QuestionHi. I'm writing from Dallas, TX. I'm wondering if it's possible to get pregnant when you have cysts. On cycle day 6, I had 3 large cysts (~ 39mm) and no other visible follicles. My estrogen was 364 which I assume was coming from the cysts but my RE said "something else might be brewing". Now, on cycle day 9, the 3 large cysts are still there but I also have 2 smaller follicles (~ 7mm). Do I still have a chance this cycle with the smaller follicles or do the cysts ruin it? Do I have to get rid of the cysts first? If so, what is the best way to get rid of cysts and avoid them in the future?
AnswerHello,
There are many different kinds of cysts, some of which are hormonally active. If hormonally active cysts are present at the start of a cycle, that cycle cannot be used for ovulation induction because it will not work. Usually the cysts will grow, causing major problems. In that case, the cycle is aborted and the patient is usually treated with birth control pills to see if the cysts will resolve. If the cysts do not resolve on the BCP, then it is likely to be some form of tumor, in which case, laparoscopy (surgery) will need to be done to remove the cysts. Sometimes, RE's will aspirate the cysts at the beginning of a cycle in order to be able to continue that cycle. This is generally only done with IVF cycles, however.
Most cysts in young women are benign physiologic cysts. That means that the ovary produces them naturally. These will usually resolve on their own or with birth control pills. They can't be avoided unless one uses the birth control pill to suppress the ovaries. Many times, we use BCP's prior to a fertility treatment cycle in order to avoid this problem.
I hope this answers your questions,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
