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    Can a woman with a thick uterus line and polycystic ovarian syndrome get pregnant?
    Bea29 posted:
    Hi I am 29 yrs old, no kids yet. I've been diagnosed with polycystic ovarian syndrome and last week i went to the gyn emergency due to bleeding. I usually never get a period am very irregular, due that in 2004 i had a cyst removed from my left ovary. My gyn er dr told me that if my regular gyn dr ever mentioned about the polycystic syndrom, and i said no never mentioned that to me. So the er gyn dr did a byopsy and the results was that i have the line of my uterus thick. I really dont know what that means. I been looking on line for some answers. My main question is if a woman with polucystic ovarian syndrome and thick line of uterus can have babys? Also the er gyn dr said that in the past days i had lost alot of blood due to the abnormal bleeding. She said that i was gonna need a blood transfusion, but she never told me when. I feel short of breath, dizzie,my heart gets super fast when i try to walk and i feel weak. Should i go back to the er gyn dr or should i go to a regular emergency room? So confused. Please help. Thank you.
    Jane Harrison Hohner, RN, RNP responded:
    Dear Bea: You have asked some very important questions. Let's take them in order, OK?

    1. Endometrial hyperplasia ("too thick lining") means an overgrowth of the lining of the uterus. . Simply stated, if the uterine lining is like grass or lawn, estrogen is like the fertilizer (causes a thickening of the lining), and progesterone is like the lawnmower (keeps the lining thin by three different mechanisms). This is why DepoProvera (high dose synthetic progesterone) brings about a thin lining, and why birth control pills (relatively progesterone dominant) bring about shorter, lighter periods. It is also why women who miss ovulations (no progesterone produced) are at a greater risk for a too thick lining. The most common reasons for a younger woman to not be ovulating (no lawn mower activity so thicker lawn) is being heavy set. Being heavy set increases the risk for having polycystic ovarian syndrome (PCOS).

    A too thick lining is a common cause of heavy and prolonged bleeding. The diagnosis can be made by ultrasound or endometrial biopsy. The ultrasound image measures the thickness of the lining ("endometrial stripe"); with hypeplasia it is usually more than 12-15 mm. I had a patient once with a thickness of 30mm! The endometrial biopsy takes a sample of lining tissue and the pathologist can then make a very accurate diagnosis base upon the cells seen under the microscope. The treatment for a too thick lining which does not contain abnormal cells is synthetic progesterone pills or shots. This shrinks down the too thick lining.

    Once a too thick lining has been treated to get back to a normal thickness this does not impact fertility. However, PCOS and the lack of ovulations can make it difficult to get pregnant when you want to. Women with PCOS can take much longer to conceive. If you are heavy set ;losing 7-10% of your body weight can restore ovulations, increase progesterone production, and improve fertility.

    2. Severe anemia can arise if a woman has chronic heavy vaginal bleeding. It sounds like you have a severe anemia is they were considering a blood transfusion.symptoms of severe anemia can include shortness of breath, dizziness, weakness, etc.

    3. I would urge you to get follow up. Generally speaking the best place for continued care is to see a MD (eg the GYN) rather than going back for repeat visits to the ER. Usually the ER will make a recommendation for continued follow up; sometimes they will even make the patient a follow up appointment. If you can see the GYN you saw in the ER so much the better as they are already familiar with your case.

    In Concern,

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