Have all female friends heard of the term chocolate cyst of the ovary (hereinafter referred to as "chocolate cyst")? This is not caused by eating too much chocolate! The name is given only because the liquid in the cyst is very close to the color of chocolate.
Ovarian chocolate cyst is actually endometriosis of the ovary, endometriosis, as the name implies, the endometrium has grown outside the uterine cavity, and these endometriums are functional and periodic Changes cause bleeding. It is more common to grow in the pelvic cavity, especially the position of the ovary. Repeated and periodic bleeding leads to the formation of ovarian cysts. The fluid in the cysts is old blood accumulation, which is a bit like chocolate.
What are the disadvantages of ovarian chocolate cysts?
In terms of symptoms, endometriosis has three more common symptoms: dysmenorrhea, masses, and infertility. People who simply have a clever capsule may not have obvious dysmenorrhea, because the ovarian pain is not very obvious, but the clever capsule is usually accompanied by scattered ectopic lesions and pelvic adhesions in the pelvic cavity, and there will be more obvious symptoms of dysmenorrhea, but it cannot The diagnosis of Qiao capsule is excluded based on the absence of dysmenorrhea, because 27-40% of patients with endometriosis have no dysmenorrhea.
When the clever capsule is relatively large, the mass will be felt during the gynecological examination. It is usually fixed. It must be distinguished from the ovarian tumor. You can perform imaging examinations such as color Doppler ultrasound or MRI, as well as tumor markers such as CA125. Differential diagnosis.
The worst part of the Qiao capsule is that it will be accompanied by infertility. The infertility rate of patients with endometriosis is as high as 40%. With the grading upgrade of endometriosis, the chance of natural pregnancy will be significantly reduced, and the chance that patients with severe endometriosis can get pregnant naturally is less than 30%. There are roughly three possible causes of infertility due to endometriosis. Changes in the pelvic microenvironment (adhesion) affect the combination and transport of sperm and eggs. Abnormal immune function produces antibodies, which destroys the metabolism and physiological functions of the endometrium. Abnormal ovarian function causes Ovulation disorders and corpus luteum insufficiency.
How to treat Qiao capsule with infertility? Gynecology and reproductive departments have different opinions. Gynecologists think that they should do laparoscopy to remove the clever capsule, remove the ectopic lesions, and restore the function of pregnancy. Doctors in the reproductive department believe that there is a high chance that the ovarian function will be damaged after the removal of the clever capsule, and it is recommended that the surgery be removed carefully.
Who should we listen to?
Indeed, I saw a lot of patients in the outpatient clinic because of the low ovarian function after the cystectomy, which is so low that they can’t even do test-tube babies. It is regrettable to look at! Because during the stripping operation, the peeled cyst wall will inevitably bring some normal ovarian tissue. There are many small antral follicles in these ovarian tissues (that is, the ovarian reserve), which will never grow back after being lost. , The ovaries have no ability to regenerate.
Because of the expansion of the clever capsule before the operation, the normal ovarian tissue has been compressed and shrunk, and the ovarian function is no longer comparable to that of normal people. After the operation, it is really worse, and the consequences can be imagined. Up. From the perspective of gynecology, a more rational approach is to evaluate the ovarian function (especially AMH) before surgery. If it is not good, then choose this stripping surgery carefully!
And another issue worthy of attention is that the cystic cyst is easy to relapse after being removed. The ectopic endometrial tissue has the same characteristics as tumor cells that are difficult to destroy. It is benign disease but has malignant behavior and the cystic cyst recurs. The rate is as high as 40%. Some people will go for a stripping operation after recurrence, and eventually end up with premature ovarian failure regretting it. Therefore, a second operation is generally not recommended.
In fact, in the reproductive department, Qiao capsule has a very good conservative treatment, which is cyst puncture and alcohol curing, which can maximize the protection of ovarian function and prevent cyst recurrence. It can also help you get pregnant as soon as possible. I think this is The best choice for patients with sacculus.
Finally, if the cyst is not large and the ovarian function is good, try to get pregnant as soon as possible. If you can't get pregnant within half a year, you can use artificial insemination, which is close to natural pregnancy, to increase the chance of pregnancy. If the cyst is large, firstly eliminate the possibility of ovarian tumors, you can choose assisted reproductive treatment in the reproductive department.
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