Can delayed periods be due to pregnancy or fibroids?

Hello,

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I read your query and understand your concern.

I do not see pregnancy in the scan. Let me give a few facts. The earliest detection of pregnancy is by a urine pregnancy test, which detects the beta HCG (human chorionic gonadotropin) hormone level of 25 mlU/ml. This is the hormone of pregnancy. But ultrasound detects pregnancy only after beta HCG has reached 1500 mlU/ml. So if the urine test itself was negative, how can it be seen on the scan? In the scan (attachment removed to protect the patient’s identity) you can notice a white line in the middle of the uterine shadow and this means that the walls of the uterus are touching each other. So there is no pregnancy, fibroids, or any other problem. As you said you have PCOD (polycystic ovarian disease), and the periods can be delayed for months or years. If you want to confirm further have a blood serum beta HCG. It is the most sensitive test for detecting pregnancy. A value less than 2 mlU/ml rules out pregnancy.

PCOD is a congenital condition, you can get it from your parents. When you suddenly put on weight, this cholesterol is converted into estrogen hormone. In your body too when fat is more than normal, this is converted to the hormone which tips the balance between FSH (follicle-stimulating hormone) and the ovarian hormone. FSH stimulates the follicle from the ovary, but once the follicle is big enough to ovulate, the FSH is suppressed by the same estrogen hormone from the ovary. But when the same estrogen hormone is coming from fat, the brain is confused and follicle growth stops early at a smaller size and will not rupture. In the next scan, you will see all these follicles as polycystic ovaries.

This is usually associated with obesity, irregular cycles, absence of periods for a few months, followed by heavy periods with clots and fleshy masses, intermittent spotting, thyroid abnormalities, and prolactin problem indirectly. You develop an extra pad of fat around the mid-segment of the body, especially the waist, thighs, and breasts, with no fat beyond the elbow and knees. Excessive body hair growth, hair fall, a dark shade over the lower half of the face, acne, oily face, and black skin over the back of the neck, inner thighs, and under the surface of the breast are also seen. May have a family history of diabetes. This will not allow ovulation to occur at any time and so you cannot get pregnant, till treated. It also increases your chances of early pregnancy abortions.

But this has a solution. Your expected weight is 114.64 to 121.25 lbs. Once you reduce weight to the normal range, you will not need any medicine to get periods or to get pregnant.

To reduce weight, no fasting is needed. Avoid junk food, fast foods, red meat, and snacks in between meals. Have low-calorie foods and, high proteins. Do regular exercises like aerobics, yoga, and brisk walking, and try to reduce 4.41 to 8.83 lbs. per month. Do not hurry on weight reduction, it will be difficult to maintain. As soon as you reduce at least 11.02 lbs., you will see changes. Even if you are in the normal weight range, try this schedule, it will help.

You will have a chance of pregnancy. I suggest you undergo the following investigations.

1. Husband - Semen analysis at least two, done four weeks apart, and blood sugars.

2. Wife - Blood sugars, thyroid profile.

3. Ultrasound scans to evaluate the uterus, ovaries, and adnexa.

4. Confirm tubal patency - The tube is the connection between the uterus and ovaries which is the size of a hair follicle and cannot be seen on scans. Being such a small opening tube can get blocked easily.

5. HSG (hysterosalpingography), SSG (sonosalpingography), or laparoscopy.

If all this is done and found normal, nothing can stop a pregnancy.

Hope I have cleared your query, do write back if any more queries.

Thank you for consulting me.

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