How is PCOS Diagnosed?

Presence of polycystic ovaries in a female’s body is called Polycystic Ovarian Syndrome and can be seen by performing ultrasound. PCOS comes with an array of complex health issues. However, there are possibilities that women with PCOS do not have polycystic ovaries. Therefore, it is important to diagnose PCOS. The doctors perform following tests to detect PCOS:

1. Endometrial Biopsy

2. Glucose Tolerance Test

3. Thyroid Panel

4. Blood Lipid Profile

At Pahlajani, we perform the physical examination of women Physical to collect basic information like height, weight and blood pressure.

Followed by, the pelvic examination. In this, reproductive organs are visually and manually inspected to check masses, growths or other abnormalities of the cysts.

Later, the levels of different hormones are measured through blood tests to determine if menstrual abnormalities or androgen excess are not mimicking PCOS. 

Other tests include, fasting cholesterol and triglyceride levels and a glucose tolerance test. Blood tests are used to assess the levels of androgens in your body. Blood tests for androgens (such as testosterone) and free androgen index (FAI) are the best tests for diagnosing whether you have hyperandrogenism (high androgen levels).

Finally, an ultrasound examination is carried out to see the appearance of ovaries and the thickness of the lining of uterus. An ultrasound of the uterus, ovaries and the pelvis can be carried out to identify whether there are any cysts on your ovaries and whether an ovary is enlarged. A transvaginal ultrasound is a painless test with no radiation. It uses a pen–shaped probe with an ultrasound sensor on the tip, which is inserted into the vagina. This produces a much clearer picture than an abdominal ultrasound. Transvaginal ultrasounds are only performed on women who have been sexually active, otherwise an abdominal scan is done where the ovaries are viewed from the outside through the stomach wall.

Through the above tests, we measure the following -

1. Pituitary and Ovarian Hormone serum levels

2. Luteinizing Hormone (LH)

3. Follicle Stimulating Hormone (FSH)

4. Estradiol

5. Progesterone

6. Prolactin

7. Circulating Androgens

8. Free testosterone

9. Free androgen index (FAI): 17-hydroxyprogesterone

10. Sex hormone binding globulin (SHBG): 24 hr. urinary free cortisol

11. Dehydroepiandrosterone sulfate (DHEA-S)

The ovaries are polycystic because 12 or more follicles are visible on one ovary or the size of one or both ovaries is increased

It can be because of,

1. High levels of ‘male’ hormones (androgens) in the blood (hyperandrogenism). Symptoms - Excess hair growth, Acne

2. Menstrual dysfunction, lack of periods or menses (menstrual flow), menstrual irregularity, lack of ovulation (where an egg is released)

Women with PCOS should have a cholesterol and glucose tolerance test in every two years, and blood pressure should be checked every year.

Dr Neeraj Pahlajani

Obstetrician & IVF Specialist

(MS, DNB, FMAS, DRM - Germany)

MBBS - Lady Harding Medical College - New Delhi

MS - Obstetrics and Gynecology (PGI - Rohtak)

DNB - Obstetrics and Gynecology

FMAS - World Association of Laparoscopic Surgeons

DRM - Diploma in Reproductive Medicine (Germany)

Fellow in IVF & Embryology – (USA)

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Pahlajani Test Tube Baby Centre

(Mata Laxmi Nursing Home)

Anupam Nagar, Near T.V. Tower, Raipur (Chhattisgarh) India

Phone:  +91- 771- 4052967, +91- 771- 4053285 Mobile:  +91- 9300511044, +91- 9329630455

Email - contact@raipurivf.com, sameerp5000@hotmail.com

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Pahlajani Test Tube Baby Centre - Raipur

Low Cost IVF India - Pahlajani Test Tube Baby Centre

Pahlajani Critical Pregnancy Care Centre - Raipur

PCOD

What is PCOD?

Poly Cystic Ovarian Disorder (PCOD) is a complex female issue and common cause of infertility in women. While being the most common disorder, it is accompanied by a number of health issues. It can lead to irregular menstrual cycles, obesity, polycystic ovaries, elevated levels of androgens and absent or irregular menstrual cycles. Women with initial symptoms of PCOD like irregular cycles need to be vigilant about their hormonal imbalance.

What alters the normal menstrual cycle?

The hypothalamus produces GnRH (gonadotrophin-releasing hormone) which signals to the pituitary to produce LH (luteinising hormones and FSH (follicle stimulating hormone). The release of GnRH is pulsatile in women with regular menstrual cycles. This normal pulsatile release of GnRh signals some of the follicles in the ovary to begin maturing and for the ovaries to release estrogen and progesterone. This estrogen/progesterone signal is recognized by the pituitary gland. As the follicles begin maturing, they release and increase the hormone estrogen over time. The rising estrogen level signals the pituitary gland to curb release of FSH. This communication allows for ovulation to occur. In women with PCOD the menstrual cycle follows a different pattern of endocrine function and communication.

What are the symptoms of PCOD?

Irregular menstrual cycles, absent period, anovulatory cycles, abnormal mid-cycle bleeding, excessive or heavy menstrual bleeding, alopecia (balding), Hirsutism (excessive body hair), acne, Acanthosis nigricans, Polycystic ovaries, history of ovarian cysts, Mood disorders, Obesity, recurrent miscarriages.

What are the Health Risks with PCOD?

Infertility, menstrual cycle irregularities, possible increased risk for endometrial and breast cancer due to unopposed estrogen, cardiovascular disease, diabetes, gestational diabetes.

What Causes PCOS?

Research suggests that PCOD can have a genetic link, possible abnormal fetal development and inflammatory response. Secondary causes may be diet, lifestyle and exposure to certain environmental toxins. It directly impacts fertility. If left untreated, it might lead to serious health implications.

Genetic Predisposition and Abnormal Fetal Development

Family history is an important factors that lead to PCOD. Women whose mothers, sisters or grandmothers had PCOD are at a higher risk for developing PCOD. Also, the exposure to excessive amounts of male hormones (androgens) by the developing fetus is another factor. This means that the affected genes will not function properly later in life, which may cause PCOD during the reproductive years of a woman’s life.

Low-grade Inflammation

Women with PCOD have low-grade inflammation. It is associated with a cause for insulin resistance. It is well known that white blood cells produce substances to fight infection called inflammatory response. When inflammatory response is triggered, white blood cells produce enzymes that may contribute to insulin resistance and atherosclerosis.

Dr Neeraj Pahlajani

Obstetrician & IVF Specialist

(MS, DNB, FMAS, DRM - Germany)

MBBS - Lady Harding Medical College - New Delhi

MS - Obstetrics and Gynecology (PGI - Rohtak)

DNB - Obstetrics and Gynecology

FMAS - World Association of Laparoscopic Surgeons

DRM - Diploma in Reproductive Medicine (Germany)

Fellow in IVF & Embryology – (USA)

---------------------------------------------------------------------------------

Pahlajani Test Tube Baby Centre

(Mata Laxmi Nursing Home)

Anupam Nagar, Near T.V. Tower, Raipur (Chhattisgarh) India

Phone:  +91- 771- 4052967, +91- 771- 4053285 Mobile:  +91- 9300511044, +91- 9329630455

Email - contact@raipurivf.com, sameerp5000@hotmail.com

Visit Our Websites

Pahlajani Test Tube Baby Centre - Raipur

Low Cost IVF India - Pahlajani Test Tube Baby Centre

Pahlajani Critical Pregnancy Care Centre - Raipur

What is total fertilization failure after ICSI?

Intracytoplasmic sperm injection (ICSI) is an in vitro fertilization procedure in which a single sperm is injected directly into an egg. ICSI is generally performed following an in vitro fertilization procedure to extract one to several oocytes from a woman.

For both patient and doctor, failed fertilization comes as a shock. Although, the fertilization failure after ICSI is less common but considerable chances cannot be ruled out. Generally, fertilization failure after IVF is because of sperm problem. However, fertilization failure after ICSI is rarely because of sperm problem.

Surprisingly, most of the patients are in this notion that failure of ICSI is because of sperm problem. The much known fact that 50 per cent of the DNA comes from the sperm, becomes the reason to believe that fertilization failure after ICSI is because of sperm problems.

Now, ICSI is performed on infertile men with low sperm count or poor sperm motility. Hence, it is logical to conclude that failed fertilization is because of the abnormal sperm DNA in men, which prevents the sperm from fertilizing the eggs. 

The actual truth is that the failed fertilization after ICSI is not because of sperm but the egg. Why? After the sperm is injected inside the egg, most of its work is done. The rest of the fertilization process is driven by energy which is provided by the powerhouses of the cells – the mitochondria, which are present in the cytoplasm of the egg. The sperm has very little role to play after the ICSI has been performed.

Now why the eggs look completely normal? This is because there is no way to distinguish between a normal and an abnormal egg even if the failure has occurred because of eggs. Even if the egg functionally incompetent, it looks normal.

Failure of fertilization after ICSI can only be found out when the embryologist does the fertilization check 16 hours after ICSI. If the eggs do not get fertilized (i.e. it does not have any pronuclei) then fertilization fails.

Rarely, the incubator malfunction can damage the eggs or embryologist can also damage the eggs when doing ICSI. But, remember that failed fertilization after ICSI is usually because of an egg problem. Women, those with poor ovarian reserve and a poor ovarian response encounter these problems.

IVF with ICSI involves the use of specialized micromanipulation tools and equipment and inverted microscopes that enable embryologists to select and pick up individual sperm in a specially designed ICSI needle.

The needle is carefully advanced through the outer shell of the egg and the egg membrane - and the sperm is injected into the inner part (cytoplasm) of the egg. This usually results in normal fertilization in about 75-85% of eggs injected with sperm.

However, first the woman must be stimulated with medications and have an egg retrieval procedure so we can obtain several eggs for in vitro fertilization and ICSI.

Dr Neeraj Pahlajani

Obstetrician & IVF Specialist

(MS, DNB, FMAS, DRM - Germany)

MBBS - Lady Harding Medical College - New Delhi

MS - Obstetrics and Gynecology (PGI - Rohtak)

DNB - Obstetrics and Gynecology

FMAS - World Association of Laparoscopic Surgeons

DRM - Diploma in Reproductive Medicine (Germany)

Fellow in IVF & Embryology – (USA)

---------------------------------------------------------------------------------

Pahlajani Test Tube Baby Centre

(Mata Laxmi Nursing Home)

Anupam Nagar, Near T.V. Tower, Raipur (Chhattisgarh) India

Phone:  +91- 771- 4052967, +91- 771- 4053285 Mobile:  +91- 9300511044, +91- 9329630455

Email - contact@raipurivf.com, sameerp5000@hotmail.com

Visit Our Websites

Pahlajani Test Tube Baby Centre - Raipur

Low Cost IVF India - Pahlajani Test Tube Baby Centre

Pahlajani Critical Pregnancy Care Centre - Raipur

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