My husband and I have been trying for a new baby. Very exciting news. I’ve always wanted 2 children and having a gorgeous little boy who is my world and whom I totally adore has been the best gift ever to me.
As most know, I had various issues with falling pregnant with my little guy and since trying for another I’m experiencing similar issues.
A few weeks ago I went in clomid to assist with ovulating. No luck 🙁 I went to have a blood test to just make sure things are ok.
Unfortunately they are not. I have high levels of testosterone and am not ovulating. I was then sent for an ultrasound. This came back with more horrible news. I have am ovarian cyst the size of an egg on my right ovary. Along with the continual blows, I inly have 14 follicles on my left Fallopian tube and 7 on my right. Most women have hundreds.
So here we go again with fertility issues.
Since finding out all this information I’ve been doing research on both ovarian cysts and follicles. Below is what I’ve found.
Ovarian Cysts and Tumors
The ovaries are two small organs located on either side of the uterus in a woman’s body. They make hormones, including estrogen, which trigger menstruation. Every month, the ovaries release a tiny egg. The egg makes its way down the fallopian tube to potentially be fertilized. This cycle of egg release is called ovulation.
What causes ovarian cysts?
Cysts are fluid-filled sacs that can form in the ovaries. They are very common. They are particularly common during the childbearing years.
There are several different types of ovarian cysts. The most common is a functional cyst. It forms during ovulation. That formation happens when either the egg is not released or the sac — follicle — in which the egg forms does not dissolve after the egg is released.
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Other types of cysts include:
Polycystic ovaries. In polycystic ovary syndrome (PCOS), the follicles in which the eggs normally mature fail to open and cysts form.
Endometriomas. In women with endometriosis, tissue from the lining of the uterus grows in other areas of the body. This includes the ovaries. It can be very painful and can affect fertility.
Cystadenomas. These cysts form out of cells on the surface of the ovary. They are often fluid-filled.
Dermoid cysts. This type of cyst contains tissue similar to that in other parts of the body. That includes skin, hair, and teeth.
What causes ovarian tumors?
Tumors can form in the ovaries, just as they form in other parts of the body. If tumors are non-cancerous, they are said to be benign. If they are cancerous, they are called malignant. The three types of ovarian tumors are:
Epithelial cell tumors start from the cells on the surface of the ovaries. These are the most common type of ovarian tumors.
Germ cell tumors start in the cells that produce the eggs. They can either be benign or cancerous. Most are benign.
Stromal tumors originate in the cells that produce female hormones.
Doctors aren’t sure what causes ovarian cancer. They have identified, though, several risk factors, including:
Age — specifically women who have gone through menopause
Not having children or not breastfeeding (however, using birth control pills seems to lower the risk)
Taking fertility drugs (such as Clomid)
Hormone replacement therapy
Family or personal history of ovarian, breast, or colorectal cancer (having the BRCA gene can increase the risk)
What are the symptoms of ovarian cysts and tumors?
Often, ovarian cysts don’t cause any symptoms. You may not realize you have one until you visit your health care provider for a routine pelvic exam. Ovarian cysts can, however, cause problems if they twist, bleed, or rupture.
If you have any of the symptoms below, it’s important to have them checked out. That’s because they can also be symptoms of ovarian tumors. Ovarian cancer often spreads before it is detected.
Symptoms of ovarian cysts and tumors include:
Pain or bloating in the abdomen
Difficulty urinating, or frequent need to urinate
Dull ache in the lower back
Pain during sexual intercourse
Painful menstruation and abnormal bleeding
Nausea or vomiting
Loss of appetite, feeling full quickly
How do doctors diagnose ovarian cysts and tumors?
The obstetrician/gynecologist or your regular doctor may feel a lump while doing a routine pelvic exam. Most ovarian growths are benign. But a small number can be cancerous. That’s why it’s important to have any growths checked. Postmenopausal women in particular should get examined. That’s because they face a higher risk of ovarian cancer.
How do doctors diagnose ovarian cysts and tumors? continued…
Tests that look for ovarian cysts or tumors include:
Ultrasound. This test uses sound waves to create an image of the ovaries. The image helps the doctor determine the size and location of the cyst or tumor.
Other imaging tests. Computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) are highly detailed imaging scans. The doctor can use them to find ovarian tumors and see whether and how far they have spread.
Hormone levels. The doctor may take a blood test to check levels of several hormones. These include luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and testosterone.
Laparoscopy. This is a surgical procedure used to treat ovarian cysts. It uses a thin, light-tipped device inserted into your abdomen. During this surgery, the surgeon can find cysts or tumors and may remove a small piece of tissue (biopsy) to test for cancer.
CA-125. If the doctor thinks the growth may be cancerous, he might take a blood test to look for a protein called CA-125. Levels of this protein tend to be higher in some — but not all — women with ovarian cancer. This test is mainly used in women over age 35, who are at slightly higher risk for ovarian cancer.
If the diagnosis is ovarian cancer, the doctor will use the diagnostic test results to determine whether the cancer has spread outside of the ovaries. If it has, the doctor will also use the results to determine how far it has spread. This diagnostic procedure is called staging. This helps the doctor plan your treatment.
How are ovarian cysts and tumors treated?
Most ovarian cysts will go away on their own. If you don’t have any bothersome symptoms, especially if you haven’t yet gone through menopause, your doctor may advocate ”watchful waiting.” The doctor won’t treat you. But the doctor will check you every one to three months to see if there has been any change in the cyst.
Birth control pills may relieve the pain from ovarian cysts. They prevent ovulation, which reduces the odds that new cysts will form.
Surgery is an option if the cyst doesn’t go away, grows, or causes you pain. There are two types of surgery:
Laparoscopy uses a very small incision and a tiny, lighted telescope-like instrument. The instrument is inserted into the abdomen to remove the cyst. This technique works for smaller cysts.
Laparotomy involves a bigger incision in the stomach. Doctors prefer this technique for larger cysts and ovarian tumors. If the growth is cancerous, the surgeon will remove as much of the tumor as possible. This is called debulking. Depending on how far the cancer has spread, the surgeon may also remove the ovaries, uterus, fallopian tubes, omentum — fatty tissue covering the intestines — and nearby lymph nodes.
Other treatments for cancerous ovarian tumors include:
Chemotherapy — drugs given through a vein (IV), by mouth, or directly into the abdomen to kill cancer cells. Because they kill normal cells as well as cancerous ones, chemotherapy medications can have side effects, including nausea and vomiting, hair loss, kidney damage, and increased risk of infection. These side effects should go away after the treatment is done.
Radiation — high-energy X-rays that kill or shrink cancer cells. Radiation is either delivered from outside the body, or placed inside the body near the site of the tumor. This treatment also can cause side effects, including red skin, nausea, diarrhea, and fatigue. Radiation is not often used for ovarian cancer.
Surgery, chemotherapy, and radiation may be given individually or together. It is possible for cancerous ovarian tumors to return. If that happens, you will need to have more surgery, sometimes combined with chemotherapy or radiation.
The ovaries contain eggs (which formed in the ovary during childhood) and these are matured by the ovary (usually one at a time) in follicles which then come to the surface of the ovary and burst to release the egg into the top of the fallopian tube.
Thus if multiple follicles have been detected in an ovary, that ovary is developing more than one egg at a time – this can result non identical twins.
Usually only one follicle is developed to maturity at a time but it is possible to stimulate the ovary to produce more (using hormones) as part of interventions relating to infertility treatments.
Antral follicles are small follicles (about 2-8 mm in diameter) that we can see – and measure and count – with ultrasound. Antral follicles are also referred to as resting follicles. Vaginal ultrasound is the best way to accurately assess and count these small structures.
Many fertility specialists believe that the antral follicle counts (in conjunction with female age) are the best tool that we currently have for estimating a woman’s remaining fertility potential (or ovarian reserve). Ovarian volume measurements (also done by ultrasound), and day 3 FSH and AMH levels (blood tests) are additional studies that can help.
Presumably, the number of antral follicles visible on ultrasound is indicative of the relative number of microscopic (and sound asleep) primordial follicles remaining in the ovary. Each primordial follicle contains an immature egg that can potentially develop in the future.
In other words, when there are only a few antral follicles visible, there are far less eggs remaining as compared to when there are many more antral follicles visible. As women age, they have less eggs (primordial follicles) remaining – and they have less antral follicles visible on ultrasound. Therefor lower chances of falling pregnant.