Question: Hi there,

My name is Dr. XXXXXXX XXXX, currently working in Medical Insurance company. I have one case of our member and need to have your expert opinion.

Chief complaints/reason for admission:

This is 31 year old female member who presented with lower abdominal pain since 3-4 months, which is progressively increasing associated with dysmenorrhea. Pain increases on long hours of sitting associated dyspareunia.

On Examination:

Abdominal examination showed tenderness in the right iliac fossa.

Past Medical/Surgical History:

Hypothyroidism
She has a history of laparotomy for bilateral cyst-adenoma with dermoid cyst in 2012

Obstetrical History:

She is married since 5 years now. Nullipara.

Ultrasound Pelvis:

The uterus is retro-positioned measuring 8.52 x 4.61 x 4.25 cm in size.
The myometrium and endometrium appear normal.
Right ovary shows a cyst 3.88cm x 3.07cm.
It shows fine internal echoes.
A focus of calcification seen in right ovary.
Left ovary is obscured.

As per the treating doctor: Surgery is opted in this case based on the size of the cyst and nature of the cyst (Endometriosis/Dermoid cyst)

Procedure: Ovarian cystectomy

I would like to have your expert opinion on this case to confirm if the current condition of the patient and current diagnosis is related to secondary infertility as She tried in between for pregnancy and failed.