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Infertility

Ovarian cysts and infertility

03/05/2007

Question:

My daughter has been trying to conceive for 16months with no luck. After taking Clomid she had ovarian cysts and was advised not to continue (only took for 2months). She has had the *dye test* and everything was normal. There was some doubt about actual ovulating but for the last two months mid-cyle she has had a brown discharge which apparently could be due to ovualtion, and now after this the cysts have returned. She feels she will never get pregnant if the eggs are not released (thus causing cysts) and she cannot take Clomid. Can you suggest anything please.

Answer:

Assuming that her partner's semen analysis were normal, and that she has regular menstrual cycles with either hormonal or other testing confirming ovulation, she would be diagnosed as having unexplained infertility (based also on the report of a normal dye test). 

Eggs typically grow in cysts on the ovary called follicles.  Giving fertility medications (either shots or pills) should increase the number of follicles.  Therefore, patients can develop multiple "cysts" on the ovary when taking fertility medications.  In some cases where fertility drugs are used, cysts may not go away with a period, and may take an extra month before they resolve.  Often, we will use ultrasound monitoring, and give an injection to trigger release of the eggs, when the cysts have reached a certain size. 

I would probably recommend that your daughter see a reproductive endocrinology/infertility specialist at this point. 

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Response by:

University of Cincinnati Daniel B Williams, MD
Formerly:
Department of Obstetrics & Gynecology
College of Medicine
University of Cincinnati
Daniel B Williams, MD