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What to do when you get an ovarian chocolate cyst during child-bearing period

Updated: 2022-08-31


I. What is an ovarian chocolate cyst?

Ovarian chocolate cysts, also called ovarian endometriomas, are formations on the ovaries due to the accumulation of old menstrual blood. Every time a menstrual period comes, the cyst becomes bigger. The fluid inside an ovarian endometrioma resembles chocolate syrup and hence the name "chocolate cyst".

II. Why ovarian chocolate cysts are dangerous

Aside from causing dysmenorrhea, dyspareunia, and abnormal menstruation in women, severe abdominal pain may also happen if the cyst suddenly ruptures. In addition, it is also an important cause of infertility in women during child-bearing period. Statistics show that half of chocolate cyst patients cannot get pregnant.

III. Are surgeries necessary for ovarian chocolate cysts?

If the chocolate cyst diameter is < 4 centimeters, and the patient has no obvious dysmenorrhea and no history of infertility, she can try to conceive first. Regular follow-up visits are a must during pregnancy preparation, in order to monitor indicators such as B-ultrasound and CA125 (cancer antigen 125). Elevated progesterone after pregnancy can inhibit the growth of the ectopic endometrium, and can also cause some cysts to slowly shrink.

If the cyst diameter exceeds 4 cm, the pregnancy attempt is unsuccessful for one year with significantly increased CA125 and severe dysmenorrhea, and the conservative drug treatment is ineffective for the patient, laparoscopic surgery is recommended as soon as possible. This will not only remove the cyst, but also treat the pelvic endometriosis lesions and dredge the fallopian tubes. Following surgery, doctors will evaluate the fallopian tubes, ovaries and pelvic cavity of the patient, telling her whether there is hope for a natural pregnancy or to directly receive IVF assisted pregnancy.

IV. When to get pregnant after surgery?

In general, the patient can try to get pregnant after one or two menstrual periods following surgery. However, if the endometriosis is more serious, GnRHa injections are recommended for three to six months after the surgery. This will both prevent recurrence and relax the ovaries. The success rate will be higher in the first two months of menstrual recovery.

Gynecological Endocrinology Department at the Chongqing Health Center for Women and Children (Women and Children's Hospital of Chongqing Medical University), or CQHCWC

Address: Expert clinics at Area C, 4th Floor, or at Area A, 3rd Floor at Outpatient Clinic, Ranjiaba Branch of the CQHCWC


Outpatient service: 023-60354592

Inpatient department: 023-60354538