Should I Be Concerned About Ovarian Cysts?

– Happy Monday, sorry
we’re a little bit tardy. I think it’s about 15 minutes late for our noontime start. Hope you had a fantastic weekend, the weather in Orlando was gorgeous so, wherever you are in the
country or the world I hope it was good for you as well. What I wanted to talk about today is something that comes up all the time in our practice, and in any woman who’s
getting regular ultrasounds, or even just the occasional ultrasound. It’s ovarian cysts. This causes more stress and
confusion for our patients than probably anything
else that we work on. So what are cysts? Firstly, any woman in
their reproductive years has to have cysts on their ovaries. Cysts comes in various sizes
and shapes and appearances okay, but the cysts that all
reproductive women have to have are follicular cysts, or small
little antral follicle cysts, that represent microscopic eggs. So those of you who have
been with me know that I do ultrasounds and we count the numbers of small
little cysts on the ovary. They represent microscopic eggs. We wanna see them! And we wanna see a good amount, because the less of them the more ovarian aging okay? So those are antral follicles and we call it the AFC
or antral follicle count. So let’s put them aside
because they’re all good, and they’re less than 10 millimeters, so nothing to worry about. What about a growing follicular cyst? Well that’s what we do when
we stimulate you with either clomiphene citrate or letrozole, or gonadotropin injections. We are pushing those
little antral follicles to get larger to grow mature eggs, so the antral follicles have microscopic eggs that are immature, and the stimulation matures
them into growing follicles. So these follicles are also okay to have. :et’s put that over here, they’re benign nothing to worry about. What about we just do a random
ultrasound in your cycle and we see a cyst that’s neither of those? Well those things can be
either simple or complex. The simple ones look
just like a little circle and it’s black inside
meaning that it’s clear fluid and nothing to worry about. As long as you’re not having any pain, we just leave that aside. Sometimes you can even have
cysts on the side of the ovary, called a paraovarian cyst, or a cyst on the side of the tube called a paratubal cyst; also no worries, if no pain leave it alone. There’s a hemorrhagic cyst and that happens every
time a woman ovulates. When you release the egg from that follicular cyst that’s growing, the egg gets released from the surge of the
pituitary hormone called LH or if we give you HCG trigger, and that cyst left behind in the ovary is making progesterone and other hormones that are
important for implantation. We gotta have that cyst, that’s called a corpus luteum, and that’s from the time of ovulation until your next period. Hopefully you don’t get a period if you’re trying to conceive,
but when you get it, sometimes that cyst can hang around. Sometimes it can cause some discomfort, sometimes it could bleed and even rarely cause hemorrhage and needing surgery. But, having that, when
you do an ultrasound it could look extremely scary, or very simple or anything in between. So you just wait a little bit, six to eight weeks on average if you’re worried about the cyst to see if it goes away, okay? So you gotta have that hemorrhagic cyst. Now, the ones we get a little bit more concerned about are complex. They either are solid-appearing, or mixed simple and solid, and those are not common, but if they hang around,
and don’t resolve, then we would have you
see your gynecologist for evaluation of that, alright? That doesn’t mean cancer, but it’s not going away we need to see about that. Certainly we expedite the evaluation if there’s pain. Now two cysts in particular
that we see a lot, are endometriosis cysts or endometriomas, that’s endometriosis, that
sometimes implants in the ovary and causes what we call
a ground glass-appearing, very symmetrical, smooth but not simple, and that is often associated with pain, but if not we would
leave that alone as well, okay but it could be representing significant endometriosis inside. That’s a decision that we make whether we want to do surgery
on that for infertility. Sometimes a CAT scan can see that or MRI as well. A dermoid cyst is a embryological cyst, that has many, many of the
different cell lines in it, and that has a pretty
classic appearance also, mixed fluid levels, it
could have hair inside, teeth, neurologic tissue, anything inside. Once again, size is really important so we usually will leave
things that are less than five or around that centimeters or smaller, particularly if they are
not causing symptoms. But the bottom line is
not all cysts are bad and you gotta have those cysts, that represent microscopic eggs, so when we say cysts in the office please don’t get anxious about that unless we tell you that there’s
a cause of concern, okay? Until next time, Dr. Mark Trolice
Director of Fertility Care at the IVF Center here
in Orlando, Florida. Have an awesome week and
we’ll see you next week (light music)

Comments 12

  • Not certain about the points made but ,if anyone else wants to discover cinnamon and pcos try Dalz Cyst Discovery (should be on google have a look ) ? Ive heard some decent things about it and my cousin got great success with it.

  • I recently got diagnosed with ovarian cyst and I was wondering what steps I have to do to get pregnant

  • I have a complex cyst in both my ovaries. Left is 6.2cm and right is 6.6. I am having pain and this is so frustrating.

  • I have ovarian cyst on both ovarys an I don't get my period I was on provera to help regulate it but it did not work so I was wondering if if would go on it's own

  • Too many woman are having bad, uncomfortable and painful ovarian issues, and it’s shown that 7 thousand people watched this video; so that’s most likely a portion of people on earth to see this.
    So that shows most likely we are eating bad, sugar and too much junk and things making us to unhealthy.
    If you agree thumbs up. If your in pain thumbs up… because your not alone.
    Goddess Mother Earth…. has healing on This earth for us.

  • Recent Studies show that seed cycling can help. Eat pumpkin seeds on the full moon 14 days, then sunflower seeds 10 etc…
    And I thinking take some deep breathing grounding tai chi once a month.

  • I’m 13 and have 6 large ones

  • Thank u doc

  • I have a cyst right now, they want me to wait and see if it falls off. I do not want to have it surgically removed so I hope it does go away

  • Hi, I've not long come out of hospital,, after having a blood transfusion, and scans, one being internal. Continued non stop bleeding. I was told by the gynaecologists that the cyst was 6cm long, I had a Biopsy aswell. Still waiting for results. The examination was extremely painful, to the point they couldn't fit the coil. I very concerned, because they told me I may have to have a herestarmy. How long will I be under and how long is recovery after a major operation like this?.

  • So many women do have complex problematic cysts causing them to have pain and be infertile. This dr seems oblivious to that.


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