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Suggest Treatment To Cure Ovarian Cyst

Posted on Tue, 6 May 2014

Question: hello doctor I am XXXX from bangalore aged 26 years old.I was 6 weeks when i got miscarriage by taking pills in XXXXXXX But i dint went for scanning.But later the bleeding dint stop for one and half month so went for scan.I got the report with a blood cyst on my right ovary measuring (8.8*8.0*6.0cm).So doctor suggested for leupride 3.75 mg injection for 3 months to stop my cycle,Since regular cycle causes the cyst to grow.Later he gave XXXXXXX tab in december for cycle to happen and to get regular.But for 3 months i dint conceive.The size of cyst was bit reduced before.But now with regular cycles its measuring (7*4.7cm) as before.This month doctor gave ovaa shield tab from 3rd day of cycle and fertigyn hp 5000 injection on 12th day for release of egg.Today is 16th day of cycle.He told to take duphaston 10mg tablet for next 15 days.What is the use of this tab according to my condition?Please help seeking advice.Please advice if any other treatment.Doctor has told for trying another 2 to 3 months naturally.If not conceived he has told for laproscopic surgery to remove cyst .

Answered by Dr. Bhagyashree.B (47 minutes later)

Brief Answer: surgery required if no pregnancy Detailed Answer: Dear XXXX, Thanks for writing to healthcare magic. You have a ovarian cyst . There are different types of ovarian cyst. If the cyst is simple then it will resolve in 3 months with XXXXXXX tablets. Some cysts like endometriosis cyst requires injection leuprolide to supress the cyst. As you have received both but the cyst has not disappeared, your doctor is right in suggesting that you may need surgery for removal of cyst. The drug ovaashield is to induce egg growth. The fertigyn is for release of egg. Intercourse is advised around this period. The duphaston is to support the pregnancy. you are on right path of treatment. If you don't conceive or if the cyst increases please undergo surgery. Write back if you have any queries. Thanks. Dr Bhagyashree

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Bhagyashree.B (1 hour later)

Hello doctor, Thanks for the reply If i undergo surgery what will be the chances of conceiving afterwards?or else if i do not undergo surgery after 3 months from now as doctor suggested what will be the condition of cyst if it grows more or left like that only?Will it be dangerous to uterus or health?Rite now only my left ovary is releasing egg.Please advice. I have attached my reports which was taken before my treatment and today's follicle scan please check the difference and suggest.

Answered by Dr. Bhagyashree.B (1 hour later)

Brief Answer: chance of conceiving better with surgery Detailed Answer: Dear XXXX, Thanks for writing back. Your 1st ultrasound report suggests that you had two cysts, one clear and other endometrioma. The clear cyst was only 4-5 cm. this type is seen in many women and does not effect the chance of pregnancy. The endometrioma is a little big. To explain clearly the endometrioma has same cells as your uterine lining . so every month as you get your periods the cyst will bleed inside. The problem is if it continues for long then it may effect the fallopian tubes which are important for pregnancy. having said this there are excellent treatment methods for endometriosis. best is to remove the cyst by laparoscopy and repeat injection leuprolide for 3-4 cycles after the surgery. LEUPROLIDE prevents recurrence of cyst to some extent. also during the surgery the fallopian tubes can be examined for damage if any. so your chances of pregnancy are better if the cyst is removed. the cyst may grow or remain same if you don't operate. it does not cause major health disorder like cancer but if it ruptures inside you may need emergency surgery. In this cycle you have responded well to the fertility treatment. your ovary has released egg and you may conceive. The cyst has not change significantly. Hope this answers your queries. Thanks Dr Bhagyashree

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Bhagyashree.B (12 hours later)

Hello doctor, Thanks for the reply and suggestions. If cyst is removed by laproscopic surgery,can my right ovary will be able to release healthy eggs,or will it affect the formation of eggs for every cycle.I am very worried about undergoing operation,If surgery was the best option then why dint the doctor did not suggest me at the beginning?Please advice.

Answered by Dr. Bhagyashree.B (7 hours later)

Brief Answer: medical treatment is always tried first . Detailed Answer: Dear XXXX, Thanks for writing back. Medical treatment is always tried first. In my clinical experience I have seen lot of patients with cysts which resolve with medical treatment. As I have discussed with you earlier as you have received both leuprolide and XXXXXXX and the cyst has not decreased then surgery is required. Regarding pregnancy in future you anxiety is understood. The ovary Will release eggs even after surgery. The problem is how much adhesion have happened between the tubes and uterus. this can be analyzed only during surgery. Please relax. Many young women have ovarian cysts and response to treatment is good. Go ahead with treatment as your doctor has advised. Thanks Dr Bhagyashree.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Bhagyashree.B (16 days later)

Hello Doctor, Thanks for the reply.This month also I did not conceive after taking all the above tabs and injection.Though I had proper contact as doctor told it did not happen.Today,I consulted doctor since i got period.It was 4th day.He told due to endometriosis may be i have not conceived.Now he has given tab XXXXXXX Nac 600mg tab,its a powder type which should be mixed with water and consume,and also consewel tab to take which he had given before.This time he told he is giving only vitamin supplements.He also suggested if i did not conceive next month you have to undergo surgery.This is the last month to give a try.Please let me know about the tab XXXXXXX Nac.Whether it is helpful for conceiving?And also please give information about laproscopic surgery.What are its types?What kind of surgery is appropriate for my situation?Please tel the approximate cost of it. Thanks

Answered by Dr. Bhagyashree.B (41 minutes later)

Brief Answer: go ahead with surgery next cycle. Detailed Answer: Dear XXXX, Thanks for writing back. I can understand your disappointment on not conceiving this cycle. This cycle your doctor has prescribed you medicine that will help you conceive naturally. The tablet nac is an antioxidant which may decrease the bad effects of the endometrioma. The consevel is to improve the uterus lining and cervical mucus so that implanted embryo grows better. Having said the above your chances depends on whether your fallopian tubes are patent. This can be checked only by surgery in your case. Take the medication as advised and have intercourse around ovulation. The surgery if required next month involves removal of the cyst and to keep the ovary undamaged as much as possible. Also the patency of fallopian tubes will be checked.The surgery can be done as laparoscopic or open surgery but laparoscopic is preferred. Your further chances of pregnancy will depend on how advanced is your endometriosis . The cost varies from hospital to another. You can ask for a basic quote from your doctor. May cost 50,000-60,000 in Bangalore but I can't be sure of that. Thanks Dr Bhagyashree

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Bhagyashree.B (22 hours later)

Hello doctor, Thanks for the reply.Please tel me how exactly the laproscopic surgery is done.What can be its side effects?How much time it takes for recovery?Whether its a major or minor operation and its duration?How many days I should be in hospital if admitted?

Answered by Dr. Bhagyashree.B (23 minutes later)

Brief Answer: short stay in hospital. Detailed Answer: Dear XXXX, Thanks for writing back. The primary idea of laparoscopic surgery is to make small 5 mm holes in specific areas of the abdominal wall and introduce a camera and instruments through it. The surgeon looks at the image from camera on a tv and operates. At the end you may have 3-4 small 5 mm cuts which hurt much less than one big one. So stay in hospital is usually 24 hours. You can also return to your day today routine in a week. Any surgery is associated with a few anaesthetic and procedures related risks which will be explained by your doctor. The surgery is a major surgery and done under general anaesthesia. Thanks Dr. Bhagyashree

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj