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Expert Q&A

	By Michael D Benson, MD Attending Physician, Highland Park Hospital, IL

I stopped taking the pill four months ago because my husband and I want to try and get pregnant. Since then, I had some pain in my lower right abdomen, and discovered for the first time, that I have ovarian cysts. My family physician says I shouldn't be concerned; that they should dissolve on their own. I was wondering if this is true, and if so, is there any danger in trying to conceive right now? Also, does having ovarian cysts decrease the chances of becoming pregnant? My last two periods have been two weeks late."

You have asked several different questions:

The abdominal pain does not have any necessary or specific connection to either the ovarian cysts or fertility. As a practical matter, it does not sound likely to be related to these issues. A physical exam by your doctor should provide some clues about the source of the pain.

Ovarian cysts are absolutely necessary for ovulation (release of the egg) to occur. In fact, unless the cyst is a minimum of one inch in diameter, the egg will generally not be released from the ovary. Ovarian cysts only become an issue when two conditions are met: 1) they exceed five to six centimeters in diameter, and 2) this size persists for four weeks or more. Since ovarian cysts routinely shrink after ovulation, your doctor's response makes sense.

Late periods can reduce fertility. Specifically, menstrual cycles lasting longer than 35 days are associated with an increasing percentage of anolulatory (not releasing an egg) cycles. Long irregular cycles may or may not be related to either ovarian cysts or abdominal pain and is best approached as a specific problem.

d. I see no danger or increased risk in trying to conceive in the presence of ovarian cysts, long cycles or transient abdominal pain. Of course, there are many things that I do not know about your individual history. I suggest that if you have continued concerns that you contact your physician."

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