question about diagnosis
1 Replies
fplgiraffe - March 27

I am a bit confused about my dx and would appreciate your opinion. I am 35yo; last year had 2 periods total, last one was Sep 06. My test results show thyroid hormones, testosterone, and PRL all WNL. HSG also WNL. My FSH is borderline (12.8). I have used OPK's before and have detected LH surges but don't get periods. I am told my estrogen levels are low side of normal. I had no response to a Provera challenge test. My ovaries looked "normal" on ultrasound. At first my RE told me my problem was reduced ovarian reserve (based upon borderline FSH); but now my RE clarified that my problem is primarily hypothalamic-pituitary dysfunction. My tx plan is IUI with an aromatase inhibitor/injectibles.
Before treatment, I am wondering if any further diagnostic tests are warranted. Should imaging studies be done to rule out a non-PRL producing tumor? Is there any way to more specifically distinguish between hypothalamic vs. pituitary dysfunction?

 

B. Jacobs, M. D. - March 28

Without examining you, taking a full medical history and seeing all you lab reports, I cannot make a diagnosis. It is unlikely you have a pituitary tumor, but checking your prolactin level would help rule that out. I really cannot second guess your RE. If you feel you need a second opinion, you really should see a second RE.
Good luck.

 

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