Managing chocolate cysts in infertile women

Endometriosis is a disease that affects the conception ability of many women.  This disease is defined as the abnormal growth of the endometrial lining in various locations within the pelvis.  The endometrial tissue is actually the inner lining of the uterus and that’s where it belongs.  We do not know why this tissue spreads throughout the abdomen of some women.  When the endometrioma or endometrial cyst grows in a woman’s ovary  it is called a chocolate cyst.  Undoubtedly named by a man because what woman would associate their favorite sweet with an entity that can cause infertility and pain?

During the normal cycle of menstruation, the uterine lining swells and thickens in preparation for conception.  Unfortunately, the aberrant tissue within the ovary does the same thing.  This process is driven by hormonal changes.  Just as with normal menstruation in the uterus, this tissue grows, bleeds and then sloughs off.  This is when menstrual bleeding occurs in the uterus.  The discharge from the endometrial tissue in the cyst has no place to go; therefore, it is encapsulated within the ovary and a cyst is formed.  The contents of this type of cyst are black, tarry and thick, resembling dark chocolate in appearance; hence the name, chocolate cyst.  This can cause painful periods.

An experienced physician like Dr. Malpani may suspect this diagnosis in a woman with complaints of infertility and progressively painful periods; however, some women have no symptoms.  That’s when an incidental finding of endometrious can be found in an infertility workup or routine pelvic examination.  Manual assessment of the abdomen may reveal large cysts that the physician can feel, but many of these cysts are too small to palpate and cannot be detected during a wellness exam.  That is why your IVF physician will order a pelvic ultrasound. 

For additional information please read http://blog.drmalpani.com/2011/01/chocolate-cysts-how-we-manage-them-at.html