Dear Dr Mitchell,
I am 19 years old and was recently diagnosed with bilateral polycystic ovaries and a moderate right hydrosalpinx. Are there any chances that I can ever have children in the future?
Polycystic ovaries is a condition that is associated with enlarged ovaries, irregular menstrual periods, excessive weight gain, excessive hair growth on the face, chest and abdomen, acne, and an increased tendency to develop diabetes mellitus.
A hydrosalpinx is a dilated Fallopian tube that results from a sexually transmitted infection, usually gonorrhea or chlamydia. These infections cause Pelvic Inflammatory Disease (PID) with inflammation of the Fallopian tube, lining of the uterus, and the cervix. If it is detected late and treatment is delayed then the Fallopian tubes can become damaged and blocked, resulting in hydrosalpinges.
Polycystic ovaries can be treated. It is important to control your weight and achieve your ideal weight for height by diet and regular exercise. The use of a low dose contraceptive pill can help to suppress cyst formation in the ovaries and suppress the excessive hair growth and acne. The choice is usually one containing Cyproterone Acetate which reverses the effects of excessive testosterone (male hormone) associated with the condition.
The use of Metformin helps to improve fertility and reduce the risk of diabetes mellitus. The combination of Metformin and Clomiphene Citrate (Clomid) is usually effective in inducing ovulation and improving fertility.
It is extremely important for you to be careful not to contract any sexually transmitted infections that will damage the other Fallopian tube since you already have one damaged tube. You should always use a condom and if there is any sign of an abnormal vaginal discharge you should seek medical advice and treatment immediately.
When you are serious about becoming pregnant you should ask your doctor to do an X-ray of the Fallopian tube to determine if the other tube is blocked. The risk of an ectopic pregnancy is extremely high with damaged Fallopian tubes. This is a pregnancy that is implanted outside of the lining of the uterus and most commonly in the Fallopian tubes. If this is diagnosed late it can lead to the rupture of the Fallopian tubes, excessive blood loss, shock and even death.
If both Fallopian tubes are damaged, then surgery to clear the blockage can be done or pregnancy can be achieved by doing invitro-fertilisation (IVF). This is a procedure where the egg is removed from the ovary, fertilised with the sperm from your partner, and transferred to the lining of the uterus for growth and development. This is available locally in Jamaica with good results.
Do not panic. You are young and there are a lot of options available to you. In the interim, practise living a healthy lifestyle with regular exercise and appropriate diet to maintain your ideal weight for height. Also practise safe sexual activity to reduce the risk of infections.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.