Walaikum Salam!

I'm fine, thanks! How about you?

Yes I do remember talking to you sometimes back. And I am sorry to hear that there hasn't been any rewarding news yet. But please don't loose hope, as treatment of infertility sometimes takes time. I know these words may not bring you much solace, but atleast something to keep on the back of the mind when feelings of disappointment creep in.

Now regarding your labs, it is best to have these labs ( FSH,LH, and Estradiol E2) drawn on day 3 of your cycle, but still OK to have these from day 2-4, or maybe even 5. Anyway, based upon these results, everything looks ok except your Testosterone level, which is elevated. Testosterone is a predominantly male hormone, which is also present in small quantity in every female as well. However, certain conditions like PCOS ( Poly Cystic Ovarian Syndrome) cause an increase in testosterone levels in women, resulting in symptoms like excessive hair on face and extremities, acne, hair growth on chest etc, and irregular menses, as well as difficulty conceiving.

I am pretty certain that your Pituitary Fossa MRI would also come back as normal.

By the way, did you have your ultrasound done as well? How about your thyroid function? Has your TSH been checked?

All the best!

walaikum Salam,

I am doing very well, thanks!

As expected, you MRI is normal. Given a normal prolactin level, there probably wasn't any need for the expensive MRI of the pituitary fossa in my opinion, but anyway.

PCOS can't be diagnosed based upon just an elevated testosterone level. Most, but not all, patients with PCOS have cysts on their ovaries, hence the name Poly (many) Cystic ( Cysts) ovaries. You haven't shared the actual result of your ultrasound, but given that it showed few small cysts, I would recommend that you should get some additional testing, including a GTT ( Glucose Tolerance Test) and Insulin levels.

Even though most labs still consider the upper limit for TSH around 5, new guidilines consider anything over 3 to be of concern. You are not there yet, but just something to keep an eye on.

All the best.