Endometriotic cyst – Is it OK to Get Pregnant?

Q: Sir, I am 38 years old married woman. My right adnexa shows a cystic lesion of size 3.2*2.5 cm with internal echoes, adjacent to right ovary. There are no solid elements, septation or abnormal increased vascularity. There is suspected endometriotic cyst. Urinary bladder is distended. No calculus or wall thickening was seen. Uterus is retroverted, measuring 6.0*4.0*4.0 cm. There is no myometrial or endometrial focal lesion. Thickness is 6mm. Cervix shows nabothian cyst. Left ovary appears normal. No free fluid was noted in POD. Sir we need a child. Can this problem affect my pregnancy? Do I need any surgery? Please inform me doctor.
-By Hema

Reply:

It would be essential to first confirm the diagnosis. Is the cystic lesion in your right adnexa an endometrial cyst?

What is an Endometrial Cyst?

An endometriotic cyst  is a result of a condition called endometriosis. Here, the tissue lining the uterus from inside (endometrium) is found growing in abnormal locations outside the uterus like, ovaries or around the uterus.

During each menses, this abnormal tissue also secretes like the uterine lining. Since there is no place for this internal blood to go, cysts are formed in the adnexa. These cysts are filled with this blood shed during menses.

Due to the dark color of blood, these cysts are also called chocolate cysts.

Endometriosis Interferes With Conception

It is difficult for women with this condition to get pregnant. This is because this condition interferes with the normal process of ovulation and egg movement.

This may happen in any of the following ways:

  • Due to menstrual bleeds, blood spots are spilled all over the pelvis. This may lead to inflammation of internal organs present there.
  • As a result of inflammation, scar tissues are formed over the ovary or fallopian tubes. The tube may stick to nearby structures or even get blocked.
  • Due to scarring, the ovulation from the ovary may get affected.
  • Also, endometriosis has a tendency to spread. It may reach the ovary to produce cyst inside it. This can also inhibit ovulation.

Without proper ovulation and movement of egg through the tube, pregnancy would be difficult.

It is suggested that you first get yourself treated.

Find out what that cystic lesion is. Your doctor may like to do a laproscopy for this purpose.

Treating Endometriosis

Safe tablets and injection are available for treatment. These include danazol  and other birth control pills.

Cysts bigger than 5 cm require surgical removal. Since your cyst is pretty big, it would be recommended to get it removed surgically.

There is nothing to worry. The procedure is simple and usually done laproscopically. Once treated, you may safely plan your pregnancy.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “Endometrial Cyst and Planning for Pregnancy

  1. Aru

    Asalamu Alaikum, sir last month I have done USG and MRI that showed complex cyst in right Adnexa 305ml and CA125 was high 199. Doctor advised me surgery and have done it so cyst has been removed and biopsy of the cyst came out normal, now my marriage is in coming August this year, so am bit worried. Can I conceive as it was a chocolate cyst?

    Reply
    1. Buddy M.D. Post author

      Can you give us the details of the surgery performed? What all organs were removed, for instance ovary, tube etc.?

      Removal of the chocolate cyst is unlikely to interfere with your married life. One ovary is enough to produce eggs and lead to conception.

      Read above in detail about the cyst.

      Reply
      1. Aru

        Through laparoscopic surgery, only the cyst was removed and I am 27 years old and doctor told me that in coming cycles I need to get an injection. Can you please tell me what kind of injection that could be?

        Reply
        1. Buddy M.D. Post author

          As you may read above, endometriosis tends to inhibit ovulation. Though the cyst has been removed now, it may take time for your body to resume normal menses by itself.

          Meanwhile, it is essential to induce ovulation each month. The injections your doctor mentions are likely to be hormonal pills, to be used to induce ovulation.

          Reply
          1. Aru

            Thanks a lot for your answers as I was worried about through my age I never come to know about this cyst so had no knowledge it was really shocking for me, may Allah cure all those who are in distress. Thanks a lot.

  2. wasim banu

    I had ccq tablet to get pregnant and in Right ovary thick walled (2mm) cyst lesion of size 60x43mm with diffuse thin internal echoes like chocolate cyst and a 3x2cm thin walled cyst noted adjacent to right endometriotic endometrium measures 6.4mm
    what should I do now?

    Reply
    1. Buddy M.D. Post author

      As you may read above, it is essential to get your endometrial cyst treated before you plan conception.

      These cysts are hormone responsive, and may therefore interfere with pregnancy.

      Reply
      1. wasim banu

        My gyne said me to try to conceive without removal of the cyst as I have no child yet. She says, after surgery it would be a problem for me to conceive with one ovary. Is it possible to have a child without removal of cyst. I’m worried. Please help me out. I’m having PCOS and last year I had molar pregnancy and now I’m having 6mm chocolate cyst. Though my period date has not came there is quite little bleeding daily. Should I do laparoscopy? Or is it risky for me to conceive?
        My husband is on stay in India for one or two months. So I wanted to get pregnant 1st without any surgery. Is it possible?
        Please help me.

        Reply
        1. Buddy M.D. Post author

          It’s not that you have to go for surgery. There are medical treatment available for the chocolate cyst.

          You may conceive even now, but there are some chances that the chocolate cyst may interfere with your pregnancy.

          So, it is suggested that you get yourself treated first before conceiving. You must start having normal menstrual cycles before planning conception.

          Reply
  3. Samreen

    There’s a 34*21mm hemorrhagic (chocolate) cyst in my left ovary. I am 22yr old. From last 4-5 months there was sudden abdominal pain, fever, vomiting, nausea, stomach upsets, pain in uterus at times, tiredness. Is there any need of surgery or that cyst will disappear by tablets? My doc gave deviry 10mg tab for 5 days. I’m always sleeping after eating that tab. I want know the reason and precautions for this.

    Reply
    1. Buddy M.D. Post author

      It is worth trying the medicine for prescibed period. There are possibilities it may reduce the cyst size.

      Read above about endometrial cysts.

      Reply
      1. Anonymous

        Thanks for the suggestion and I have gain weight up to 7 kg as well as my stomach has swollen and skin tone has become very dark. What should I do for this?

        Reply
        1. Buddy M.D. Post author

          This is all the part of the medical condition you are having. As endometriosis regresses, you’ll be alright. The swelling in your stomach would lessen and the skin tone would also improve.

          Reply
          1. Anonymous

            Thanks for your suggestion and tips. But my menses didn’t start yet. My doc told to do sonography on 2-3 day of my menses.

          2. Buddy M.D. Post author

            Deviry works by altering the lining of the uterus.

            You’ll get a flow when you leave the tablets, after taking it continuously for 5 days.

            This needs to be repeated for 3 to 4 months.

  4. Malani

    We would like to know the meaning for following sentence below and what medicine I should undergo
    What kind of diseases major or minor and I am 25yrs old and whether I can marry.
    1 Large multi lobulated lesion in right adnexa
    2 Bilobed hypoechoic lesion in left adnexa- possibilities of endometrioma

    Reply
    1. Buddy M.D. Post author

      Go for your marriage after getting the endometrioma treated.

      This condition is treatable. You need to visit a gyne for this.

      Reply
  5. S. Chakraborty

    As per ultra sonography my uterus is normal.
    But there is a complex cystic right adnexal space occupying lesion with solid hyperechoic mural component – right ovarian dermoid. I have no symptoms of pain etc. except stomach disorder sometimes. What type of problem is this and what to do next?

    Reply
    1. Buddy M.D. Post author

      Dermoid cyst is a small sac like structure, which may contain hair, teeth or any other tissue type. It is so because the cyst originates from the human egg cell (from the ovary).

      These cysts need to extracted out surgically, as there are chances it may complicate later on in life.

      Reply
  6. Arya

    My ultrasound scanning result shows uterus is normal but the both ovaries are PCOS and scattered. Endometriosis is present. I am 28 years old. Last month follicular study was done. My ovulation is properly ruptured follicle. I have a chance of pregnancy.

    Reply
    1. Buddy M.D. Post author

      It is suggested that you get treated for endometriosis first, and then plan conception. This disease process can interfere with your pregnancy later on.

      You need to see a gyne and be on medicines for 3 to 6 months.

      Reply
  7. Anya

    I had clomipure 100mg Q Gold-f and cengest 200mg. My both ovaries are PCOS and endometriosis is present. 1 year before, laparoscopy was done but I did not conceive. I am 27 years old. My HSG scan report normal uterus with patent fallopian tubes on either side and peritoneal spillage was demonstrated on either side, last month follicular study done ovulation is proper on result. Do I have chance of conceiving this month?

    Reply
    1. Buddy M.D. Post author

      It is difficult to conceive with the underlying medical conditions you have.

      You need treatment for both PCOS and endometriosis.

      For this, you need to see a gyne.

      Endometriosis is a condition where the normal lining present inside the uterus is present elsewhere other than the uterine cavity. During menses, this lining, lying outside the uterine cavity, also secretes and causes spillage in the peritoneal cavity.

      It is important to remove this secretory lining, lying outside the uterus.

      Some hormonal imbalance may be responsible for all your symptoms. Your gyne may like to investigate this.

      Reply
  8. Annya

    My both ovaries are PCOS and endometriosis present. Through laparoscopic surgery only cyst removed and I am 27 years old and doctor told me endometriosis is not problem. It is started, it is small size my endometrium thickness is 12.4mm. My period is correctly and last scan ovulation properly, HSG result peritoneal spillage present on both tubes. I want to get pregnancy, any chance this time?

    Reply
    1. Buddy M.D. Post author

      From your reports, it appears that ovulation is proper. There are chances that you are able to conceive.

      However, since you are having peritoneal spillage, may be it’s necessary to treat endometriosis first, before you conceive. Don’t give it a chance to interfere with pregnancy, after conception.

      Reply
  9. Nasrin Sultana

    My chocolate cyst removed from left ovary last 2 months by laparoscopy. My fallopian tube of right ovary is blocked. Is it possible to get pregnant? I am 26 years old. I have no child. Please answer me.

    Reply
      1. Nasrin Sultana

        But my period time is normal and periodical symptoms are normal. Is there any possible result to get conceive?

        Reply
        1. Buddy M.D. Post author

          Your ovaries are alright, so you are getting normal menses. The eggs are formed and released from the ovary.

          The egg then travels through the fallopian tube towards the uterus. It is here that it is fertilized by combining with a sperm.

          Then the fertilized egg reaches the uterus to get implanted there.

          A blocked fallopian tube obstructs the passage of the egg. It also makes fertilization of the sperm and the egg difficult, making it difficult to conceive.

          You may still try for a few cycles.

          Reply
          1. Nasrin Sultana

            My left fallopian tube is good. Doctor said dye test is good for left fallopian tube. Is there any possibility to get pregnant? I am so much tensed. Please tell me what can I do?

          2. Buddy M.D. Post author

            Yes it is possible to conceive if you have even a single functional ovary and a single functional tube.

  10. Rashmi

    I have a cyst in the middle of cervix canal its a solitary cyst and I have tight cervix im trying for baby since 3 yrs with no luck could this cyst be the reason for not conceiving dr says its nabothian cyst not harmfull but since its big and in the internal side middle canal of the cervix its very painfull during sexual activity please suggest if it has to be removed

    Reply
    1. Buddy M.D. Post author

      Most of such cyst require no treatment, as your doctor says.

      However, if it’s very big, as you feel, you may get it removed by a surgeon. Removal is very easy. It may be done surgically or by electrocautery.

      Reply
  11. aanch tiwari

    My left adnexa show a heteroechoic lesion 2.9×2.4×3.4cm.left ovary is not visualised separate.it shows flow on color doppler?tubo-ovarian mass.
    this is coming in my ultrasound reports.I am on antibiotics from last 3 months, before 3 months the size was 5.1X4.5cm.
    I want to get pregnant.I have no kids yet.please suggest.doctor is suggesting for operation.
    what kind of operation it is?I am very much scared.

    Reply
    1. Buddy M.D. Post author

      This problem needs to be solved before you can get pregnant.

      As your doctor suggests, surgical resection of the mass is required.

      Reply
  12. sheela prabhu

    Hai Doctor,
    iam sheela prabhu and my age is 27 now , married since 3 yrs and iam trying to conceive for the past 2 and years, and i took a ultrasound scan on the 11 day from my periods and in the impression it was written LEFT OVARIAN CYST-POSSIBLY ENDOMETRIOSIS CYST AND ITS MEASUREMENT WAS AS FOLLOWS
    UTERES :4.2*7.0*4.0 cm
    LEFT OVARY:3.2*3.5 cm
    RIGHT OVARY:3.1*2.1 cm
    MYOMETRIUM AND ENDOMETRIUM APPEARED NORMAL
    Help me to know that whether i need to undergo a laproscopic surgery. and my weight is 80 now and iam reducing it by doing some physical exercise.reply me as soon as possible sir.
    Thank you

    Reply