Knowledge Sharing

2018.09.29

《 Netizens Questions 》I really want to get pregnant! But I have a history of gynecological problems.

Mrs. A:
Examination revealed that my left ovary has a chocolate cyst. Is laparoscopy required recently? Are there any side effects? Will it cause infertility?
Will chocolate cysts disappear without surgery after pregnancy? I was a bit scared after seeing so many examples, and I start to think about whether to receive operation or not?


Answer:
It dependents on whether the doctor removes the entire ovary or just removes the part of chocolate cysts? Removing entire ovary will certainly affect your conception, because there is no ovary on one side of your body. However, the effect of removing the chocolate cysts is smaller than removing entire ovary.
Pregnancy can make ovary cysts smaller, but the ovary cysts will not disappear. A clinic follow-up visit is recommended to allow the physician to assess the condition of your uterus and ovaries.

---

Mrs. B:
I was told to have a 2 cm uterine fibroid close to the endometrium, do I need to remove it? My doctor said that it is necessary to do hysteroscopy to see if the uterine fibroid has a protruding endometrium, if so, it is better to scrape it away. Is that okay?

I got pregnant naturally and suffered from three times habitual abortions. The first time was due to blighted ovum. The second and third fetuses’ heartbeat stopped at the eighth week. Chromosomal abnormality was found at the third time. The doctor said that this was a chance problem, and told us to prepare pregnancy continuously, but there was no good news during a whole year. "I am 37 years old this year, and my fallopian tube and ovarian function are normal. May I ask the doctor: What can I do to avoid miscarriage and get pregnant soon?


Answer:
Criteria of the need for removing the uterine fibroids:
  1. Fibroids that are too large and occupy the entire pelvic cavity which may affect the diagnosis of ovarian tumor.
  2. Causes abnormal bleeding and cannot be controlled with medical therapies.
  3. A rapid increase in fibroid size has been thought to be associated with malignancy.
     
When the symptoms are severe, surgery is a common treatment. If the patient still wants to have children, fibroidectomy can be performed.
When fibroids are too big, administration of GnRH Analog can temporarily reduce fibroids.
It is recommended to check the couples’ chromosomes for determining the cause of abortion, perform in vitro fertilization (IVF) treatment, and regularly track the health of the fetus.

A chromosome test for habitual abortion is to check whether there is a problem with the allele number and structure of the human 23rd pair of chromosomes. The chromosomes tested by boys are 46xy, while the chromosomes of girls are 46xx; in addition, the genetic translocation or deletion can be tested.

---

Mrs. C:
I have been diagnosed with adenomyosis. Will it affect my pregnancy?


Answer:
Adenomyosis is one kind of endometriosis that invades and grows in the uterine muscle layer. Therefore, the volume of the uterus will become larger. In severe cases, it can cause large-sized uterus than the normal uterus, which may cause intensive contraction of the uterine muscles in the future, and may cause the embryo difficult to be implanted, easy to cause abortion or premature birth after pregnancy. The treatment can be various according to the degree of illness and personal conditions. It is recommended that you go to the hospital for evaluation before your decisions on the subsequent pregnancy treatment.

---

Mr. D:
My wife found out that she has endometrioma. I would like to ask whether endometrioma and endometriosis are the same disease and can cause infertility? How does it come about? Is it possible to recur? After laparoscopic surgery, is it possible to get pregnant naturally or are there other ways to get pregnant? In addition, is there any danger or sequela of laparoscopic surgery?


Answer:
Endometrioma is one type of endometriosis, which can also cause infertility. The reason is that most of the menstrual blood flows through the fallopian tubes to the abdominal cavity and implants in the ovaries to form ectopic tumors.
The prime time for natural conception is within six months after laparoscopic surgery. However, the probability of recurrence is higher than 60% after surgery or treatment of endometriosis, laparoscopic surgery has certain risks, but the risks are lower.

---

Mrs. E:
After looking for an obstetrician for ultrasound and hormonal examinations, I found that I had polycystic ovarian disease, and caused the female hormones cannot be secreted normally. Under the stimulation of male hormones, menstruation, obesity, and even masculinization occur. If laparoscopic surgery is performed, will polycystic ovary disease not relapse for a long time and will I become slimmer? How long will I become pregnant?


Answer:
The infertility treatment for polycystic ovary disease can be divided into the following steps:
In the first stage, you can take oral ovulation medicine to trigger ovulation. If it is not effective, in the second stage, add an ovulation injection. If it still does not work, consider using a pituitary inhibitor plus an ovulation injection or receiving a laparoscopic surgery. After six months, the effect can reach 80% or 90% of the chance of natural ovulation, the cost is relatively cheaper, but requires an intervention.

When you restore normal ovulation, you will lose weight, but it also varies from person to person. As for whether it will recur, depending on the genetic constitution of the individual. The situation may exist at the childbearing age, but disappear after menopause. Later, there may be diabetes, and it cannot be ignored. As long as ovulation is restored, and your male mate is without infertility problems, generally, pregnancy will be smoothly within six months!