Dear Professor Winston,
I am 38 and my husband is 32. I was diagnosed with PCOS 13 years ago. We managed to conceive our so 2 years later. Hes now 11. Since then we have had no luck conceiving. I had ovarian drilling 8 years ago and during the procedure they found bilateral hydrosalpinx. They cleared my tubes and in the post op check and also a year ago the cysts have not returned and both tubes are still clear. I had a blood test done recently and its confirmed that I do ovulate but I’m wondering about a few things. My LT phase is on average 10 days. Is there a way to lengthen that? Also even though my tubes are patent, what are the chances that they still work the way they should. I’m aware that the surgery can leave the tubes permanently damaged. I’m also concerned about my age. Please help with any
information or advice. Thank you so much.
You mention that you had tubal surgery eight years ago and that recently you had a check to see whether your cysts had returned and whether the tubes were clear. How was this check done? Was it done by laparoscopy and if so, are there any photographs because this would be extremely helpful in offering you definitive advice. Often quite subtle changes, irrespective of whether the tubes are open or not, would give a powerful clue about what to do next.
I suspect that your tubes are quite damaged even though they are open and it is not unlikely that when the inflammation that caused your tubal block, the ovaries were also involved. This is quite common and very frequently this so-called “salpingo-oophoritis” leaves not only damaged tubes but also ovaries which are bit scarred and do not work as well. This is true whether you have had pco or not in the past. Chronic oophoritis (inflammation or scarring of the ovaries) can lead to less effective ovulation (even though you may be developing follicles) and may possibly be why your cycle has changed a bit.
Do you have any photos from the recent check you had done? If so, that would be very helpful. But I think my advice must be to recommend getting ovarian function tests done – particularly AMH. If the levels are reasonable and indicate reasonable ovarian function, I suggest that IVF is likely to be the best chance to help you get pregnant though I do understand this is a route you may not want to take.
My best wishes,