Hello,
Thanks for posting your query at DoctorSpring.com
Actually there is no discrete endometrioma seen here.
The ovaries are enlarged, and multiple cystic lesions are seen.
Your symptoms fit with those of endometriosis, but first, I would advise a repeat ultrasound scan.
I have a doubt whether this is a chocolate cyst at all.
Even if you have definitive endometriosis, there is a first line of therapy - medical management.
Drugs / injections such as Lupride, Progesterone, Danazol can be tried first.
Simple OC pills / Progesterone only Pills also can be tried first.
Also, is pregnancy a concern here ?
Looking forward to hearing from you.
Take care.
Patient replied :
Yes madam, We are planning for a pregnancy from last 1 year. Doctor has done initial scanning also by keeping some kind of stick through my uterus. She has identified some abnormal cysts of size more than 2cms. And she said that it keeps growing every menstrual period cycle. So, to confirm about whether or not it is enddometriosis, she suggested CA-125 and other tests in which it is found >200. Int the MRI and found that 2.6x1.9 cms cyst is present and that it is a chocolate cyst.
Well even if it is confirmed that it is endometriomas, you can try medical management first.
If you are trying to conceive, then it might make sense to remove the endometriomas first surgically and then plan for fertility treatment.
The risk is that normal ovarian tissue might be lost, resulting in decreased ovulatory capacity.
Patient replied :
Madam, are you saying that even with the chocolate cysts present, by taking medication can I try to conceive?
See, a chocolate cyst is a variant of endometriosis.
Endometriosis manifests in various ways - spots, burns, cysts, adhesions, bands.
Endometriosis can be given a trial first with medication, and then surgery if it is does not respond to medicines.
If fertility is a top priority, then surgery is faster .
The risk with surgery is that along with the cysts, part of normal ovarian tissue too maybe removed.
That is what I was trying to explain.
The choice is yours.
I would have liked a repeat transvaginal ultrasound scan to know the extent of the cysts.
Regards.