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When PCOS is not PCOS


Forum: Trying to Conceive with Medical Assistance

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  • 1 Post By *Whiskey*
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  #1  
October 4th, 2013, 07:06 AM
*Whiskey*'s Avatar Blessed
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Did you know that there is another genetic anomaly that can mimic PCOS, without being PCOS? It's interesting in that is has all the same symptoms, minus one little thing. 17-OHP or 17-hydroxyprogesterone levels.

In a woman with normal levels of this hormone, showing the classical signs of PCOS, ie, hirsutism, acne, weight issues, irregular menstruation or amenorrhea, PCOS (or Polycystic Ovarian Syndrome) is the culprit. However, elevated levels of 17-OHP almost always points to NCAH or Nonclassical Congenital Adrenal Hyperplasia.

Since PCOS is so difficult to diagnose, most doctors will join several symptoms together and use that as the diagnosis. Which is not necessarily a bad thing. On investigation, elevated DHEA-S and high normal androgens can point to PCOS as well as NCAH.

Elevated levels of 17-OHP are usually caused by a deficiency of 21-Hydroxylase. 21-Hydroxylase is an enzyme that creates cortisone in the body.

NCAH normally presents in females after puberty and worsens with age. Mostly it is treated symptomatically, that is to say a doctor will treat symptoms usually with a glucocorticoid (hydrocortisone, prednisone, dexamethasone).

However, if quality of life is not being affected by the symptoms, no treatment is necessary. If there are infertility issues, normal processes of ovulation induction are the recommended course of action. Genetic counseling is recommended with the discovery of NCAH as it is indicative of being a carrier, two copies of NCAH will result in Congenital Adrenal Hyperplasia.

There have been recent studies on using metformin with NCAH for infertility treatment, based off results from patients with PCOS being treated with metformin. Since NCAH and PCOS are so closely linked, it is believed it can be beneficial in both cases.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Not a formal article, just information that I have gathered in the process and wanted to share.
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  #2  
October 4th, 2013, 04:01 PM
Lucy S.'s Avatar POAS addict
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Wow interesting!
So unless you have bloodwork there is no way of knowing though correct?
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  #3  
October 4th, 2013, 04:42 PM
*Whiskey*'s Avatar Blessed
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Pretty much, and you need the right series of blood serums drawn, not to mention fasting and has to be in the morning. LOL.
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  #4  
October 4th, 2013, 05:12 PM
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Good stuff! Thanks for sharing your research!
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  #5  
October 4th, 2013, 06:15 PM
*JenJen*'s Avatar impatiently waiting
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curious. now I want to check my results to see if I have ever had that lab drawn.... and if not get it drawn.
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  #6  
October 4th, 2013, 06:55 PM
*Whiskey*'s Avatar Blessed
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Honestly, I would.

This link might help. It's a bit medically mumbo jumbo but it's good.

Helps if I add the link http://nurse-practitioners-and-physi...yndrome-2.aspx
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Last edited by *Whiskey*; October 4th, 2013 at 07:10 PM.
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  #7  
October 4th, 2013, 07:18 PM
*JenJen*'s Avatar impatiently waiting
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I will after the stupid shutdown ends.
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  #8  
October 6th, 2013, 09:57 AM
JennyLee's Avatar TTC #1 after loss
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Interesting - thanks for sharing! I'm assuming this is not generally tested?
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  #9  
October 6th, 2013, 10:30 AM
*JenJen*'s Avatar impatiently waiting
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Quote:
Originally Posted by Whiskey View Post
Honestly, I would.

This link might help. It's a bit medically mumbo jumbo but it's good.

Helps if I add the link Polycystic Ovarian Syndrome on ADVANCE for NPs & PAs

that was actually a really interesting read...and obviously I have spent way too much time in the IF world since I could understand it all without any googling lol.
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2006-2014 6+ years of NTNP, TTC, TTCMA, Losses, Surgeries, and Diagnoses.
RPL and Genetic Tests came back 100% normal | Endo, PCOS, severe MFI
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  #10  
October 6th, 2013, 10:55 AM
*Whiskey*'s Avatar Blessed
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LOL I kinda figured you'd be just fine reading it without translation.
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  #11  
October 6th, 2013, 11:17 AM
*JenJen*'s Avatar impatiently waiting
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I almost feel like I should go to nursing school after all this. I might as well put the knowledge I have to good use.
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2006-2014 6+ years of NTNP, TTC, TTCMA, Losses, Surgeries, and Diagnoses.
RPL and Genetic Tests came back 100% normal | Endo, PCOS, severe MFI
Multiple early losses between 3 and 8 weeks.

Broken in heart, mind, and body. On a break until Summer 2016






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  #12  
October 7th, 2013, 03:31 AM
ChiChica's Avatar Mega Super Mommy
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Thanks for posting! My RE checked for this. She said it was much less common than PCOS but that it was really important to differentiate the two for treatment purposes.
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