Endometrioid ovarian cyst - a benign tumor that is most common in women of reproductive age. In some cases, such cysts are associated with infertility. This violation of endometrial tissue begins to grow outside of the uterus. It is estimated that endometriodnyh ovarian cyst is formed in 5-10% of women of reproductive age.

Symptoms of ovarian cysts endometriodnyh

For a long time this type of cyst may cause no symptoms. Such its features as irregular menstrual cycles Irregular menstrual cycle: look for the cause   and severe pain during menstruation, many women ignore, considering them as a normal variant. Eventually endometrial cyst may lead to symptoms such as chronic pelvic pain, unusually heavy menstruation or absence of menstruation, pain during urination and / or infertility.

Causes of ovarian cysts endometriodnyh

Endometriodnyh cyst is considered a subtype of endometriosis; It occurs in 17-44% of women diagnosed with endometriosis. These tumors are sometimes called chocolate cysts because they contain a thick, a chronic blood that looks like a brownish liquid. The exact cause of this disorder is unknown, but in this regard there are several theories. According to one of them, menses, which are part of the endometrial tissue, may stagnate in the appendages, and gradually grow into the upper layers of ovarian tissue, which leads to the formation of cysts.

Among the factors that increase the likelihood of developing cysts endometriodnyh - dysmenorrhea, abortion, unhealthy lifestyle, and family history of endometriosis. However, none of these factors does not guarantee that a woman will sooner or later formed endometrioid cyst, as well as their absence does not guarantee that the woman did not threaten a violation.

Diagnostics

The gold standard for the diagnosis of a cyst endometriodinoy considered laparoscopy, however, transvaginal ultrasonography (US) also can provide a lot of useful information. Thus, by using ultrasound can be distinguished endometriodinuyu cyst most other benign (not cancerous) ovarian tumors. In the US the typical endometriodinoy cysts are found dense, thick wall and homogeneous, liquid inner content.

Endometriodinaya ovarian cysts and fertility

The exact mechanism of action of this type of cyst on fertility, or a woman's ability to reproduce, is currently not well understood. It is assumed that in severe forms of this disorder infertility may be associated with a reduced quality of oocytes and because endometriodnyh cyst often develops simultaneously with endometriosis can be added, and problems such as obstruction of the fallopian tubes and distortion of the reproductive system.

Recent studies suggest that some patients with cyst this type may begin the inflammatory process, which also leads to the fact that the eggs suitable for conception becomes smaller. Research in this area continues, and scientists hope that in the future the relationship between endometrial cyst and fertility becomes clearer. This would more effectively treat infertility and perhaps more accurately predict the likelihood of success in artificial insemination of women with this disorder.

How to treat ovarian cysts endometriodnyh

Treatment of endometrial ovarian cyst has been for many years, it remains a controversial topic in the medical community. Choice of treatment may depend on factors such as the exact location and size of the cyst, comorbidities, age of the patient, and so on.

Combined oral contraceptives effectively relieves symptoms of endometrial cysts, but for women, who in the future want to have children, this treatment is not enough. In addition, by receiving hormones cyst does not go away, and after medical treatment the symptoms are likely to appear again.

• Laparoscopic surgery to remove the cyst

The advantages of this operation are relatively short recovery period (as well as any other transactions carried out using a laparoscope - compared with open surgery) and a relatively low risk of recurrence. Besides, after the operation increases the probability of spontaneous pregnancy and significantly reduced pain in the pelvic area. According to the results of various studies, after the removal of ovarian cysts endometriodinoy pregnancy occurs in 14-54% of women who had previously tried unsuccessfully to conceive a child. As for artificial insemination, a woman younger than 35 years old it is recommended to carry out no earlier than one year after surgery, and women over 35 years old - at least six months.

In addition, the laparoscopic removal of ovarian cysts can cause such side effects as premature ovarian failure. The likelihood of this side effect varies from 2.3 to 0.3%, and most often occurs in women with bilateral endometriodinoy ovarian cysts.

In addition, inflammatory processes which began after the operation may cause the formation of scar tissue, which sometimes leads to a decrease in normal ovarian tissue. It can also interfere with the output of eggs from the ovaries.

• Aspiration endometriodnyh ovarian cysts

This minimally invasive procedure that is performed using ultrasound trasnvaginalnogo. Guided by the image on the monitor, the surgeon inserts a hollow needle into the cyst, and removes the liquid contained therein. There are three main risks associated with this procedure - a relapse, infection and scar tissue formation.

In the study, participants who were patient with ovarian cyst endometriodnyh suffering from problems with conception, it was found that the likelihood of recurrence is particularly high after the first procedure of aspiration (its probability is 91.5%). However, after re-treatment (sometimes the procedure was carried out up to six times) the risk of relapse was reduced to 5.4%. On average, the patient took three procedures to reduce the likelihood of recurrence minimized. Repeated aspiration was performed, on average, 33 days after the previous procedure. Within two years after treatment pregnancy occurred at 43.4% of study participants, and 73.2% of them became pregnant in the first 7-18 months after aspiration. Of the 56 women who had managed to get pregnant How to Get Pregnant: Recommendations to help , 44 pregnancy occurred naturally, and 12 - after artificial insemination.

In general, the aspiration has long been considered insufficient effective treatment endometriodinoy ovarian cysts. However, the results of the study show that the conduct of the re-aspiration improves treatment outcomes. Besides, even a few of these treatments are associated with less risk than a laparoscopic operation.

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