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Suggest treatment for dermoid cyst in right ovary and polycystic ovary

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Posted on Mon, 23 Jun 2014
Question: hello I have some gynecological problem can I discuss about that. I need some opinion.

We are planning for a baby for last 3 months. I did my pelvic scan and I found that there is a dermoid cyst in my right ovary. The volume of right ovary is 84.4 cc while the left ovary is 11.7 cc.
Both ovary shown poly cystic morphology. Uterus appeared normal. No obvious growing follicles seen on the 10th day of period since consuming 100mg of clomiphene for 5 days from 2nd of period (My LMP date is 21/05/2014 and my period is irregular. This one had happened after taking deviry). Can you please suggest what should we do now to have a baby?
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Answered by Dr. Manisha Jain (7 hours later)
Brief Answer:
removal of dermoid and induction with FSH

Detailed Answer:
Hello,

Thanks for trusting health care magic.

I have seen all your reports and they are clearly suggestive of
- dermoid cyst
- polycystic ovary
In my opinion this dermoid cyst should be removed first and then only you should start with ovulation induction.
PCOD patients especially if resistant to clomiphene should be induced with FSH injections in high doses which are then titrated according to number and size of follicles.
I'm an infertility specialist and deal with such patients daily. Don't be hasty for induction of ovulation without removal of dermoid as it can undergo torsion during pregnancy.

I hope I have answered your question but in case you have any query I will be happy to help.

Regards,
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Manisha Jain (6 hours later)
Hello, Firstly,I thank you a lot for your advice. Actually I got some mix opinion from different doctor some of them suggest to remove that dermoid before pregnancy & some suggest that I need not to remove it before pregnancy so we got confused & I do not know what should I do now.

I just want to ask you that with this dermoid can I conceive? or if I cure this out before my pregnancy then is it create any problem?
doctor
Answered by Dr. Manisha Jain (56 minutes later)
Brief Answer:
Removal of cyst before pregnancy mandatory.

Detailed Answer:
Hello dear, I understand your concern but in my practice I do dermoid excision first and then go for induction protocol.
You can definitely conceive without any adverse effect on chances of conception.
But dermoid cysts tend to undergo torsion i. e. Rotation around its pedicle which compromises the blood supply to dermoid cyst and thus acute pain in abdomen.
Torsion is a surgical emergency and if occurs will require immediate management and surgery in pregnant state is associated with High abortion chances.
So i n my opinion REMOVAL OF CYST SHOULD PRECEDE PREGNANCY.
Wish you best of luck. Take care.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Manisha Jain

OBGYN

Practicing since :2007

Answered : 5136 Questions

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Suggest treatment for dermoid cyst in right ovary and polycystic ovary

Brief Answer: removal of dermoid and induction with FSH Detailed Answer: Hello, Thanks for trusting health care magic. I have seen all your reports and they are clearly suggestive of - dermoid cyst - polycystic ovary In my opinion this dermoid cyst should be removed first and then only you should start with ovulation induction. PCOD patients especially if resistant to clomiphene should be induced with FSH injections in high doses which are then titrated according to number and size of follicles. I'm an infertility specialist and deal with such patients daily. Don't be hasty for induction of ovulation without removal of dermoid as it can undergo torsion during pregnancy. I hope I have answered your question but in case you have any query I will be happy to help. Regards,