The disease called endometriosis occurs when the endometrium layer inside the uterus settles somewhere else, for reasons not fully known, and causes thickening and bleeding as well as shedding in this area. Chocolate cysts, or endometriomas, occur when the adhesions that form in this way settle in the ovaries and cyst there. These cysts usually hold one ovary. Rarely, they can hold two eggs at the same time. Chocolate cysts, which cause deterioration in the function of the ovary, decrease in the healthy tissue inside, or negatively affect the ovarian reserve, can cause pregnancy failure.
The residues that occur due to the behavior of the tissue in the uterus in the areas where it is transported cause adhesions in the surrounding tissues. With these adhesions, the anatomical structure of this area is disrupted. It prevents the organs from performing their functions. In the case of such a blockage in the fallopian tubes caused by residues or adhesions in the tubes, a situation may occur that prevents the passage of the egg or sperm cell from this area. In the event of this effect, it can be said that the chocolate cyst is the cause of inability to conceive. With adhesions, the hairs at the end of the fallopian tubes lose their function. This prevents the egg released from the ovaries from passing into the fallopian tube and may be the cause ofinfertility .
Adhesions, or adhesions between organs, are another factor that causes infertility. In particular, adhesions between the uterus, ovaries, fallopian tubes and intestines are a factor in this. It has been determined that approximately 20-40% of women who go to the doctor for infertility have chocolate cysts. It can be said that chocolate cysts are effective on infertility even in the first two stages, which are the initial stages. This factor significantly reduces women's chances of getting pregnant. If this cyst is not treated, endometriosis foci tend to spread. Chocolate cysts that exceed 3 cm in size have the chance to be treated with laparoscopy. Treatment in this way provides definitive treatment for the disease. Women can try to get pregnant naturally for up to a year after this treatment. In vitro fertilization treatment is recommended for patients who cannot get pregnant at the end of this period.
There is a small chance of pregnancy in patients with endometrial disease. Whenpregnancy is achieved in these patients, regression of endometriosis foci and cysts can be observed. Since chocolate cysts are a disease specific to women of reproductive age, they show regression in women entering menopause. However, if not treated in time, it is a disease that progresses insidiously. As the cysts grow, the woman may experience a process that can lead to the risk of ectopic pregnancy, infertility and removal of the ovaries.
How does a chocolate cyst prevent pregnancy?
It can be said that women who have severe menstrual cramps, pain during deep sexual intercourse, pain in the abdomen and groin, bloody stools, burning and bleeding during urination, nosebleeds during menstruation, bruises in various parts of their body and are of reproductive age are at risk of chocolate cysts.
Chocolate cysts, which contain a liquid that resembles melted chocolate in the consistency of boza, become in a position to prevent pregnancy in women when they reach the ovaries and cords. Chocolate cysts are seen in approximately 40% of women who cannot have children, and can be effective in very rare cases in women who are in menopause, and even in men. They can also be diagnosed incidentally, without causing any complaints in women.
Chocolate cysts are formed when the layer of cells that are regularly prepared every month to create pregnancy, do not receive sufficient hormone support when pregnancy does not occur and are shed in the form of menstrual bleeding, occur in an area other than the uterus in the body. If these affect the ovaries and tubes, they become an obstacle to pregnancy.
How are chocolate cysts treated?
Differential diagnosis of endometriomas is made by examining tumor markers and resistance and flow indices in Doppler blood flow in cysts developing in the ovaries. However, for a definitive diagnosis, pathological examination of the tissue removed after the operation is required.
Surgical operations, especially laparoscopy, are used in the treatment of chocolate cysts. However, there is no permanent cure for the disease. The aim of these treatments is to relieve pain and stop the progression of the disease. Because there is always a possibility of recurrence of treated chocolate cysts.
Natural conditions that prevent chocolate cysts from forming
There are two natural conditions that prevent chocolate cysts. These are the woman's pregnancy and menopause. Hormonal treatments are applied to patients in the mild stages of cysts. In advanced stages, surgical treatment is required. Depending on the age of patients who have undergone surgical treatment, it can be expected to become pregnant between 6 months and a year. If this does not happen, it is recommended to resort to assisted reproduction methods. The large size of the chocolate cyst removed from women can especially cause a decrease in egg reserve. Therefore, if methods such as insemination treatment cannot be successful, in vitro fertilization treatment becomes inevitable.
Do chocolate cysts prevent pregnancy?
Chocolate cysts and their smaller forms, namely cysts in the first and second stages, can prevent women from getting pregnant. As the stages of the cysts increase, their relationship with infertility also increases. The larger the size of the chocolate cysts, the more adhesions they have to the surrounding tissues, the more they can prevent pregnancy. Cysts that are 4 cm or smaller should not be removed surgically. Chocolate cysts that are larger than this size should be operated on. The first year after surgery is the period when the woman is most likely to get pregnant. This process should be evaluated very well for women who want to have children. Otherwise, assisted reproductive methods will need to be used.
What are the negative effects of chocolate cyst on pregnancy?
They can cause blockage in the fallopian tubes,
Some hormones and substances released from the chocolate cyst may cause dysfunction of the tubes.
They may prevent the fertilized egg from transferring into the uterus.
If women become pregnant despite having chocolate cysts, the existing chocolate cysts may tend to grow during pregnancy or may remain in their current shape. Chocolate cysts, which do not cause any adverse effects in later pregnancy, may cause miscarriage in early pregnancy.
As a result, endometriosis prevents pregnancy. However, the probability of pregnancy for women without this disease is half that of women with chocolate cysts. Therefore, it cannot be generalized that women with chocolate cysts cannot get pregnant. Compared to women who do not have the problem, the probability of pregnancy decreases by half every month. When endometriosis turns into a chocolate cyst and the cysts become visible, surgery becomes a topic of discussion. However, if the woman wants to have children and is over 35 years old, that is, when her egg reserve starts to decrease, she should discuss this issue with her doctor and evaluate how she can get pregnant without removing the cysts. Because the surgical procedure performed is a procedure that will reduce the capacity of the eggs. Although laparoscopic procedures that will cause little harm can be performed for this, the conditions for getting pregnant without removing the cysts should be evaluated. Therefore, women should not prioritize surgery. This is especially the case for those who want a baby. In cases of severe pain in patients at this young age, it may not be a big deal if the surgery damages the egg reserve a little. This is an issue that should be evaluated with the doctor. For patients over 40 years of age, if they have pain and have enough children, there is no obstacle to having surgery.
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