I have been plagued with ovarian cysts since my earliest menstrual cycles. In order to stop their growth I was put on birth control pills at an age when I wasn’t even considering sexual activity (that would quickly change, but at the time I was pretty darn innocent). In my teens and early twenties the cysts caused a pain so intense my legs would go numb.
To say my lifestyle was unhealthy at that age would be an understatement. It seems that when you drink a two liter of Mountain Dew a day it wreaks havoc on your body. Its hard to believe that was ever me. Yes, gluten-free and organic me once ate fast food daily and downed caffeinated sugar water like it was going out of style.
Image by Louish Pixel via Flickr
My how we change as we age and face our own mortality.
As an adult my diet and lifestyle improved immensely and the cysts all but went away.
Despite my clean diet, the cysts have been back full force since starting IVF again last year. This is not at all unusual. Many women have cysts after cycling, so it makes sense that someone like me would do battle against the pesky little boogers after constantly flooding my body with all kinds of cyst creating hormones.
Cysts are the worst when it comes to preparing for an IVF cycle. One day you are cruising along, ordering meds, getting excited about an upcoming cycle and then you go to an ultrasound appointment and WHAMMO, the tech finds a cyst and everything comes to a screeching halt.
Image by thecrazyfilmgirl via Flickr
Many doctors sideline a patient when a cyst is discovered. Most cysts are functional cysts, fluid filled follicles that never released and egg and returned to resting state. They generally disappear on their own within 6 to 8 weeks. Since it is the safest route of elimination, doctors typically just wait it out.
There are several other types of cysts that are less likely to go away on their own. Many of those cysts should be removed surgically and biopsied to check for cancer.
Occasionally if a functional cyst is small and is not active, which can be determined by measuring estrogen production, a doctor will proceed with the IVF cycle and work around the cyst.
The cyst we discovered last week was not small, and since it had been hanging around since February despite the fact I was suppressed for much of the time, we decided to go in and eliminate the trouble maker. Suppression will normally allow for a cyst to go away and also keeps others from forming, so it was concerning that the cyst was still there and had grown slightly over the course of 8 weeks. The cyst needed to go.
There are two ways to remove a cyst. One is laparoscopic surgery which involves general anesthesia and at least a one cycle break for recovery time. The more common and less invasive approach, aspiration of the cyst, is the one we chose last week.
I find it a little comical that our aspirations to have a baby sooner rather than later were saved by a literal aspiration of a cyst.
When the doctor surprised us and told us we would just go in and get rid of the cyst I was elated, but before I could even speak my mind kicked into gear and realized that this was going to be a lot like retrieval, but without anesthesia.
All I can say is OUCH.
The doctor inserted a long ultrasound probe that had a small tube like structure on it that contained a needle (Ouch). He injected the area with lidocaine (Ouch) and then pierced the vaginal wall (Ouch) in order to reach the ovary. Once there he inserted a needle (Ouch) and drew all the fluid out of the cyst while we watched in awe. Why awe?
It was such an amazing feeling to annihilate my fertility nemesis. Every time I go in for a baseline ultrasound I am overcome with fear that a large dark spot, the tell tale phantom shadow of a cyst, will be there to rain on my fertility treatment parade. Those giant dark spots have haunted me for years as I waited and wondered if one would be there when the critical time to start arrives.
After living in fear of dreaded cysts, watching one shrink out of existence right before my eyes made me feel a little like David must have felt when he nailed Goliath between the eyes.
The procedure did have some after effects. I had light bleeding for four days in addition to moderate cramping for the first two days. I was assured by my clinic this was all normal. Also, Bill had an unusually good vantage point and is still regrouping despite his attempts at distracting himself during the procedure.
The good news is this should have no effect on the outcome of our cycle.
Studies on cysts and how their removal impacts IVF cycles are few and far between, but every study I could find indicates there are no known issues due to the removal of cysts immediately prior to beginning an IVF cycle. Live birth rates for cycles following aspirations of cysts are the same as the national average.
I have cycled with cysts in the past and know it affected the number of eggs produced, so I am at peace with our decision to take the aggressive approach, even if it did hurt a bit.
Laughter Through Tears 