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What causes recurring ovarian cysts?

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Posted on Tue, 1 Sep 2015
Question: We are having several problems and I would appreciate detailed help here -
Me and my wife got pregnancy a year ago, she aborted due to birth problems of the baby and the heart stopped all of a sudden at 4 months - So we induced the abortion in Dec of 2014.

Since then, and we're trying to get pregnant without success - we tried several methods with our doctor - including Clomid and merional injections and everything else -- some months we found some cysts in which we had to take Diane for 20 days then tried again - and failed again - then 2 months later, Cysts again! what's going on with the cysts?

Last 2 trials, we say 4+ mature follicles and we were told that the pregnancy chance is high! we also failed.

So my questions are:

1- Why are Cysts coming back everytime? Doctors said they were Functional cyst , last cyst is about 4.4 in size.

2- Why are we failing to get pregnant with the presence of mature follicles?

3- Does abortion have anything to do with what's going on with us/

4- Is there a way to prevent cysts from ever coming again?

5- Is there ANY method to know 100% that a follicle did produce a healthy Egg? I started to believe that they would be empty follicles?

6- Any advice?


Thanks,
XXXX
doctor
Answered by Dr. Deepti Verma (31 minutes later)
Brief Answer:
Detailed answer below

Detailed Answer:
Hello XXXXXXX
I have gone through your question and understand your concerns.
Answer to your queries are discussed below serially.
1) Repeated cyst in the ovaries are likely due to hyper stimulation of the follicles by ovulation induction drugs like Clomid and Merional. In hyperstimulation multiple follicles grow but few or none rupture leading to cyst in the ovaries.

2) Mature follicule do not assure pregnancy. rupture of follicules is mandatory.
There can be other factors for inability to get pregnant like fallopian tube dysfunction , inappropriate endometrial growth. Appropriate investigations need to be carried to confirm the cause of failure to conceive.

3) Previous abortion has no relation with the current situation in your case.

4) Your wife should take a lower dose of ovulation induction to prevent hyperstimulation of ovaries and hence formation of cysts.

5) No there is no method to confirm whether a mature follicle has produced a healthy eeg or not. However ovulation can be confirmed by serial follicular scans and see for the sign of rupture of follicle and release of eeg. Yes it can also be an empty follicle because it is not rupturing and enlarging to a size of cyst.

6) Your wife should get investigations like hysterosalpingography to confirm patency of tubes. Serial follicular monitoring to confirm the growth and rupture of follicles. In my opinion she should stop taking ovulation induction drugs for at least 3-6 cycles, get the above investigations done and then restart the treatment.

Please do mention about weight , height, diabetes, hypothyroidism or any other diseases.
Hope you found the answer helpful.
Do get back to me for further queries.
Dr Deepti XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepti Verma (10 hours later)
Hello Doctor , Thanks for your reply.

So you think we should proceed with the XXXXXXX for 20 days to eliminate the current Cyst? because our doctor said its almost impossible to get pregnant with the presence of this cyst.

Thanks,
XXXX
She doesn't have Diabetes - she's about 51 KGs , she's 163 CM tall , no problems in the thyroid , she has Hepatitis C and some genetic mutations which made the doctor say that she needs Clexane injection everyday while pregnant.
doctor
Answered by Dr. Deepti Verma (1 hour later)
Brief Answer:
She can continue taking Diane tablet

Detailed Answer:
Hi dear, yes she can continue with Diane for 2-3 cycles to eliminate the cyst, however pregnancy is not possible till she is taking Diane, as this is a contraceptive pill.
Cyst in ovaries lead to hormonal dysfunction and hence hinder in conception.
Genetic mutation is likely to be the cause of abortion she had earlier.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5068 Questions

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What causes recurring ovarian cysts?

Brief Answer: Detailed answer below Detailed Answer: Hello XXXXXXX I have gone through your question and understand your concerns. Answer to your queries are discussed below serially. 1) Repeated cyst in the ovaries are likely due to hyper stimulation of the follicles by ovulation induction drugs like Clomid and Merional. In hyperstimulation multiple follicles grow but few or none rupture leading to cyst in the ovaries. 2) Mature follicule do not assure pregnancy. rupture of follicules is mandatory. There can be other factors for inability to get pregnant like fallopian tube dysfunction , inappropriate endometrial growth. Appropriate investigations need to be carried to confirm the cause of failure to conceive. 3) Previous abortion has no relation with the current situation in your case. 4) Your wife should take a lower dose of ovulation induction to prevent hyperstimulation of ovaries and hence formation of cysts. 5) No there is no method to confirm whether a mature follicle has produced a healthy eeg or not. However ovulation can be confirmed by serial follicular scans and see for the sign of rupture of follicle and release of eeg. Yes it can also be an empty follicle because it is not rupturing and enlarging to a size of cyst. 6) Your wife should get investigations like hysterosalpingography to confirm patency of tubes. Serial follicular monitoring to confirm the growth and rupture of follicles. In my opinion she should stop taking ovulation induction drugs for at least 3-6 cycles, get the above investigations done and then restart the treatment. Please do mention about weight , height, diabetes, hypothyroidism or any other diseases. Hope you found the answer helpful. Do get back to me for further queries. Dr Deepti XXXXXXX