Is it possible to get pregnant with infertility issues?

Question

Hello doctor,

I consulted my gynecologist for an infertility issue. After scanning they found AFC 30 in the right ovary and AFC 25 in the left ovary. I have been suffering from a small right hemorrhagic ovarian cyst measuring 20 x 17 mm. Is it okay to try for pregnancy or should I cure them first? What issues can be faced?

Thanks.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Your antral follicle count (AFC) is 30 in the right ovary and 25 in the left, which is quite high. This suggests a high ovarian reserve, which can be a good thing for fertility. However, it may also indicate polycystic ovary syndrome (PCOS) if you have irregular cycles, insulin resistance, or other symptoms. The small hemorrhagic ovarian cyst (20x17mm) is usually not a major concern, as these cysts often resolve on their own within a few cycles. However, if it persists or grows, it could affect ovulation or cause pain.

Yes, you can try for pregnancy, but if you have PCOS or irregular ovulation, it might take longer or require assistance (like ovulation induction medications). The cyst itself is unlikely to prevent pregnancy unless it grows larger or disrupts ovulation. Possible issues you might face:

Irregular ovulation: If you have PCOS, you may not ovulate regularly, making conception harder.
Hormonal imbalance: High AFC can mean higher androgens, leading to ovulation issues.
Increased risk of miscarriage: If PCOS is present, insulin resistance and hormonal imbalances can slightly increase miscarriage risk.
Cyst complications (rare): If the cyst ruptures or twists, it can cause sudden pain and may need medical attention.

You should get the following done:

1. Check your hormones: Ask for AMH (anti-Mullerian hormone), LH (luteinizing hormone), FSH (follicle-stimulating hormone), prolactin, insulin, and thyroid tests to assess fertility and rule out PCOS.

2. Track ovulation: Use ovulation test kits or follicular scans to confirm ovulation timing.

3. Consider ovulation support if needed: If you are not ovulating regularly, your doctor may suggest ovulation-inducing medications like Letrozole or Clomid.

4. Monitor the cyst: Repeat an ultrasound in four to six weeks to check if it resolves on its own.

If your cycles are regular and you are ovulating, you can try naturally. If not, a fertility specialist may help improve your chances with medications or treatments. Let me know if you need more details.

I hope this information will help you.

Thanks.