Questions about cysts, follicles. and ovulation

andisings · 05-19-2006, 05:22 AM

Hi, ladies. I have about a billion questions, and know this may get long. I'll try to nut-shell it. This involves follicles, ovulation, and the fact that I'm on the pill.

I'm 28, and was DX at 17 with PCOS. Huge family history, and I'm the result of about 7 years of Clomid (my mom was seriously determined). I've always been told I was textbook PCOS, with no periods, unusual weight gain, hirsuitism, and lots of other things that I didn't know were PCOS until I came to this site over a year ago. I've been on Met for over a year (1000mg) and BCP since I was 17. I'm getting married in Oct, and we'll start TTC next summer.
Yesterday I had horrible pain in my abdomen (left lower quadrant) and most of my symptoms pointed to a ruptured cyst. Of course, everyone who knew about this (even my mother -- go figure) asked if maybe I'd ovulated. I spent a long time explaining that I don't do that.....

My doctor (who is WONDERFUL) had me go in today for an US to see what's going on. We both fully expected a ruptured cyst. The US tech - also great - told me a bit of what she saw, which I know she's not supposed to, but was very thoughtful. She showed me all sorts of things on the screen. It was only an abdominal US but she said it was very clear and the Dr. in the US dept. said that a trans-vaginal US was not needed. I saw both ovaries clearly. My right one is clear as a bell, small, and had great blood flow. Small as in not enlarged due to PCOS (which I'm pretty sure it WAS when I was a teen and DX). The left was slightly larger and the blood flow not as strong, but she was at an angle. When she told me what she saw, she said there is a small folicle on my left ovary. WHAT?? Is it possible that this is a follicle as in gonna ovualte sort of follicle?? She said it's not a cyst, and is small. It's the ONLY thing that was visable. No other cysts. Nothing. And everything is clear and fine. Needless to say, you could have knocked me over with a feather.

But, if I have a follicle, could I be ovulating?!? Was that ovulation pain?? I've been on the BCP for 11 years!!! How is this even possilble? I've had everything I've taken for granted for years totally challenged in one day. My fiance and I were hoping to TTC but were fully discussing options like adoption. We're stunned, if this means what we're thinking it may. Can anyone give me any ideas what may be going on? I know I'll hear from my doc soon, but am just floored. Never thought ovulation was possible in general, much less on the pill!! Help?

Okay, so I'm not looking a huge gift horse in the mouth... but PCOS has been a part of my life for over 11 years, and I can't even imagine babies being conceived without intervention...not in my familiy! I feel bad being so happy about not having cysts, but my whole perception of my health just got up-ended.... Hm. Thank you in advance for anything ya'll can tell me!!

andisings · 05-22-2006, 07:49 AM

*bump* does anyone have any information that could help me understand this at all? I'm totally lost and on top of all that happened last week, I've felt nauseous and icky all weekend. Help?

JElaineB · 05-22-2006, 09:44 PM

Hi, I'm new here, but not new to PCOS. I too have had PCOS since I was a teen and have been on BCP since I was 18 years old. The only time I went off it was to TTC my son (who is now 3.5 years old).

First, I am assuming you are on combo pills (estrogen + progestin)? Did you miss any pills? Missing a pill can increase your chances of ovulating. However, if you have a follicle after the pain then I don't think it was ovulation pain. Ovulation would have ruptured the fluid-filled follicle and it would have turned into a solid mass of cells (the corpus luteum).

Also keep in mind that the pill is not 100% perfect in preventing ovulation/pregnancy even if you take it perferctly every day. Even if it is 99% effective (which is higher than typical use) that means 1 out of 100 women using it per year will get pregnant even if they take it on time every day.

Also, don't assume that just because you have PCOS you won't be able to ovulate. I personally know I am more fertile on the pill than off. Weird but true. I conceived my son 17 days after going off the pill. The pill helps regulate my hormones such that it makes it possible for me to ovulate once I stop taking it. If I stop for too long (>2 months) then I don't ovulate (found this out when I was TTC - I used a home ovulation monitor - now called ClearBlue).

I don't know what your pain was, but I hope you are feeling ok now. Good luck with the wedding plans!

andisings · 05-23-2006, 03:24 AM

[quote=JElaineB] I personally know I am more fertile on the pill than off. Weird but true. I conceived my son 17 days after going off the pill. The pill helps regulate my hormones such that it makes it possible for me to ovulate once I stop taking it.

That is pretty much what I'm thinking is happening here. I mean, I'm thrilled that things look good on my US, but definiately don't need to be PG right now! The pain is all gone, and we'll see what happens. Thank you so much for your advice, and for kind words. It's nice to know someone else's perspective and experiences!

Wedding plans are rocking along -- thanks for asking!