My follicles are growing, but no LH surge. Should I worry?

Hello,

Welcome to icliniq.com.

No one likes to hear this, especially women, but your weight may be a contributing factor. You might have PCOS (polycystic ovary syndrome)/PMOS (polyendocrine metabolic ovarian syndrome). PCOS/PMOS is a congenital condition, meaning it is genetically programmed and inherited from your parents.

When you gain weight, the excess cholesterol in your body can convert into estrogen hormones. This conversion can disrupt the balance between follicle-stimulating hormone (FSH) from the brain and the ovarian hormones.

FSH stimulates follicle growth in the ovary, but once the follicle reaches a sufficient size for ovulation, the estrogen hormone from the ovary suppresses FSH. However, when excess estrogen hormone comes from fat, it can confuse the brain, resulting in the early cessation of follicle growth at a smaller size, which prevents ovulation.

These follicles become resistant to luteinizing hormone (LH) and continue to grow, eventually forming cysts. During your next scan, you may observe these cystic follicles, commonly known as polycystic ovaries.

PCOS (polycystic ovarian syndrome)/PMOS (polyendocrine metabolic ovarian syndrome is a condition that is often associated with the following:

1. Obesity.
2. Irregular menstrual cycles.
3. Absence of periods for several months, followed by heavy periods with clots and fleshy masses.
4. Intermittent spotting.
5. It can also be related to thyroid abnormalities and indirectly linked to prolactin issues.
6. Additionally, you may notice the accumulation of excess fat around the midsection, particularly in the waist, thighs, and breasts, with little fat distribution beyond the elbows and knees.
7. Other symptoms may include excessive body hair growth, hair loss, darkening of the skin on the lower half of the face, acne, oily skin, and darkened skin on the back of the neck, inner thighs, and underneath the breasts.
8. There may be a family history of diabetes, particularly on the father's side. This condition can hinder ovulation and make it difficult to conceive until it is treated. It also increases the risk of early pregnancy loss.

However, there are solutions available to address concerns related to PCOS/PMOS. I suggest you do the following:

• Once you achieve a normal weight range, you may not require medication to regulate your menstrual cycles or improve fertility. Pregnancy is likely to be healthier in such cases.
• To reduce weight, avoid fasting and eliminate junk food, fast food, and red meat from your diet.
• Minimize snacking between meals and opt for low-calorie foods with high protein content.
• Engage in regular exercise, particularly targeting the waist and hip areas, including activities like aerobics, yoga, and brisk walking (swinging your hands well).
• Aim to lose two to four kilograms per month, but avoid rushing the weight reduction process as it may be challenging to maintain.
• Once you have successfully reduced at least 11 pounds, you should notice positive changes.

Since your goal is pregnancy, you want a healthy egg to be released from the ovary at the right time, with the endometrium (uterine lining) having the appropriate thickness. This will optimize the chances of the egg meeting the best sperm for successful embryo formation.

Ideally, you would want the egg to be released around the 12th to 15th day of your menstrual cycle, rather than randomly when the cyst happens to rupture. Taking a few months to gradually lose weight can significantly improve your chances of getting pregnant, eliminating the need for frequent follicular scans and follow-ups.

I hope this information helps you.

Do write back if any more queries.

Thank you.