My husband and I have been trying to have a baby for three years with no success. My doctor says I may have polycystic ovarian disorder, as he has seen cysts on my ovaries in few of my cycles. But this has happened mainly when I was stimulated with drugs such as clomiphene and metrodin. I have normal monthly menses and no excessive facial hair. My thyroid is normal, and so are my blood sugar levels. My laparoscopy and HSG results were normal too. I do have a slight growth of hair on my tummy. Is that a symptom of PCOD? How do I know if this is the right diagnosis?

Audrey

PCOS (polycystic ovary syndrome) is a syndrome, NOT a disease. A syndrome is merely a group of symptoms that commonly occur together, such as irregular menses, obesity, elevated male hormones and/or excess hair growth. In fact, there is little agreement regarding which symptoms must be present to make this diagnosis. As such, PCOS is not diagnosed by a specific test. Rather, PCOS is diagnosed if you have the associated symptoms AND you have tested negative for other diseases such as thyroid problems, enzyme deficiencies, tumors and diabetes.

We now understand that many women with PCOS demonstrate insulin resistance on testing. Physicians will often test blood sugar and reassure patients that there is no problem, as the fasting insulin level is within the normal range. This is a mistake. Women with insulin resistance usually have normal fasting blood sugars but frequently demonstrate a very high insulin level two hours after drinking a sugar solution on a glucose tolerance test. Many will often report a history of hypoglycemic episodes.

You said that your menses are normal and that you don't have excess facial hair. Most physicians consider irregular menses the most important criterion for diagnosis of PCOS. Using this standard, you would not be considered to have PCOS. But if your family history for type II diabetes is strong, or you are obese, an insulin glucose challenge test may demonstrate whether insulin resistance is a problem. If so, treatment could lead to pregnancy.