens, which may cause excess hair growth on the
face, chin, upper lip, nipple area, chest, lower abdomen and thighs
or male pattern baldness
- Acne
- Obesity in approximately 50 percent of cases
- Dark patches on the skin
- Prolonged PMS-like symptoms
- Pelvic pain
Besides
a thorough physical exam and family medical history, doctors may use
the following diagnostic tools:
-A pelvic
ultrasound to determine if ovaries are enlarged, to see if cysts are
present and to measure the thickness of the lining of the uterus
-Blood
tests to detect elevated levels of androgens. Hormone levels measured
may include prolactin, thyroid stimulating hormone, 17-hydroxyprogesterone,
testosterone and DHEA-S. Levels of glucose, insulin, cholesterol and
triglycerides may also be assessed.
-Blood
test to detect high levels of lutenizing hormones (LH) or an elevation
in the ratio of LH to follicle stimulating hormones (FSH)
